Percutaneous Intrapericardial Interventions Using a Highly Articulated Robotic Probe

Abstract

-In order to overcome the limitations of currently available assistive technologies for minimally invasive surgery (MIS), we have developed a novel highly articulated robotic probe (HARP) that can exploit its snake-like structure to navigate in a confined anatomical environment while minimally interacting with the environment along its path. We believe that for procedures involving epicardial interventions on the beating heart, cardiac MIS can be effectively realized with the HARP, entering the pericardial cavity through a subxiphoid port, reaching remote intrapericardial locations on the epicardium without causing hemodynamic and electrophysiologic interference and delivering therapeutic interventions under the direct control of the surgeon.

Flexible Medical Devices: Review of Controllable Stiffness Solutions

“…This modification can lead to an increase or a decrease of flexural stiffness (E b I) while keeping the same material properties. Increasing or displacing the amount of material further away from the central axis as illustrated in Figure 1a and expressed by Equation (1) leads to an increase in flexural stiffness (E b I). In this family, the external dimensions of the structure may be modified.…”

“…The tension of several wires (A) or a central wire (B) is used to lock the segments and to induce a stiffness change. The segments can be beads [122], cylindrical elements connected by spherical joints [1,123] or rigid cylindrical elements [125]. The change of stiffness comes from the friction between the elements due to the tension in the cables [2].…”

“…The ShapeLock mechanism is based on segments locked by wire tensioning to freeze the device in a given configuration and to increase its rigidity [138]. The Highly-Articulated Robotic Probe (HARP) is an endoscopic tool using cable tension to lock its joints and segments [1,123].…”

“…Soft tools with controllable stiffness performances can have applications in the medical field, as in Minimally-Invasive Surgery (MIS) in which the endoscopic tools are mainly used [1]. On the one hand, the flexibility of these medical devices is appreciated as they can follow tortuous paths with little to no interaction force with organs and with low risk of damaging tissues or causing pain to the patient, being therefore a safer mode [2].…”

Effect of backlash on surgical robotic task proficiency

“…Some of these robots will enable less invasive endolumenal surgery in the gastrointestinal tract [6]- [7], subxiphoid access to the heart [8], and interventional-radiology based cardiac surgery within the heart [9].…”