Extending Reach, Accuracy, and Therapeutic Capabilities: A Soft Robot for Peripheral Early-Stage Lung Cancer - PROJECT SUMMARY This proposal focuses on the design, development, and validation of a novel soft surgical robot to address critical unmet needs within the world of lung cancer. Lung cancer is the leading cause of death from cancer in the United States and worldwide with an estimated 1.8 million deaths a year, more than breast cancer, prostate cancer, and colon cancer combined. Early diagnosis and therapy are essential to increase the survival rate of lung cancer. Because approximately 70% of lung nodules reside in the deeper peripheral region of the lung, adequate sampling of the tissue is challenging. Traditional manual bronchoscopes are limited in their ability to access small bronchi because of large diameters. Robotic bronchoscopes available on the market are easier and more intuitive to maneuver. However, they still present distal dexterity limitations and deep exploration is still performed without visualization by using semi-flexible needles that are pushed manually by the clinician. This affects biopsy accuracy and precision and ultimately diagnostic yield, causing delays in diagnosis and treatment and increasing the risk for tumor growth and spread. In this proposal, we will leverage our prior pioneering work on the design, fabrication, and preliminary validation of a miniaturized soft robotic bronchoscope for early-stage lung cancer diagnosis and treatment. This air-powered, image-guided robot is the smallest and most flexible and dexterous robotic bronchoscope, allowing navigation in branches deeper in the lung and visual feedback throughout the procedure. The system features two separate working channels to facilitate, for the first time, simultaneous (i.e., within the same bronchoscopy procedure) diagnostic and therapeutic capabilities and hasten early-stage lung cancer treatment. We will optimize the soft robotic bronchoscope navigation and stabilization control based on computer vision algorithms. We will merge pre-operative planning and intra-operative data and evaluate accuracy and precision in registration. We will develop a mechanical stabilization system at the robot tip, that will anchor to the surrounding anatomy and work in concert with software stabilization. This will enhance robot lesion tracking abilities during breathing and other involuntary or accidental movements and counteract tissue reaction forces during biopsy to improve surgical tasks’ accuracy and precision. We will enable robotic actuation control for needle tool deployment and steering via multi-DOF soft robotic micro actuators at the robot tip. Sharp bending angles and large strokes will enable access to hard-to-reach lesions without losing visualization. We will validate the robot in-vitro and ex-vivo and compare metrics with standard bronchoscopy. We anticipate our technology to have better navigational abilities, more accurate instrument placement, reduced procedure times, less tissue trauma, better diagnostic yield, shortened learning curve, and an overall enhanced procedural experience. Our team is uniquely positioned to achieve success of this study, possessing expertise in surgical robotics, soft robotics, medical devices, and interventional pulmonology, and having a long history of close and fruitful collaboration.
