Innovative Tools & Techniques for Robotic Heart Surgery

创新工具

• 批准号: 6817355
• 负责人: GREGORY D BUCKNER
• 金额: $ 43.79万
• 依托单位: NORTH CAROLINA STATE UNIVERSITY RALEIGH
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-08-16 至 2007-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6817355
• 关键词: bioengineering /biomedical engineering; biomedical equipment development; disease /therapy duration; endoscopy; health care cost /financing; heart /lung bypass; heart surgery; robotics; sheep; surgery material /equipment; surgical wound; technology /technique development; training

DESCRIPTION (provided by applicant): Today's surgical robots employ generalized end effectors that directly extend the motions, capabilities, and limitations of a surgeon's own hands. These robots give surgeons the ability to work on very small scales, with great precision, and through smaller incisions. They provide direct visualization through the use of magnified 3-D images and greater accuracy through motion scaling and active filtering of hand tremors. In the specific field of cardiac surgery, minimally invasive robot-assisted (MIRA) procedures show improvements in patient satisfaction and key outcome parameters including decreases in overall hospital stays. Unfortunately, these gains have been offset by significantly increased operative times, resulting in increased overall healthcare costs. Based on East Carolinas University's experience in MIRA mitral valve repairs, patient bypass times are currently increased approximately 60% (2.6 hours with MIRA vs. 1.5 hours using conventional procedures). It is evident that specific technological advancements could significantly decrease MIRA mitral valve repair times. Surgeons and researchers working in this field expect that costs will dramatically decrease as surgeons and medical device manufacturers collaboratively develop robotic tools and technologies specifically suited for MIRA cardiac procedures. Additionally, these procedures could be made less invasive with "totally-endoscopic" technologies. Accordingly, the specific aims of this multidisciplinary research program focus on developing technologies that facilitate and extend the capabilities of MIRA cardiac surgery. These include: (1) Devices for rapid and secure fixation of suture materials and prosthetic devices: specifically instruments and cartridges that provide "push-button" fixation for specific procedures (e.g. atrial closure and leaflet repair) using both existing suture materials and advanced clips and staples. (2) Endoscopic retractors to improve visualization of essential cardiac structures: endoscopically-deployable retractors that utilize the superelastic properties of Nitinol to facilitate totally closed surgical procedures. (3) Systems to aid the surgeon in incision planning, robotic navigation, and operative training: technology that can be used to measure and register critical anatomical landmarks with pre-operative and intra-operative spatial data to identify optimal port placement and robot instrument trajectories.

描述（由申请人提供）： 今天的手术机器人采用通用的末端执行器，直接扩展外科医生自己的手的运动，能力和限制。这些机器人使外科医生能够在非常小的范围内工作，具有很高的精度，并通过更小的切口。它们通过使用放大的3-D图像提供直接可视化，并通过运动缩放和主动过滤手颤提供更高的准确性。在心脏手术的特定领域，微创机器人辅助（MIRA）手术显示出患者满意度和关键结局参数的改善，包括总体住院时间的减少。不幸的是，这些收益被手术时间的显著增加所抵消，导致整体医疗成本增加。根据东卡罗莱纳大学在MIRA二尖瓣修复方面的经验，患者搭桥时间目前增加了约60%（MIRA为2.6小时，而传统手术为1.5小时）。很明显，特定的技术进步可以显著缩短MIRA二尖瓣修复时间。在该领域工作的外科医生和研究人员预计，随着外科医生和医疗器械制造商合作开发专门适用于MIRA心脏手术的机器人工具和技术，成本将大幅降低。此外，这些手术可以通过“全内窥镜”技术进行微创。因此，该多学科研究计划的具体目标集中在开发促进和扩展MIRA心脏手术能力的技术。其中包括：（1）用于缝合材料和假体器械的快速和安全固定的器械：特别是使用现有缝合材料和先进的夹子和斯台普斯为特定手术（例如心房闭合和瓣叶修复）提供“按钮”固定的器械和钉仓。(2)内窥镜牵开器可改善重要心脏结构的可视化：内窥镜可展开牵开器，利用镍钛合金的超弹性特性促进完全闭合的外科手术。(3)辅助外科医生进行切口规划、机器人导航和手术培训的系统：可用于测量和配准关键解剖标志与术前和术中空间数据的技术，以确定最佳端口放置和机器人器械轨迹。