scholarly journals Design of a Surgical Port for Minimally Invasive Beating-Heart Intracardial Procedures

2011 ◽  
Vol 5 (4) ◽  
Author(s):  
Christopher M. DiBiasio ◽  
Keith V. Durand ◽  
Jonathan Hopkins ◽  
Zach Traina ◽  
Alexander H. Slocum ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Surgical Procedures ◽  
Beating Heart ◽  
Surgical Instruments ◽  
Direct Access ◽  
Surgical Instrument ◽  
System A ◽  
Pulmonary Bypass ◽  
Heart Wall ◽  
Rapid Tool

Direct-access, minimally invasive, beating-heart intracardial procedures have the potential to replace many traditional surgical procedures requiring cardio-pulmonary bypass as long as micro-emboli are prevented from entering the cardiovascular system. A new surgical port was developed to introduce surgical instruments into chambers of the beating heart during minimally invasive, intracardial surgical procedures without allowing the introduction of micro-emboli 0.1 mm or larger in size. The design consists of an outer port body that is secured to the heart wall using a purse string suture and a series of inner tubular sleeves that form the interface between the port and the transecting instrument. The design enables rapid tool changes and accommodates a wide variety of instruments. The port uses a fluid purging system to dislodge and remove emboli from a surgical instrument. Laboratory and clinical tests show that the port adequately seals around a surgical instrument and prevents the introduction of emboli with diameters greater than 0.1 mm into the heart while minimizing hemorrhage.

Development of a mechanical decoupling surgical scissors for robot-assisted minimally invasive surgery

Robotica ◽  
2021 ◽  
pp. 1-13
Author(s):  
Xingze Jin ◽  
Mei Feng ◽  
Zhiwu Han ◽  
Ji Zhao ◽  
Hankun Cao ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Wrist Joint ◽  
Surgical Instruments ◽  
Gear Train ◽  
Test Results ◽  
Surgical Instrument ◽  
Decoupling Method ◽  
Stable Performance

Abstract In minimally invasive surgery, surgical instruments with a wrist joint have better flexibility. However, the bending motion of the wrist joint causes a coupling motion between the end-effector and wrist joint, affecting the accuracy of the movement of the surgical instrument. Aiming at this problem, a new gear train decoupling method is proposed in the paper, which can automatically compensate for the coupled motion in real-time. Based on the performance tests of the instrument prototype, a series of decoupling effects tests are carried out. The test results show that the surgical instrument has excellent decoupling ability and stable performance.

scholarly journals A Hybrid Electromagnetic and Tendon-Driven Actuator for Minimally Invasive Surgery

Actuators ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. 92 ◽  
Author(s):  
HaoChen Wang ◽  
SaiHui Cui ◽  
Yao Wang ◽  
ChengLi Song
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Degrees Of Freedom ◽  
Surgical Instruments ◽  
Surgical Instrument ◽  
Kinematics Analysis ◽  
The Finite Element Method ◽  
Natural Orifice ◽  
Electromagnetic Structure

Minimally invasive surgery (MIS) is a surgical technique that facilitates access to the internal tissues and organs of a patient’s body via a limited number of small incisions or natural orifice of the patients. Such a technique requires specialized slender surgical instruments with a high levels of dexterity and functionality. However, the currently available MIS instruments are rigid and could offer only limited degrees of freedom (DOFs) that hampers the surgeon’s effort to perform the required operation accurately. In this study, we have developed a hybrid electromagnetic and tendon-driven actuator as an integral part of MIS surgical instruments to provide them with optimum angulation. The design uses a novel electromagnetic structure to lock the position of individual joints, and a tendon-driven structure for the articulation of the surgical instrument. The finite element method (FEM) was utilized to predict the performance of the actuator, which was experimentally validated. Subsequently, a prototype was assembled, and corresponding kinematics analysis was presented to visualize the improvement of the developed mechanism on the functional workspace of the MIS instruments. It was concluded that the developed mechanism could offer three additional DOFs for the surgical instrument and angulation of 180° for each articulated joint.

scholarly journals Video-assisted minimal access surgery for complicated mitral valve endocarditis, tricuspid valve insufficiency and progressive coronary disease after previous CABG - in the time of COVID-19: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Terézia B. Andrási ◽  
Nunijiati Abudureheman ◽  
Alannah Glück ◽  
Maximilian Vondran ◽  
Gerhard Dinges ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Mitral Valve ◽  
Minimally Invasive ◽  
Tricuspid Valve ◽  
Surgical Instruments ◽  
Tricuspid Valve Repair ◽  
Long Term Outcome ◽  
Tricuspid Valve Insufficiency ◽  
Valve Insufficiency ◽  
Neurosurgical Intervention

Abstract Background The timing for heart surgery following cerebral embolization after cardiac valve vegetation is vital to postoperative recovery being uneventful, additionally Covid-19 may negatively affect the outcome. Minimally invasive methods and upgraded surgical instruments maximize the benefits of surgery also in complex cardiac revision cases with substantial perioperative risk. Case presentation A 68 y.o. patient, 10 years after previous sternotomy for OPCAB was referred to cardiac surgery on the 10th postoperative day after neurosurgical intervention for intracerebral bleeding with suspected mitral valve endocarditis. Mitral valve vegetation, tricuspid valve insufficiency and coronary stenosis were diagnosed and treated by minimally invasive revision cardiac surgery on the 14th postoperative day after neurosurgery. Conclusion The present clinical case demonstrates for the first time that the minimally invasive approach via right anterior mini-thoracotomy can be safely used for concomitant complex mitral valve reconstruction, tricuspid valve repair and aorto-coronary bypass surgery, even as a revision procedure in the presence of florid endocarditis after recent neurosurgical intervention. The Covid-19 pandemic and prophylactic patient isolation slow down the efficacy of pulmonary weaning and mobilisation and prolong the need for ICU treatment, without adversely affecting long-term outcome.

The “Spacemaker”, a New Device for Minimally Invasive Cardiothoracic Surgery: An Evaluation and Feasibility Study

2015 ◽  
Vol 10 (4) ◽  
pp. 241-247
Author(s):  
Pieter W.J. Lozekoot ◽  
Sandro Gelsomino ◽  
Paul B. Kwant ◽  
Orlando Parise ◽  
Francesco Matteucci ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Surgical Procedures ◽  
Lung Tissue ◽  
Lung Ventilation ◽  
Cardiothoracic Surgery ◽  
Respiratory Compromise ◽  
One Lung Ventilation ◽  
New Device ◽  
Lead Placement ◽  
The Right

Objective Our aim was to evaluate a new inflatable lung retractor, the “Spacemaker”, and its efficacy in facilitating minimally invasive cardiothoracic surgery without the need of one lung ventilation or carbon dioxide overpressure insufflation. Methods The device was tested in 12 anesthetized pigs (90–100 kg) placed on standard endotracheal ventilation. The device was introduced into the right or left side of the chest, depending on the intended procedure to be performed, via a 3-cm incision in the fifth intercostal space. A total of seven animals were used to evaluate hemodynamic and respiratory response to the device, whereas another five animals were used to assess the feasibility of a variety of minimally invasive cardiothoracic surgical procedures. Results Introduction was easy and unhindered. The device was inflated up to 0.6 bar, thereby pushing the lung tissue gently away cranially, posteriorly, and caudally without interfering with pulmonary function or resulting in respiratory compromise. In addition, hemodynamics remained stable throughout the experiments. Different closed-chest surgical procedures such as left atrial appendage exclusion, pulmonary vein exposure, pacemaker lead placement, and endoscopic stabilization for coronary surgery, were successfully performed. Removal was quick and complete in all cases, and lung tissue showed no remnant atelectasis. Conclusions The “Spacemaker” may represent a reliable alternative to current conventional techniques to facilitate minimally invasive cardiothoracic surgery. Further research is warranted to confirm the effectiveness and the safety of this device and to optimize the model before its use in humans and its introduction into clinical practice.

Research on Three-Dimensional Displacement Measurement Technology of the Beating Heart

2011 ◽  
Vol 403-408 ◽  
pp. 5182-5186
Author(s):  
Sheng Yi Yang ◽  
An Gu ◽  
Meng Li ◽  
Chang Jian Lu
Keyword(s):  
Heart Surgery ◽  
Classical Mechanics ◽  
Three Dimensional ◽  
Beating Heart ◽  
Displacement Measurement ◽  
Surgical Instruments ◽  
Analytical Models ◽  
Measurement Technology ◽  
Position Measurement ◽  
Mechanics Of Materials

In robotic-assisted heart surgery, the method of canceling the relative motion between the surgical site on the heart and the surgical instruments was introduced in this paper. A whisker sensor was designed for three dimensional position measurement in beating heart surgery. Analytical models were developed according to the classical mechanics of materials, and theoretical formulas were derived for displacement measurement. Feasibility and effectiveness of the method were verified by simulation experiments. We can obtain measurements by loading displacement to the whisker sensor, and draw conclusions by comparing the measurements.

Kinematics of a Fully-Decoupled Remote Center-of-Motion Parallel Manipulator for Minimally Invasive Surgery

2012 ◽  
Vol 6 (2) ◽  
Author(s):  
Chin-Hsing Kuo ◽  
Jian S. Dai
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Inverse Kinematics ◽  
Parallel Manipulator ◽  
Degrees Of Freedom ◽  
Surgical Instruments ◽  
End Effector ◽  
Minimally Invasive Surgical ◽  
Inverse Kinematics Problem

A crucial design challenge in minimally invasive surgical (MIS) robots is the provision of a fully decoupled four degrees-of-freedom (4-DOF) remote center-of-motion (RCM) for surgical instruments. In this paper, we present a new parallel manipulator that can generate a 4-DOF RCM over its end-effector and these four DOFs are fully decoupled, i.e., each of them can be independently controlled by one corresponding actuated joint. First, we revisit the remote center-of-motion for MIS robots and introduce a projective displacement representation for coping with this special kinematics. Next, we present the proposed new parallel manipulator structure and study its geometry and motion decouplebility. Accordingly, we solve the inverse kinematics problem by taking the advantage of motion decouplebility. Then, via the screw system approach, we carry out the Jacobian analysis for the manipulator, by which the singular configurations are identified. Finally, we analyze the reachable and collision-free workspaces of the proposed manipulator and conclude the feasibility of this manipulator for the application in minimally invasive surgery.

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