SciFi in Real Life: Steerable Needles in Your Brain

I remember the 1966 movie, "Fantastic Voyage", starring Stephen Boyd, Raquel Welch, Edmond O'Brien, and Donald Pleasence.  The idea was to shrink a submarine and crew to microscopic size so they could save the life of some politico.  The main image I retain is Raquel Welch (left) in a skin-tight suit that is stripped down to the minimum by rampaging and probably sexist, male white blood cells. 

The rest of the story remains a blank.

 Well, the concept has come true in a way with a new image-guided surgical system under development at Vanderbilt University. It employs steerable needles about the size of those used for biopsies to penetrate the brain with minimal damage and suction away the blood clot that has formed.

 The story goes on to describe this as a high-tech method to remove blood clots from a patient's brain after they suffer a life threatening embolism. 

Now, instead of suction tubes, how about electrodes or a tip that can freeze a microscopic portion of a brain to erase a memory, change a  personality, remove inhibitions, or implant a compulsion without damaging the rest of a personality.

 It is a very real possibility.  Imagine if you will a man or woman wide awake, strapped down to a surgical table as a probe is carefully guided into place, say the memory center of the brain, or one that controls a certain behavior.  The person is helpless to prevent what is being done to them, so their facial expression would go from anger to rage to fear to panic then to??

 Here's the rest of the press release:

The system is described in an article accepted for publication in the journal IEEE Transactions on Biomedical Engineering. It is the product of an ongoing collaboration between a team of engineers and physicians headed by Assistant Professor Robert J. Webster III and Assistant Professor of Neurological Surgery Kyle Weaver. 

Brain clots are leading cause of death, disability
The odds of a person getting an intracerebral hemorrhage are one in 50 over his or her lifetime. When it does occur, 40 percent of the individuals die within a month. Many of the survivors have serious brain damage.

"When I was in college, my dad had a brain hemorrhage," said Webster. "Fortunately, he was one of the lucky few who survived and recovered fully. I'm glad I didn't know how high his odds of death or severe brain damage were at the time, or else I would have been even more scared than I already was."

Steerable needle could prevent "collateral damage" during surgery
Operations to "debulk" intracerebral hemorrhages are not popular among neurosurgeons: They know their efforts are not likely to make a difference, except when the clots are small and lie on the brain's surface where they are easy to reach. Surgeons generally agree that there is a clinical benefit from removing 25-50 percent of a clot but that benefit can be offset by the damage that is done to the surrounding tissue when the clot is removed. Therefore, when a serious clot is detected in the brain, doctors take a "watchful waiting" approach -- administering drugs that decrease the swelling around the clot in hopes that this will be enough to make the patient improve without surgery.

For the last four years, Webster's team has been developing a steerable needle system for "transnasal" surgery: operations to remove tumors in the pituitary gland and at the skull base that traditionally involve cutting large openings in a patient's skull and/or face. Studies have shown that using an endoscope to go through the nasal cavity is less traumatic, but the procedure is so difficult that only a handful of surgeons have mastered it.

Last summer, Webster attended a conference in Italy where one of the speakers, Marc Simard, a neurosurgeon at the University of Maryland School of Medicine, ran through his wish list of useful imaginary neurosurgical devices, hoping that some engineer in the audience might one day be able to build one of them. When he described his wish to have a needle-sized robot arm to reach deep into the brain to remove clots, Webster couldn't help smiling because the steerable needle system he had been developing was perfect for the job.

Webster's design, which he calls an active cannula, consists of a series of thin, nested tubes. Each tube has a different intrinsic curvature. By precisely rotating, extending and retracting these tubes, an operator can steer the tip in different directions, allowing it to follow a curving path through the body. The single needle system required for removing brain clots was actually much simpler than the multi-needle transnasal system.

I think this can save a lot of lives.
When Webster returned, he told Weaver about the potential new application. The neurosurgeon was quite supportive: "I think this can save a lot of lives. There are a tremendous number of intracerebral hemorrhages and the number is certain to increase as the population ages."

Graduate student Philip Swaney, who is working on the system, likes the fact it is closest to commercialization of all the projects in Webster's Medical and Electromechanical Design Laboratory. "I like the idea of working on something that will begin saving lives in the very near future," he said.

Active cannula removed 92 percent of clots in simulations
The brain-clot system only needs two tubes: a straight outer tube and a curved inner tube. Both are less than one twentieth of an inch in diameter. When a CT scan has determined the location of the blood clot, the surgeon determines the best point on the skull and the proper insertion angle for the probe. The angle is dialed into a fixture, called a trajectory stem, which is attached to the skull immediately above a small hole that has been drilled to enable the needle to pass into the patient's brain.

The surgeon positions the robot so it can insert the straight outer tube through the trajectory stem and into the brain. He also selects the small inner tube with the curvature that best matches the size and shape of the clot, attaches a suction pump to its external end and places it in the outer tube.

Guided by the CT scan, the robot inserts the outer tube into the brain until it reaches the outer surface of the clot. Then it extends the curved, inner tube into the clot's interior. The pump is turned on and the tube begins acting like a tiny vacuum cleaner, sucking out the material. The robot moves the tip around the interior of the clot, controlling its motion by rotating, extending and retracting the tubes. According to the feasibility studies the researchers have performed, the robot can remove up to 92 percent of simulated blood clots.

"The trickiest part of the operation comes after you have removed a substantial amount of the clot. External pressure can cause the edges of the clot to partially collapse making it difficult to keep track of the clot's boundaries," said Webster.

The goal of a future project is to add ultrasound imaging combined with a computer model of how brain tissue deforms to ensure that all of the desired clot material can be removed safely and effectively.
Other members of the research team are Jessica Burgner, formerly a postdoctoral fellow at Vanderbilt and now executive director of the Hannover University Center for Mechatronics in Germany, and Ray Lathrop, a graduate student at Vanderbilt.
*  *  *  *  *

Story Source:  Vanderbilt University (2013, August 8). Robot treats brain clots with steerable needles. ScienceDaily.

Comments

Post a Comment

Popular posts from this blog

Greek Bronze Age ended 100 years earlier than thought

Image
Source: www.shef.ac.uk The charred remains of Assiros Toumba in Greece. Writing historical fiction set in the Greek Bronze Age?  Or simply enjoy reading this genre'?  Here's a study you may find interesting. C onventional estimates for the collapse of the Aegean civilization may be incorrect by up to a century, according to new radiocarbon analyses. While historical chronologies traditionally place the end of the Greek Bronze Age at around 1025 BCE, this latest research suggests a date 70 to 100 years earlier. www.weather-forecast.com Archaeologists from the University of Birmingham selected 60 samples of animal bones, plant remains and building timbers, excavated at Assiros in northern Greece, to be radiocarbon dated and correlated with 95.4% accuracy using Bayesian statistical methodology at the University of Oxford and the Akademie der Wissenschaften Heidelberg, Germany. Researcher Dr Ken Wardle says, 'These new results tell a story that is totall
Read more

How the lives of Georgian gaolbirds and highwaymen shaped modern Britain

Image
Writing historical fiction requires solid research of available materials and databases.  The key word here is available.   So news of a new publicly accessible database that allows an author to research a very interesting past era is priceless almost beyond words.   I expect some exciting fiction to come out of this announcement. Here's the story, with a link to the source in the attribution. *  *  *  *  * London Lives, a landmark project led by Professor Bob Shoemaker from the University of Sheffield and Professor Tim Hitchcock from the University of Sussex, has uncovered a mass of extraordinary new evidence which reveals how the lives of thousands of 18th-century poor and criminal Londoners helped shape modern Britain. Based on evidence made available in a publicly available database, the study sheds new light on the everyday lives of thieves, prostitutes, vagrants, highwaymen, con-men, paupers and jailbirds, revealing how their daily fight for survival led to t
Read more

Mood Instability and Your Characters

Image
You're putting together a character who's mood simply bounces all over the place, happy one moment, in a fit of rage the next.  Researchers at King's College London note that this sort of mood instability is part of a number of mental health disorders.  So how do you structure the personality and behavior of a character like this?  Below is the King's College report, along with a brief description from mentalhealth.com, of typical behavior, sometimes in the extreme, of a person who is very emotionally unstable.  This is offered strictly as a guide for crafting character in fiction - and NOT for the amateur diagnosis of the state of someone's mental health.  That is always best left to trained professionals. Another note about emotionally unstable behavior:  as any parent will tell you, this is how adolescents and teen-agers often behave.  It's a normal part of growing up - but it is a matter of degree .  In the extreme, however, this behavior can be diag
Read more

SciFi: Introducing "Technofossils" the legacy of modern humans for future generations to explore

Image
Source:  blogs.miaminewtimes.com  Daniel Fiorda's "Nostalgic Hardware" Techno-Fossil Art Imagine what a future archaeologist would think finding any of the myriad bits and pieces of technology we bury in modern middens, aka garbage dumps.  So now we have a name for it:  Technofossils, coined recently to describe the stuff humanity tosses out. T he fossil impact humans make on the planet is vast and unprecedented in nature -- there's been nothing remotely like it since the Earth formed over four and half billion years ago. The researchers argue that, like dinosaurs, who left their bones and footprints behind for future generations to discover, humans will also leave a footprint behind -- one made up of material goods unique to humankind that are so different from anything else produced by animals in the history of Earth that they deserve their own name: technofossils. Dr Zalasiewicz said: "Palaeontologists call preserved animal-made structures trace f
Read more

Remember faces but not names? You got it wrong.

Image
Source:   Daily Excelsior So, you think you're good at remembering faces, but terrible with names? New research has revealed we are actually better at remembering names than faces The cringe-worthy experience of not being able to remember an acquaintance's name leads many of us to believe we are terrible with names. However, new research has revealed this intuition is misleading; we are actually better at remembering names than faces. With the Christmas party season fast approaching, there will be plenty of opportunity to re-live the familiar, and excruciatingly-awkward, social situation of not being able to remember an acquaintance's name. This cringe-worthy experience leads many of us to believe we are terrible at remembering names. However, new research has revealed this intuition is misleading; we are actually better at remembering names than faces. The authors of the study, from the University of York, suggest that when we castigate ourselves f
Read more