Fracture-Directed Steerable Needles

Abstract

Steerable needles hold the promise of improving the accuracy of both therapies and biopsies as they are able to steer to a target location around obstructions, correct for disturbances, and account for movement of internal organs. However, their ability to make late-insertion corrections has always been limited by the lower bound on the attainable radius of curvature. This paper presents a new class of steerable needle insertion where the objective is to first control the direction of tissue fracture with an inner stylet and later follow with the hollow needle. This method is shown to be able to achieve radius of curvature as low as 6.9[Formula: see text]mm across a range of tissue stiffnesses and the radius of curvature is controllable from the lower bound up to a near infinite radius of curvature based on the stylet/needle step size. The approach of “fracture-directed” steerable needles indicates the promise of the technique for providing a tissue-agnostic method of achieving high steerability that can account for variability in tissues during a typical procedure and achieve radii of curvature unattainable through current bevel-tipped techniques. A variety of inner stylet geometries are investigated using tissue phantoms with multiple stiffnesses and discrete-step kinematic models of motion are derived heuristically from the experiments. The key finding presented is that it is the geometry of the stylet and the tuning of the bending stiffnesses of both the stylet and the tube, relative to the stiffness of the tissue, that allow for such small radius of curvature even in very soft tissues.