Steerable catheters for minimally invasive surgery: a review and future directions

Figures & data

Figure 1. Bard Stinger Ablation Catheter and its control unit (a) the catheter with the control unit; (b) the distal tip of the catheter; (c) the inside of the control unit.

Table 1. Comparisons of some typical steerable catheters in the literature.

Author (year)	Actuation principle	Section	DOF	Bending angle	Sections coupling	Distal tip force	Application	Outer Diameter (mm)
Guo et al. (1995) [11]	Conducting polymer	1	2	42.3°	N/A	×	Aneurysm surgery	2
Della Santa et al. (1996) [30]	Conducting polymer	1	2	28°	N/A	×	General MIS	0.8
Lim et al. (1995) [31]; Lim et al. (1996) [32]	SMA	2	4	13°	Co-placed	×	General MIS	2.8
Haga et al. (1998) [33]; Haga et al. (2000) [34]; Haga et al. (2002) [71]	SMA	1	2	90°	N/A	Sensors	General MIS	1.4
Park and Esashi (1999)	SMA	2	4	51°	Co-placed	Sensor	General MIS	2
Takizawa et al. (1999) [63]	SMA	1	2	45°	N/A	Sensor	Cerebral surgery	1.5
Jayender et al. (2009) [65]	SMA	2	4	24.7°	Co-placed	Model	Cardiac surgery	1.5
Szewczyk et al. (2011) [13]	SMA	1	2	70°	N/A	×	Neuroradiology	1.2
Bailly et al. (2011) [10]	Hydraulic	2	4	90°	Independent	×	Aneurysm surgery	4.9
Bailly et al. (2011) [10]	Hydraulic	1	2	90°	N/A	×	Aneurysm surgery	4.9
Ikuta et al. (2012) [8]	Hydraulic	2	2	170°	Co-placed	×	Endovascular surgery	3
Degani et al. (2006) [42]	Tendon	1	3	90°	Independent	×	Cardiac surgery	12
Harada et al. (2007) [16]	Tendon	1	2	40°	N/A	×	Intrauterine fetal surgery	2.4
Zhang et al. (2009) [17]
Xu and Simaan (2010) [45]	Tendon	3	6	90°	Co-placed	Model	General MIS	7.5
Kutzer et al. (2011) [15]	Tendon	1	1	135°	N/A	×	Removal of osteolysis	5.99
Jung et al. (2011) [37]	Tendon	1	3	180°	N/A	×	Cardiac surgery	6.35
Camarillo et al. (2009) [46]	Tendon	2	4	90°	Independent	×	Cardiac surgery	4
Jeon et al. (2012) [59]	Magnetic	1	2	45°	N/A	×	Endovascular surgery	2
Niobe II system (Stereotaxis 2016)	Magnetic	1	2	120°	N/A	Sensor	Cardiac surgery	2.67
Webster et al. (2006) [73]	Pre-bent concentric tube	1	2	N/A	N/A	×	General MIS	0.7
Webster et al. (2009) [83]	Pre-bent concentric tube	3	6	N/A	Co-placed	×	General MIS	0.8(d)//2.39(p)
Dupont et al. (2010) [81]	Pre-bent concentric tube	3	5	N/A	Co-placed	×	General MIS	1.85(d)/2.41(m)/2.77(p)
Abayazid et al. (2013) [80]	Pre-bent concentric tube	1	2	N/A	N/A	Model	General MIS	0.5
Butler et al. (2012) [12]	Tendon & Pre-bent concentric tube	3	6	−/−/180°, 100° (p)	Independent	×	Neurosurgery	1(d)/1.3(m)/3.7(p)
Magellan™ robotic catheter (Hansen Medical Inc 2016b) [7]	Tendon & Pre-bent concentric tube	3	6	−/180°(m)/90°(p)	Independent	sensors	Peripheral vasculature	1(d)/2.13(m)/3.25(p)
Couture and Szewczyk (2017) [66]	SMA	2	6	155	N/A	sensor	Cardiovascular system	2

‘x’ means unavailable; (d) means the distal section; (m) means the middle section; (p) means the proximal section.

Figure 2. Schematic diagram of the structure of the tendon-driven steerable catheter. (The red arrows indicate the movement of tendon and the deflection of the distal section)

Figure 3. Location and number of tendons in the tendon-drive catheters. (a) The catheter is driven by one tendon and examples can be found in [5,35–37]; (b) The catheter is driven by a pair of tendons which are placed in 180° and examples can be found in [15,38,39]; (c) The catheter is driven by three tendons placed 120° apart and examples can be found in [40,41]; (d) The catheter is driven by four orthogonally spaced tendons and examples can be found in [16,42,43].

Figure 4. Steerable catheters with an open lumen. (Left: The cannula driven by two tendons with an open lumen was designed by Kutzer et al. [15]. Reprinted with the permission from [15] © 2011 IEEE. Right: The catheter driven by four tendons with an open lumen was designed by Jung et al. [42]. Reprinted with the permission from [42] © 2011 IEEE.

Figure 5. Cross-sectional view of the tendon driven steerable catheter [43].

Figure 6. Steerable catheters with a discrete backbone [40] (Left: entire steerable catheter system; Right: one segment of the backbone). Reprinted with the permission from [30] © 2006 IEEE.

Figure 7. Bending laser manipulator developed by Harada et al. [16] (Left: prototype of the manipulator; Right: bending mechanism). Reprinted with the permission from Harada et al. [16] © 2006 IEEE.

Figure 8. Schematic diagram of the structure of the multi-backbone steerable catheter.

Figure 9. The section coupling (Left: co-placed; Right: distributed).

Figure 10. Niobe® ES magnetic navigation system.

Figure 11. Overall structure of the catheter developed by Park and Esashi (Park and Esashi 1999). Reprinted with the permission from (Park and Esashi 1999) © 1999 IEEE.

Figure 12. Laser machined SMA actuators by Tung et al. (Tung et al. 2008). Reprinted with the permission from (Tung et al. 2008) © 2008 Elsevier.

Figure 13. Movement of the needle with a bevel tip tiedles.

Figure 14. Active cannula made of super-elastic Nitinol tubes [85]. Reprinted with the permission from [85] © 2009 IEEE.

Figure 15. Basic structure of the micro catheter [11]. Reprinted with the permission, from [11] © 1995 IEEE.

Figure 16. Structure of the catheter developed by Haga et al. (Haga et al. 2005). Reprinted with the permission from (Haga et al. 2005) © 2005 IEEE.

Figure 17. The prototype of two-section catheter by Bailly et al. [10]. Reprinted with the permission from [10] © 2005 IEEE.

Figure 18. Hydraulic pressure driven active catheter [8]. Reprinted with the permission from [8] © 2012 IEEE.

Figure 19. Schematic diagram of robotic endoscopy developed by Butler et al. [12]. Reprinted with the permission from [12] © 2012 IEEE.

Figure 20. Magellan™ Robotic Catheter. (Left: Magellan™ 6 Fr Robotic Catheter, available at: http://www.hansenmedical.com/us/ en/ vascular/magellan-robotic-catheters/magellan-10fr-robotic-catheter; Right: Magellan™ 10 Fr Robotic Catheter, available at: http://www.hansenmedical.com/us/en/ vascular/magellan-robotic-catheters/magellan-10fr-robotic-catheter).

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