Automated Nerve Suturing Using Dual Arm Nanorobotic System Considering Needle Insertion Depth

Abstract

Peripheral nerve injuries represent a significant clinical challenge in reconstructive surgery, traumatology, and neurosurgery, often leading to permanent sensorimotor deficits and diminished life quality. Thus, achieving precise epineurial suturing without nerve fascicle damage and tension remains a long-term aspiration for nerve repair. Yet, current techniques, mostly using direct suturing by surgeons, showcase unavoidable tension and limited functional outcomes. To address them, this work proposes a dual arm nanorobotic system-based approach for highly automated, precise, repeatable nerve suturing. An optimized path planning algorithm is designed leveraging the epineurial thickness estimation in order to control needle insertion depth and suturing trajectory. Due to the natural advantages of nanorobotics and microscope, the developed system can suture nerve with micron-scale diameter within confined space. Ex-vivo experiments on three types of rabbit sciatic nerves demonstrated the effectiveness and motion accuracy of 48 microns and 39 microns for two arms. In-vivo experiments with anatomic and functional analyses further validated the functional recovery, showing the potential for clinical translation.