Auto-suture device for nasal surgery

Client: Dr. Benjamin MarcusDepartment of OtolaryngologyAdvisor: Professor Tyler

Mark Yarmarkovich~LeaderJoseph Cabelka~CommunicatorJennifer Wager~BSACTherese Rollmann~BWIG

Problem Statement

Develop device to reduce suturing process in nasal surgery (septoplasty) Reduce OR costs ($60/min)

The device should mimic the procedure currently used by the surgeon

Design Constraints

Reduce suturing time (less than 10 minutes)

Autoclavable or one-time use Dimensions must conform to the nose Cost up to $300 for disposable, $1500

for multiple use

Background: Nose

Septum: cartilage dividing nose into two chambers; 3-5 mm wide Cartilage Young’s Modulus=10MPa

Mucous membrane lining each side of septum

Nostril width: 10mm-15mm Flexible

Background: Septoplasty

Deviated septum Septum is severely

shifted from midline Causes difficulty

breathing, sleeping

Background: Septoplasty

Incision made to expose caudal end of septum

Cartilage excised to prevent overriding

Cartilage swung into alignment

Background: Suture Sutures

Close incision Strong, non-toxic polymer

fiber Absorbable

Purse-string suture pattern Continuous Circular Inverting

Current Device

Autosuture devices currently available for bowel surgery Large scale

Endostitch Automatic Needle Passer

Materials

Autoclavable or one-time use Light weight and easy to handle Durable if multiple use

Titanium

Composite

Stainless Steel Grade 420

Medical Grade Plastic

(PEEK)

Density 4.42 g/cm3 7.75 g/cm3 1.32 g/cm3

Working Temperature

450°C 400°C 249°C

Design I: Mechanical Needle Passer

Needle passed with pulley system

Locked into place by notched edges

Design I: Mechanical Needle Passer

Pros Mimics procedure Manipulated by

surgeon Adjustable number

of sutures

Cons Many small parts

Difficult to manufacture

Difficult to autoclave

Requires dexterity

Design II: Clamp

Clamped on either side of the septum

Suture is manually inserted through raised septum

Design II

Pros Easy to

manufacture Can be disposable Safe

Cons Not adjustable to

size of nose Not automatic

Design III: Magnetic Needle Passer

Magnetic field generated by coils secures needle

Switch controls magnetic field activation

Design III: Magnetic Needle Passer

Pros Simple mechanism Easy to manipulate Mimics procedure Adjustable number

of sutures

Cons Magnetic field must

generate sufficient force to hold the needle in place

Size

Design Matrix

Design I Design II Design IIISuturing time (15) 11 8 13

Cost (5) 4 5 4

Manufacturability (5) 1 4 3

Safety (10) 7 9 6

Mimic procedure (10) 8 5 8

Size (5) 4 1 3

Total (50) 35 32 37

Future Work

Discuss design options with client Build prototype Test device for suture time and ease of

use

References

Autosuture. 29 January 2007<http://www.autosuture.com>. Azom. 6 March 2007<http://www.azom.com/details.asp?

ArticleID=1141>. Cornell. 27 February

2007<http://www.mae.cornell.edu/PDF/mcv3/JB.36.1069.pdf>. Fact Sheet. 2 March

2007.<http://www.entnet.org/healthinfo/sinus/deviated-septum.cfm>. Kortenbach, Juergen Andrew . “Automatic needle-passer suturing

instrument .” Patent no. 5,814,054. 1998. Lore, John. An Atlas of Head and Neck Surgery. 1988:Philadelphia. Modern Plastics. 6 March

2007<http://www.modernplastics.com/april05/wdtubing.html>. Septoplasty. 27 February

2007<http://emedicine.com/ent/topic128.htm>. Septum. 7 March 2007 <http://z.about.com/d/p/440/e/f/7166.jpg>.