NeuroFlex

Especially patients with conditions affecting the cerebrospinal fluid flow and pressure inside the brain’s ventricles caused by cysts, tumors, stenosis or congenital defects can be diagnosed or treated minimally invasively through neuroendoscopy [2].

However, when using the long, rigid system that the neuroendoscope is, there is a very limited reach at the tip. It is extremely dangerous to move the endoscope, once it is placed inside the brain, as tiny movements can have disastrous consequences such as large bleeds and permanent brain damage. This movement in the sagittal plane is illustrated in Figure 1.

The NeuroFlex aims to increase safety of neuroendoscopic procedures by increasing the reach and concurrently decreasing the movement needed in the full endoscopic system to reach the different areas inside the brain.

The NeuroFlex is equipped with biopsy forceps and has a shaft diameter of 2mm. The distal portion of the shaft is articulate, using DEAM’s familiar steering technique. The steerable tip and how it can reach around while keeping the shaft still, is visualised in Figure 2.

This project is founded in a partnership between DEAM and prof. dr. Eelco Hoving, the clinical director of the neuro-oncological department of the Prinses Maxima Centre. A close collaboration was needed to define the user requirements of the instrument and to develop the prototype to the level it is at now. This fully functional prototype is shown in Figure 3.

The first functional prototype was evaluated and tested. The set-up for this is shown in Figure 4. Promising results were found concerning the safety of steerability in neurosurgical instruments.

In the future, this instrument with its specific dimensions and other properties (2mm diameter shaft, the joystick control, the long rigid shaft with articulate tip etc.) might proof especially suitable for other applications too!