Quantification of the stress generated by theendoscopic movement in the brain parenchymaduring intra ventricular surgical procedure

Abstract

Endoscopy is increasingly used for intra ventricular surgeries such as hydrocephalus and tumor removal (Miwa et al. 2015 Miwa T, Hayashi N, Endo S, Ohira T. 2015. Neuroendoscopic biopsy and the treatment of tumor-associated hydrocephalus of the ventricular and paraventricular region in pediatric patients: a nationwide study in Japan. Neurosurg Rev.[Crossref], [PubMed], [Web of Science ®], , [Google Scholar]). Robotic based surgeries are more and more developed to control the trajectory and the movement of the endoscope and then to enhance the accuracy of surgical procedures and to reduce post-operative issues. The use of computer- aided robot is then well-suited to accurately reach ventricles cavities through the brain parenchyma and to minimize cerebral damage caused by the movement of the endoscope. On a mechanical point of view, moderate and severe traumatic brain injury (TBI) had a 50% risk to locally occur when Von Mises stress respectively exceeds 18 and 38 kPa (Willinger & Baumgartner 2003 Willinger R, Baumgartner D. 2003. Human head tolerance limits to specific injury mechanisms. Int J Crashworthiness.[Taylor & Francis Online], , [Google Scholar]). The purpose of this study was to assess the Von Mises stress generated in the brain by the endoscopic movement.