Innovative Tools & Techniques for Robotic Heart Surgery

创新工具

• 批准号: 6904673
• 负责人: GREGORY D BUCKNER
• 金额: $ 43.63万
• 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/6904673
• 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)： 今天的手术机器人使用了通用的末端执行器，可以直接扩展外科医生自己手的运动、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，以极高的精度，通过更小的切口进行手术。它们通过使用放大的3D图像提供直接可视化，并通过运动缩放和手部震动的主动过滤提供更高的精确度。在心脏手术的特定领域，微创机器人辅助(MIRA)程序显示出患者满意度和关键结果参数的改善，包括减少总住院时间。不幸的是，这些收益被显著增加的手术时间所抵消，导致整体医疗成本增加。根据东卡罗来纳大学在Mira二尖瓣修复方面的经验，患者的搭桥时间目前增加了约60%(使用Mira的时间为2.6小时，而使用传统程序的时间为1.5小时)。显然，特定的技术进步可以显著减少Mira二尖瓣修复时间。在这一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设备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，成本将大幅下降。此外，使用“完全内窥镜”技术可以减少这些手术的侵入性。因此，这一多学科研究计划的具体目标是开发促进和扩展Mira心脏手术能力的技术。这些设备包括：(1)用于快速、安全地固定缝合材料和假体设备的设备：特别是使用现有缝合材料以及先进的夹子和订书器为特定手术(例如，关闭心房和修补小叶)提供“按钮”固定的器械和墨盒。(2)改善心脏基本结构可视化的内窥镜牵引器：可在内窥镜下展开的牵引器，它利用镍钛的超弹性特性，促进完全封闭的外科手术。(3)辅助外科医生进行手术计划、机器人导航和手术培训的系统：该技术可用于通过术前和术中的空间数据测量和登记关键解剖标志，以确定最佳的端口位置和机器人器械轨迹。