Minimally invasive epicardial injections using a novel semiautonomous robotic device

Takeyoshi Ota, Nicholas Patronik, David Schwartzman, Cameron Riviere, and Marco A. Zenati
Circulation, Vol. 118, No. suppl 1, October, 2008, pp. S115-S120.


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Abstract
Background—We have developed a novel miniature robotic device (HeartLander) that can navigate on the surface of the beating heart through a subxiphoid approach. This study investigates the ability of HeartLander to perform in vivo semiautonomous epicardial injections on the beating heart. Methods and Results—The inchworm-like locomotion of HeartLander is generated using vacuum pressure for prehension of the epicardium and drive wires for actuation. The control system enables semiautonomous target acquisition by combining the joystick input with real-time 3-dimensional localization of the robot provided by an electromagnetic tracking system. In 12 porcine preparations, the device was inserted into the intrapericardial space through a subxiphoid approach. Ventricular epicardial injections of dye were performed with a custom injection system through HeartLander’s working channel. HeartLander successfully navigated to designated targets located around the circumference of the ventricles (mean path length5125 mm; mean speed3826 mm/min). Injections were successfully accomplished following the precise acquisition of target patterns on the left ventricle (mean injection depth3.00.5 mm). Semiautonomous target acquisition was achieved within 1.00.9 mm relative to the reference frame of the tracking system. No fatal arrhythmia or bleeding was noted. There were no histological injuries to the heart due to the robot prehension, locomotion, or injection. Conclusions–In this proof-of-concept study, HeartLander demonstrated semiautonomous, precise, and safe target acquisition and epicardial injection on a beating porcine heart through a subxiphoid approach. This technique may facilitate minimally invasive cardiac cell transplantation or polymer therapy in patients with heart failure.

Keywords
computers, heart failure, minimally invasive robotic surgery, myocardium

Notes
Sponsor: National Institutes of Health
Associated Center(s) / Consortia: Medical Robotics Technology Center
Associated Lab(s) / Group(s): Surgical Mechatronics Laboratory
Associated Project(s): HeartLander

Text Reference
Takeyoshi Ota, Nicholas Patronik, David Schwartzman, Cameron Riviere, and Marco A. Zenati, "Minimally invasive epicardial injections using a novel semiautonomous robotic device," Circulation, Vol. 118, No. suppl 1, October, 2008, pp. S115-S120.

BibTeX Reference
@article{Patronik_2008_6697,
   author = "Takeyoshi Ota and Nicholas Patronik and David Schwartzman and Cameron Riviere and Marco A Zenati",
   title = "Minimally invasive epicardial injections using a novel semiautonomous robotic device",
   journal = "Circulation",
   pages = "S115-S120",
   month = "October",
   year = "2008",
   volume = "118",
   number = "suppl 1",
}