Steerable Needles in the Lung

With lung cancer accounting for over 22% of cancer-related deaths in US, advancing the technologies surrounding the diagnosis and treatment of suspicious nodules within the lung is crucial. Reaching these nodules can be risky due to the risk of pneumothorax with percutaneous methods, and the minimally invasive interventions via bronchoscopy are limited to nodules near the bronchial tree. To overcome these challenges, we propose deploying a robotic system consisting of a clinical bronchoscope, notched aiming device, and laser-patterned, bevel tip needle to decrease risk and increase yield during diagnosis. In this work we present a semi-autonomous robotic system capable of navigating the tortuous airways to steer to nodules located in the periphery of the lung. This work describes, for the first time, the use of a robotic steerable needle in an in vivo animal model in a lung application. This work supports the clinical feasibility of the robotic steering system by showing its success in the presence of respiratory motion, cardiac motion, and other in vivo risks. Three steers were performed in an in vivo porcine model with an average targeting error of 2.63 mm. In addition, we conducted ex vivo experiments to compare our system to manual bronchoscopy, which showed that the robotic system was able to reduce the targeting error by an average of 11.35 mm. The successful in vivo, autonomous steers presented in this work coupled with the ability to outperform manual bronchoscopy ex vivo,highlights a promising solution for difficult-to-reach nodules in the lung.