Image-Based Path-Planning for Navigation of Soft-Growing Robots in the Spinal Sub-Arachnoid Space

Safe navigation within the spinal subarachnoid space is constrained by its narrow, compliant, and delicate anatomy. Conventional catheters and continuum robots rely on proximal pushing, generating friction and shear along the tissue device interface that limit distal controllability and increase the risk of neural injury. Here, we present a 2 mm diameter eversion-growing robotic platform that enables friction minimised extension and steering within the human spinal subarachnoid space, validated through computational modelling, phantom experiments, and intact human cadaver studies. The robot integrates a miniature endoscope for real time intrathecal visualisation and advances by pressure driven tip eversion, localising motion to the distal tip while minimising translational sliding of the deployed body. Phantom experiments demonstrated reductions of 65.2% in mean interaction force and 48.0% in peak interaction force compared with matched push-based insertion. Physics based modelling showed that eversion based growth redistributed tissue loading, reducing local stress concentrations and interfacial shear relative to conventional insertion. In an intact human cadaver, the system achieved 150 mm of controlled intrathecal extension with concurrent fluoroscopic and endoscopic visualisation, providing access across multiple vertebral levels from a standard lumbar entry point. Postprocedural laminectomy and durotomy revealed no observable macroscopic disruption of the dura mater or surrounding neural structures. These results provide the first mechanically characterised and multimodally validated demonstration of eversion-based robotic navigation in intact human spinal anatomy, establishing a quantitative and procedural foundation for future intrathecal interventions. Further validation in larger anatomical cohorts and under physiological conditions will be required before clinical translation.

Vine robots navigate cluttered environments by extending from their tip. Although their ability to operate in such environments has been extensively demonstrated, little work has addressed growth planning, i.e., finding optimal growth paths. Moreover, existing planners do not account for the growth pressure necessary to follow a given path, which can cause the robot to burst when it is too high. In this paper, we address the problem of finding minimum-pressure paths for vine robots growing around polytopic obstacles. We propose an efficient algorithm that is guaranteed to find globally optimal solutions in 2D and approximate solutions in 3D, with an error that vanishes as a discretization parameter approaches zero. First, we derive a growth pressure equation for vine robots of arbitrary shape, which we use to show that there always exists a minimum-pressure path that is piecewise-linear and can bend only at specific points on the obstacles. We then leverage this observation to reduce the growth-planning problem to a shortest-path problem with time-dependent weights, which we efficiently solve using a modified Dijkstra's algorithm. We demonstrate the speed and scalability of our approach through numerical simulations. We also validate our algorithm with hardware experiments and provide an open-source and high-performance implementation in the Python package, VinePlanner: https://github.com/Ahsoka/VinePlanner.

Soft eversion robots, also known as vine robots, have attracted growing interest for navigation and inspection tasks, including minimally invasive medical applications [1]. A vine robot consists of a thin, flexible, inextensible tube folded inward that everts and grows forward when pressurized. This tip-growth enables navigation with minimal friction, making vine robots well suited for complex environments such as the human colon [2]. While their inherent softness allows passive conforma- tion to curved pathways in confined spaces, navigation performance strongly depends on environmental inter- actions, including contact angle and the length of un- constrained deployed material [3], [4]. Sharp directional changes, such as those in the sigmoid colon, often limit passive growth and necessitate active steering. Existing solutions include distributed artificial muscles [5] or dedicated tip-based steering mechanisms [6]. In addition, many applications require payload delivery, such as sensors and tools [7], [8]. Within the ERC Synergy project EndoTheranostics, this motivates the development of vine robots capable of delivering micro- surgical tools during growth. Prior work has integrated working channels within the vine body [8], [9], but these approaches constrain tool size, introduce friction, and limit access to the environment to the robot tip. In this work, we propose a multi-vine architecture in which two vine robots are coupled to an externally integrated working channel via soft mounting tips [10]. Independent vine actuation enables active tip steering while advancing the working channel without embed- ding it within the vine bodies Figure 1. Experiments demonstrate sharp steering of nearly 90 degrees during growth, highlighting the potential of this architecture for versatile medical and non-medical applications.