The term “Multi-Angle and Rear Viewing Endoscopic tooL” (MARVEL) denotes an auxiliary endoscope, now undergoing development, that a surgeon would use in conjunction with a conventional endoscope to obtain additional perspective. The role of the MARVEL in endoscopic brain surgery would be similar to the role of a mouth mirror in dentistry. Such a tool is potentially useful for in-situ planetary geology applications for the close-up imaging of unexposed rock surfaces in cracks or those not in the direct line of sight.
A conventional endoscope provides mostly a frontal view — that is, a view along its longitudinal axis and, hence, along a straight line extending from an opening through which it is inserted. The MARVEL could be inserted through the same opening as that of the conventional endoscope, but could be adjusted to provide a view from almost any desired angle. The MARVEL camera image would be displayed, on the same monitor as that of the conventional endoscopic image, as an inset within the conventional endoscopic image. For example, while viewing a tumor from the front in the conventional endoscopic image, the surgeon could simultaneously view the tumor from the side or the rear in the MARVEL image, and could thereby gain additional visual cues that would aid in precise three-dimensional positioning of surgical tools to excise the tumor. Indeed, a side or rear view through the MARVEL could be essential in a case in which the object of surgical interest was not visible from the front.
The conceptual design of the MARVEL exploits the surgeon’s familiarity with endoscopic surgical tools. The MARVEL would include a miniature electronic camera and miniature radio transmitter mounted on the tip of a surgical tool derived from an endo-scissor (see figure). The inclusion of the radio transmitter would eliminate the need for wires, which could interfere with manipulation of this and other surgical tools. The handgrip of the tool would be connected to a linkage similar to that of an endo-scissor, but the linkage would be configured to enable adjustment of the camera angle instead of actuation of a scissor blade.
It is envisioned that thicknesses of the tool shaft and the camera would be less than 4 mm, so that the camera-tipped tool could be swiftly inserted and withdrawn through a dime-size opening. Electronic cameras having dimensions of the order of millimeters are already commercially available, but their designs are not optimized for use in endoscopic brain surgery. The variety of potential endoscopic, thoracoscopic, and laparoscopic applications can be expected to increase as further development of electronic cameras yields further miniaturization and improvements in imaging performance.
This work was done by Youngsam Bae, Anna Liao, and Harish Manohara of Caltech and Hrayr Shahinian from Skull Base Institute for NASA’s Jet Propulsion Laboratory.
In accordance with Public Law 96-517, the contractor has elected to retain title to this invention. Inquiries concerning rights for its commercial use should be addressed to:
Innovative Technology Assets Management
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Refer to NPO-45579, volume and number of this NASA Tech Briefs issue, and the page number.
This Brief includes a Technical Support Package (TSP).
Adjustable-Viewing-Angle Endoscopic Tool for Skull Base and Brain Surgery
(reference NPO-45579) is currently available for download from the TSP library.
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Overview
The document discusses the development of the Multi-Angle and Rear Viewing Endoscopic Tool (MARVEL), aimed at enhancing surgical visualization during endoscopic procedures, particularly in brain and skull base surgeries. Traditional endoscopes provide limited views due to their fixed vantage points and the constraints of a small opening, which can obstruct the view of vital anatomical structures, especially when blocked by tumors.
The MARVEL is designed to address these limitations by incorporating a secondary endoscope that allows surgeons to view the side or rear of a tumor without disrupting their primary endoscope setup. This secondary endoscope is engineered to resemble familiar endo-instruments, ensuring ease of use and quick adaptation for surgeons. The document emphasizes the importance of maintaining hand-eye coordination and minimizing distractions during surgery, suggesting that the MARVEL should integrate seamlessly into the existing surgical workflow.
Key observations from surgeries indicate that surgeons typically spend about one minute switching between endo-instruments, and the time for switching should be less than five seconds to maintain efficiency and focus. The MARVEL aims to facilitate this by being intuitive and comfortable to handle, thus allowing surgeons to concentrate on the procedure without unnecessary delays.
Technologically, the MARVEL is envisioned as a self-contained device featuring a miniature camera that can rotate at the tip, providing versatile viewing angles. A wireless transmitter will enhance mobility by eliminating cumbersome wires. Additionally, the MARVEL will utilize a scissor mechanism to adjust the distal tip's angle, further improving its functionality.
To keep the surgeon's attention on the primary endoscope, an inset window will display images from the MARVEL on the primary monitor. This design allows for simultaneous viewing without diverting focus, which is crucial during delicate surgeries. If the primary endoscope is stereoscopic, the MARVEL's orientation can be tracked in three-dimensional space, providing a comprehensive understanding of the surgical field.
Overall, the document highlights the potential of the MARVEL to revolutionize endoscopic surgery by improving visualization, enhancing surgical efficiency, and ultimately leading to better patient outcomes. The integration of advanced technology into surgical tools represents a significant step forward in medical innovation.
