Development of Needle Guide Unit Considering Buckling Bone-Perforation Control Strategy Based on Computed Tomography-Guided Needle Insertion Robot.

Abstract

A computed tomography (CT)-guided robotic assistance system is useful for needle insertion into metastatic carcinoma of vertebrae, which has limited pathways. However, the use of conventional needles in this procedure can result in bone fracture in the perforation area caused by the reaction force of the inserted needle. In this study, we developed a multistage retractable needle guide unit that avoids the buckling and crushing of the needle tip that commonly occur in 25-gauge ultrafine needles. First, we clarified a relationship between the shape of the guide and the termination factor when a buckling load is applied to the needle. Next, we revealed the point at which the plastic deformation of the needle occurred when the bone is drilled. Based on these results, we developed a guide unit with the reaction force set to an appropriate value. Finally, an evaluation test of bone needle insertion was conducted on porcine vertebrae with using the developed needle guide unit equipped with a 25-gauge needle. The needle penetrated the vertebra without buckling or crushing of the needle tip, which demonstrates the value of this multistage retractable needle guide unit when ultrafine needles are required. Clinical Relevance- Cancer tumors often metastasize to bones. There is a treatment called percutaneous vertebroplasty which restores the patient's quality of life by injecting poly (methyl methacrylate) (PMMA) into a bone. It helps to reinforce the bone that has become brittle due to cancer metastasis to the vertebral body or osteoporosis. This treatment often involves puncture of the vertebrae but the limited puncture pathway makes it difficult to perform the treatment manually. Therefore it is necessary to construct a system that supports accurate puncture by a robot such as the proposed method.