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Image-registered, Hand-held, Concentric Tube Robot for Percutaneous Treatment of Calculi

Award Number: R01DK119269
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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ABSTRACT Percutaneous Nephrolithotomy (PCNL) suffers from lack of sufficient dexterity of the nephroscope to access stag horn and complex stones through a single insertion port, therefore necessitating multiple procedures or creation of several access tracts to treat the entire stone. Multiple procedures or access tracts can increase parenchyma damage, blood loss, complication rates and healthcare costs. Therefore, there is a need for improving the current method of performing PCNL by enhancing access of the nephroscope to large and complex stones in the pelvicalyceal anatomy through an optimal port. Our long-term goal is to develop a robotic endoscope that can access the entire stone through a single insertion port with accurate guidance to minimize complications. The objective of this grant is to improve access to the stone by designing and developing an image-registered hand-held concentric tube robot (CTR) instrumented with a position sensor, mini fiberscope and laser ablation fiber. In order to minimize the number of tracts created, we will also develop an optimization algorithm for calculating the “optimal” puncture location and desired trajectory for the CTR. The rationale that underlies the proposed research is that the CTR inserted along a desired trajectory through an optimal port will enable the urologist to safely obtain access to the entire stone through a single tract, thereby ensuring complete stone removal while minimizing damage to the kidney parenchyma. In addition, the navigation system will aid in visualizing and targeting the stones in 3 dimensions, thereby providing enhanced depth perception compared to the standard 2D projection fluoroscopy. We plan to achieve the objective by pursuing the following specific aims: 1) Develop a hand-held CTR device instrumented with a position sensor to cover the entire calyx and deliver the laser fiber. We will also develop an algorithm to evaluate the optimal puncture location to enable access to the entire stone while maximizing the dexterity of the CTR. 2) Develop surgical navigation software that fuses the diagnostic CT and intraoperative tracked ultrasound images to visualize the CTR and neighboring anatomy in real-time. 3) Validate the CTR device and navigation system in ex-vivo kidney tissue and porcine models. The proposed research is significant since it will enable a higher stone-free rate while reducing the complication rate associated with the PCNL procedure. The proposed research is innovative in that it builds on state-of-the-art CTR technology, motion planning and navigation algorithms, and mixed-reality visualization modalities to enable urologists to accurately and safely target kidney calculi during PCNL.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2023 ( Subtotal = $346,091 )
2023	2023	BRIGHAM & WOMENS HOSPITAL INC	75 FRANCIS ST	BOSTON	MA	02115	SUFFOLK	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	5	1/11/2023	NON-COMPETING CONTINUATION	$346,091
														Subtotal = $346,091

Issue Date FY: 2022 ( Subtotal = $365,321 )
2022	2022	BRIGHAM AND WOMEN'S HOSPITAL, INC., THE	75 FRANCIS ST	BOSTON	MA	02115	SUFFOLK	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	4	3/25/2022	NON-COMPETING CONTINUATION	$36,533
2022	2022	BRIGHAM AND WOMEN'S HOSPITAL, INC., THE	75 FRANCIS ST	BOSTON	MA	02115	SUFFOLK	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	4	12/8/2021	NON-COMPETING CONTINUATION	$328,788
														Subtotal = $365,321

Issue Date FY: 2021 ( Subtotal = $369,794 )
2021	2021	BRIGHAM AND WOMEN'S HOSPITAL, INC., THE	75 FRANCIS ST	BOSTON	MA	02115	SUFFOLK	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	3	2/2/2021	NON-COMPETING CONTINUATION	$36,981
2021	2021	BRIGHAM AND WOMEN'S HOSPITAL, INC., THE	75 FRANCIS ST	BOSTON	MA	02115	SUFFOLK	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	3	12/22/2020	NON-COMPETING CONTINUATION	$332,813
														Subtotal = $369,794

Issue Date FY: 2020 ( Subtotal = $359,849 )
2020	2020	BRIGHAM AND WOMEN'S HOSPITAL, INC., THE	75 FRANCIS ST	BOSTON	MA	02115	SUFFOLK	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	2	12/12/2019	NON-COMPETING CONTINUATION	$323,863
2020	2020	BRIGHAM AND WOMEN'S HOSPITAL, INC., THE	75 FRANCIS ST	BOSTON	MA	02115	SUFFOLK	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	2	2/10/2020	NON-COMPETING CONTINUATION	$35,986
														Subtotal = $359,849

Issue Date FY: 2019 ( Subtotal = $373,151 )
2019	2019	BRIGHAM AND WOMEN'S HOSPITAL, INC., THE	75 FRANCIS ST	BOSTON	MA	02115	SUFFOLK	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	12/14/2018	NEW	$373,151
														Subtotal = $373,151

Grand Total All Awards = $1,814,206

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Image-registered, Hand-held, Concentric Tube Robot for Percutaneous Treatment of Calculi

Award Number: R01DK119269

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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