Robotic intracerebral hemorrhage evacuation: An in-scanner approach with concentric tube robots

Several robotic systems have been proposed for removing blood from the brain in patients who have undergone a hemorrhagic stroke. In this paper we explore the use of imagebased feedback to address tissue deformation when aspirating a hemorrhage in a phantom model. This is the first time intraoperative image feedback has been used with a concentric tube robot in this application. We describe a layer by layer approach to motion planning. Computed tomography (CT) images are collected periodically during hemorrhage removal. After each CT scan, the robot's tip path is re-planned to account for the tissue deformation that has occurred since the previous scan. We compare open loop hemorrhage removal to our sequential imaging-replanning approach, illustrating that the latter has the potential to enhance the safety and efficacy of the procedure.