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Design, Fabrication, and Experimental Study of a Flexible Cardiac Stabilizer for Beating Heart Robotic Surgery

Houshmand, Arvin | 2016

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  1. Type of Document: M.Sc. Thesis
  2. Language: English
  3. Document No: 48102 (58)
  4. University: Sharif University of Technology, International Campus, Kish Island
  5. Department: Science and Engineering
  6. Advisor(s): Farahmand, Farzam
  7. Abstract:
  8. A popular way for performing minimally invasive heart surgery is to use cardiac stabilizers that fix the heart during surgery. In the recent years several research works have been conducted to develop effective cardiac stabilizers. While these developments have attempted to improve fixation of the heart, there are reports indicating that a rigid cardiac stabilization may induce injury to heart muscle tissues due to restricting the heart motion in all directions. A more efficient approach than rigid cardiac stabilization might be to use a flexible cardiac stabilizer in combination with a surgical robot having motion compensation capability. The scope of this research is designing a device to stabilize and measure the movement of heart during fully endoscopic beating heart robotic surgery. In the first step, an endoscopic heart stabilizer is designed and developed, that is capable of constraining the heart motion in different directions except for the normal direction which remains free to avoid harming the beating heart. This flexible cardiac stabilizer can be also equipped with appropriate sensors to measure the heart motions in normal direction to be used for controlling the surgical robot. The device can pass from a 20mm trocar and be attached to the heart surface, using a suction head. A parallelogram mechanism is employing for opening the device’s head inside the patient’s body. The device converts the complicated heart movement to a single rotation around fingers joint that is measured by an encoder. In the next step, this device is tested with a heart simulator in robotic surgery laboratory of research center of biomedical technology and robotics, Imam Khomeini Hospital Complex. Also its performance is examined in an in vivo experiment, in animal surgery laboratory of Shahid Rajaie cardiovascular, medical, and research center. This study compare the heart motion in (i) free condition (ii) after stabilized using the designed device, and (iii) after stabilized using a commercial octopus tissue stabilizer. Also it compares the measured heart movement in normal direction with the results of a stereo IR-camera. Results indicated that, the designed device stabilized the heart on the heart plane same as commercial octopus tissue stabilizer (0.15 mm in this study), the normal motion of the heart is 3 mm in this case same as its free movement, and measured values with designed device follow the heart motion trend with 0.17 mm r.m.s. error. Chapter 1 considers the heart surgery methods and Chapter 2 refers to the tools required for beating heart surgery, considering merits and limitation of current tools for robotic heart surgery. Chapter 3 highlights the novel design of a stabilizer tool for beating heart surgery. Chapter 4 shows the results of the heart simulator and in vivo experiments. Chapter 5 highlights performance of the proposed designed and fabricated flexile stabilizer device and recommends further works to improve it for robotic surgery
  9. Keywords:
  10. Robotic Surgery ; Beating Heart Surgery ; Cardiac Stabilizer ; Heart Motion Measuring ; Animal Test

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