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Biorobotics: Driving a Less Invasive Approach To Cardiac Surgery

Open-heart surgery is a highly invasive, expensive procedure, requiring patents to be put on a heart-lung machine. Beyond the risks of the surgery itself, a patient may face a host of secondary issues, such as short- and long-term cognitive loss.
A research team at the BioRobotics Laboratory, led by Robert D. Howe, Abbott and James Lawrence Professor of Engineering at SEAS in collaboration with Dr. Pedro del Nido, Chief of Cardiac Surgery at Children’s Hospital Boston, developed a far less invasive approach using a surgical catheter.

What was the challenge?

Howe and Nido wanted to expand the capabilities of a catheter to address the special requirements of complex cardiac surgery, while offering a far less invasive approach than traditional procedures.

What was the innovation?

Current cardiac catheters lack the ability to quickly and dexterously interact with the fast-moving structures inside a beating heart. Howe and Nido developed the “cathbot,” a robotic actuated catheter system that is fast and maneuverable. The device can compensate for the quick motion of the cardiac tissue while performing surgery on the delicate structures of the heart.

How does it work?

The cathbot system is composed of an actuated catheter module that is inserted inside the heart; a 3D ultrasound imaging system that views the catheter and the tissue of interest; and a visual servoing system that commands the robotic device to follow a specific trajectory based on the 3D imaging information. The catheter module braces itself against the heart structures while the end effector compensates for the motion of the tissue and applies a specific repair. The 3D ultrasound imaging allows both the tissue and the catheter tool to be visualized and tracked in real time. The visual servoing system then extracts both the tool and tissue trajectory from this visual information and determines how the catheter should be moved to compensate for the cardiac motion.

What are the advantages?

The catheter-based approach allows for sophisticated heart repairs to be performed less invasively. For example, a surgeon does not have to make large incisions in a patient’s chest, and the patient does not have to use a heart-lung bypass machine or rely on heavy sedation. As a result, the device may make life-saving cardiac repair procedures available to a larger pool of patients who would be too old or sick for a traditional open-heart procedure. Further, as the system can operate on a beating heart, a clinician can evaluate the quality of the repair during the procedure. Finally, the system could be less costly than conventional methods, saving time during surgery and recovery.

What are some next steps?

The Harvard team is further investigating how to best use the technology for heart valve repair, such as mitral valve annuloplasty, cardiac tissue resection, precision cardiac biopsies, cardiac electrophysiology procedures, and heart defect closures. Since the cathbot system is reconfigurable (by simply swapping out the catheter end effector), the researchers anticipate testing the device for a wide range of related procedures. The ultimate goal is to commercialize the technology, making a less invasive approach to cardiac surgery a reality.

Where I can learn more?

Harvard’s Office of Technology Development is now working to identify a medical device company with whom the research team will partner to drive the research forward and commercialize the technology.


For Further Information, Please Contact:

Sam Liss, Director of Business Development

(617) 495-4371

sam_liss@harvard.edu

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