This article presents a medical robotic system for deep orbital interventions, with a focus on Optic Nerve Sheath Fenestration (ONSF). ONSF is a currently invasive ophthalmic surgical approach that can reduce potentially blinding elevated hydrostatic intracranial pressure on the optic disc via an incision on the optic nerve. The prototype is a multi-arm system capable of dexterous manipulation and visualization of the optic nerve area, allowing for a minimally invasive approach. Each arm is an independently controlled concentric tube robot collimated by a bespoke guide that is secured on the eye sclera via sutures. In this article, we consider the robot's end-effector design in order to reach/navigate the optic nerve according to the clinical requirements of ONSF. A prototype of the robot was engineered, and its ability to penetrate the optic nerve was analysed by conducting ex vivo experiments on porcine optic nerves and comparing their stiffness to human ones. The robot was successfully deployed in a custom-made realistic eye phantom. Our simulation studies and experimental results demonstrate that the robot can successfully navigate to the operation site and carry out the intervention.

中文翻译：

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多臂连续机器人的视神经鞘开窗术

本文介绍了一种用于深眼眶介入的医疗机器人系统，重点是视神经鞘膜开窗术 (ONSF)。ONSF 是目前一种侵入性眼科手术方法，可以通过视神经上的切口减少视盘上潜在的致盲性颅内静水压升高。该原型是一个多臂系统，能够灵巧地操纵和可视化视神经区域，从而实现微创方法。每个手臂都是一个独立控制的同心管机器人，由一个定制的导向器准直，该导向器通过缝合线固定在眼巩膜上。在本文中，我们考虑机器人的末端执行器设计，以便根据 ONSF 的临床要求到达/导航视神经。设计了机器人的原型，并通过对猪视神经进行离体实验并将其刚度与人类视神经进行比较来分析其穿透视神经的能力。该机器人已成功部署在定制的逼真眼部幻影中。我们的仿真研究和实验结果表明，机器人可以成功导航到操作现场并进行干预。