# Improving the Safety and Efficacy of Intraventricular Neurosurgery via Robotics

> **NIH NIH R01** · BOSTON CHILDREN'S HOSPITAL · 2020 · $472,004

## Abstract

Project Summary
Out of over 380,000 brain surgeries performed in the USA every year, at least 20% are to remove lesions located
inside or adjacent to the brain’s ventricles, i.e., cavities filled with clear fluid. Using endoscopes, neurosurgeons
can navigate their instruments through the ventricles to reach these lesions with less damage to healthy brain
tissue than occurs in open surgery. Current endoscopes, however, are restricted by three main factors which
limit their use to about 5% of the potential cases (1% of all brain surgeries). First, endoscopes have tools
emerging parallel to the working shaft, precluding many of the two-handed surgical techniques of open surgery
that are used to dissect tissue and stop bleeding. Second, most neurosurgeons use straight rigid endoscopes
that cannot negotiate around corners without causing significant brain retraction injury. Third, there is a risk of
leaving behind significant residual tumors and also injuring critical neurovascular structures that are not directly
in the line of sight. The first two problems can be solved by providing two dexterous arms at the tip of endoscope
and by enabling easily controllable steerability for navigating around corners. The third issue can be addressed
by intraoperative MR imaging, with the added benefit of real-time imaging of the target lesion throughout the
operation. Currently, however, intraoperative MRI is limited to open surgery and allows only intermittent imaging
due to MR-incompatibility of standard surgical instruments as well as the difficult ergonomics of operating inside
a scanner. The project goal is to create robotic endoscopes for use inside an MR scanner. These surgeon-
controlled instruments will enable intuitive steering through the ventricles to the site of a lesion. There, two tip-
mounted dextrous arms can be deployed for bimanual lesion resection under combined endoscopic and MR
visualization. It is anticipated that these systems will enable endoscopic resection of 50% of lesions inside and
adjacent to the ventricles (10% of all intracranial lesions) while also improving the safety and efficacy of current
endoscopic procedures – resulting in a 10-fold increase in the number of brain surgeries that can be treated
endoscopically. Aim I will create a straight MRI-compatible bimanual neuroendoscope with two dexterous arms
comprised of telescoping elastic tubes. Aim II will offer a longer curvilinear surgical trajectory to deeper
ventricular and periventricular lesions by integrating a telescoping tendon-drive technology for endoscope
steerability with the tip-mounted arms of Aim 1. Both systems will be evaluated and refined through a series of
phantom and animal studies. The project leaders are experts in neuroendoscopic surgery, MRI-compatible
technologies and medical robot design.

## Key facts

- **NIH application ID:** 9908191
- **Project number:** 5R01NS099207-04
- **Recipient organization:** BOSTON CHILDREN'S HOSPITAL
- **Principal Investigator:** Pierre E Dupont
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $472,004
- **Award type:** 5
- **Project period:** 2017-08-01 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9908191

## Citation

> US National Institutes of Health, RePORTER application 9908191, Improving the Safety and Efficacy of Intraventricular Neurosurgery via Robotics (5R01NS099207-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9908191. Licensed CC0.

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