Engineering Assisted Surgery™Robots and Nanobots

Ninian PeckittFRCS FFD RCS FDS RCS FACCS

Oral and Maxillofacial Surgeon / Facial Plastic Surgeon

BR Medical Suites Dubai Healthcare City, Dubai, UAEAl Zahra Hospital Dubai UAE

Adjunct Associate Professor of Engineering Assisted SurgeryMassey School of Engineering and Advanced Technology New Zealand

Engineering Assisted Surgery™

the application of engineering and industrial

technology in the delivery of healthcare

Engineering Assisted Surgery™

Customised ImplantsNinian Peckitt

Customised Implants

Ninian Peckitt

Medical Robotics

the use of intelligent machine technologies

………………..in clinical and surgical medicine

Medical Robotics

• Patient monitoring and stabilization

• Minimally Invasive Surgery (MIS)

• Remote surgery (telesurgery)

• Patient rehabilitation

• Medical training

• Nano-Robots (Nanobots)

Robotic Exoskeleton (REX)

RP 7 Robotic DoctorTouch Health

Rex Biotics Auckland N.Z

£200k

Smart Pills

Proteus Smart Pill http://www.proteus.com

• Sensors signal and relay vital-stat information after ingestion

• Monitors Compliance / Therapeutic progress

• Signal triggered by Pill’s minerals mixing with gastric fluids

• Band-Aid style Microelectronic receiver is placed on the skin.

date–stamps information

tracks compliance /sleep patterns / posture / falls / heart / respiratory rates

Heart Monitoring

Avivo Heart Monitoring Device http://www.corventis.com

• Wireless Blue Tooth technology

• Disposable Band-Aid sensor

• Cell phone–sized receiver

• Posture / Activity / Fluid status/ Heart /Respiratory Rates

daVinci Surgical System

http://davincisurgery.com

• Intuitive Surgical - Debut 1999 joystick-controlled

• three robotic hands (for a camera and instruments)

• precise “keyhole” incisions

• perform complex surgeries via optics and imaging

• Million-dollar-plus price tag

Freehand Laparoscopic Camera Controller (Prosurgics Ltd)

• Automated device with steady hands for Minimally Invasive Surgery

• Holding lights / cameras / telescopes

• The surgeon wears a sensor

• Much like a climber’s headlamp

• Controls the robotic arm head movements and a foot pedal

• Cost $20,000 http://www.freehandsurgeon.com

Robotic Jaw

School of Engineering and Advanced Technology, Massey University, New Zealand

• forces /movements in the chewing food

• complete picture of motion

• applications across medicine / food technology

Torrance JD, Hutchings SC, Brolund JE, Huang L, Xu WL

Int. J. of Intelligent Systems Technologies and Applications 2010 Vol 8 No 1/2/3/4 pp288-302

Nanobots

• Nanobot biomedical applications likely in 10 years

• Molecular-scale electronics, sensors and motors are expected to enable microscopic robots with dimensions comparable to bacteria

• Recent developments in biomolecular computing demonstrate feasibility of processing logic tasks by bio-computers

Nanobots

• Building Biosensors and Nano-Kinetic Devices Studies for Operation and Locomotion of Nanobots are now advanced

• Classical objections to the feasibility of nanotechnology now resolved:

-quantum mechanics

- thermal motions

- friction

• Complex integrated high performance nanosystems can be analysed / simulated to pave the way for use of nanorobots in biomedical engineering

Nanobots and Cell Surgery

Nanomanufacturing

Creation of materials and products through:

1. Direct Molecular Assembly (DMA)

2. Indirect Crystalline Assembly (ICA)creation of conditions that foster the growth of nanoscale crystals that are then combined into macroscale materials and products

3. Massive Parallelism Assembly (MPA)the creation of many nanomachines /nanobotssynergy to assemble atoms and moleculesInto macroscale materials and products.

Making Nano Robots

Nanobots and Nanobotic Control Devices

• Biochips for medical applications

• DNA based Micro-Robots

• Bacteria / Biologically integrated devices controlled by Electromagnetic Fields

• Voice-Controlled / Mind-Controlled Robots

– Neuronal impulses to trigger actions

– Robotic Arm could very well function as a real human arm.

Molecular NanobotsRice University Houston Texas

Fullerene

• Any molecule composed entirely of carbon, in hollow

- Sphere (buckyballs) e.g. Buckminsterfullerene (C60)

- Ellipsoid

- Cylindrical (carbon nanotubes / buckytubes)

Synthetic Molecular Motors

• Molecular Machines capable of rotation under energy input

• Peptide that induces motion

• Non-Peptide Synthetic motors

Synthetic Motors

Basic Requirements

• Repetitive 360° motion

• Consumption of Energy

• Unidirectional Motion

Wormdrive

Chemically driven rotary molecular motorsKelly et al

http://www.nature.com/nature/journal/v401/n6749/full/401150a0.html

• 3-bladed triptycene rotor

• Plus a helicene (symmetric molecule)

• Unidirectional 120° rotation

• Powered by Chemical Energy

• stereoselective ring opening of a racemic biaryl lactone

• Feringa’s design - molecule with 360° rotation

Chemically driven rotary molecular motorsFeringa

Light-driven rotary molecular motorsFeringa

Acc. Chem. Res. 2001, 34, 504-513

• Their 360° molecular motor system

• bis-helicene connected by an alkene double bond

• displaying axial chirality and 2 stereocenters

• unidirectional rotation - 4 reaction steps

Feringa Principle Nanocar

• The Feringa principle incorporated in a prototype nanocar

• Helicene-derived engine

• oligo (phenylene ethynylene) chassis / 4 carborane wheels

• is expected to move on a solid surface

• scanning tunneling microscopy monitoring

• Motor does not perform with fullerene wheels because they quench the photochemistry of the motor moiety

Electron tunneling driven rotary molecular motorshttp://scholar.google.co.uk/scholar_url?url=http://www2.chem.uic.edu/pkral/paper/motor.pdf&hl=en&sa=X&scisig=AAGBfm2u_hkMxEi76UXWB9J4XotyX4FcJA&nossl=1&oi=scholarr&ei=L9_-VOnKLcXB7gbS4YGAAw&ved=0CCEQgAMoATAA

• Analogous to macroscale electric motors

• Could be driven by an electric current passed through molecules

• Quantum Tunnelling - wave-particle duality of matter

• Král has developed nanoscale rotary machines

Electron tunneling driven rotary molecular motors

Electron tunneling driven rotary molecular motors

• Motor - carbon nanotube shaft

• Shaft - Carbon Nanotube Bearings

• Polymerized iceane molecule stalks

- saturated bonds are attached to the shaft

- 120° or 60° with respect to each other.

• Blades – Fullerine Molecules

• Electrostatic Fields periodiaclly charges discharges blades

Drexler-Merkle Differential Gear Nanorex Inc

• 2 shafts (output and input): 742 atoms each

• 4 bevel gears: 209 atoms each

• 1 casing (gearbox): 5972 atoms

• Total: 7 components with 8292 atoms

NanocarRice University Houston Texas

The Nanocar molecule 2005

• the original nanocar no molecular motor

• Demonstrates roll or slide of fullerines

• Scanning tunnelling microscopy scanning

• The nanocar is able to roll about because the fullerene wheel is fitted to the alkyne "axle" through a carbon-carbon single bond

• The hydrogen on the neighboring carbon is no great obstacle to free rotation.

• When the temperature is high enough, the four carbon-carbon bonds rotate and the car rolls about.

Professor James M Tour Rice University

• A new model of the nanocar has been built

• Rotating molecular light powered motor attached to chassis

• When struck by light the motor rotates

• Car is propelled like a paddle wheel

• Axles (Alkyne Molecules) spin independent of each other

• Other motor systems can be activated by:

• Sound (Mallouk, Pennsylvania)• Electromagnetism

Andrew TurberfieldUniversity of Oxford

Nanotrain

• A train track was made from micrometre sized tubes

• A protein named Kinesin travels along the track

• Kinesin is adapted to include DNA sequences

– required to build a protein along the track

– or to carry a payload of dye molecules along the track.

Tom MalloukPennsylvania State University

Power System - Ultrasound

• Motors are rods made of gold and platinum

• One end of rod is convex one end is concave

• Ultrasonic waves bounce off each end differently

• This gives rods enough power to spin

• Movement up to 100 times their body length per second in water is possible

• Mallouk believes that minimally invasive surgery may be possible

Kosta KostarelosUniversity of Manchester

• Making swimming nanoparticles

• Could be guided to a specific place in the body

• Thinks development of smart medical nanobots unlikely

• Believes nanomachine capable of repetitious tasks is more likely

Nanotrucks

• Linking drugs with nanoparticles improves therapeutic effect

• Molecular DNA carriers are folded (Origami) and closed containing active drug

• Target the right cell and after binding open up to release their payload.

• Paclitaxel (pancreatic breast and lung cancer) works better when attached to nanoparticles and is now in clinical use

• Spherical Nucleic Acids cross blood brain barrier and can be used to release cytotoxic drugs after attachment to brain tumours.

Gang BaoGeorgia Institute of Technology

DNA repair-bots

• Nanobots which snip out damaged sections of DNA

• Using a template replacement with undamaged segments

• Work is aimed at repairing the damaged segments of DNA in sickle-cell patients.

Applications of Nanotechnology

Diagnosis

Parkinsons Disease

• Patients have 25% less uric acid in serum - Difficulty in accurate measurement

• Graphene Sponge superconductor in which are grown nano needles of zinc oxide

• Huge surface area for electrical circuit

• Uric acid sticks to the zinc oxide and loses some electrons

• Change in uric acid concentration calculated from current generated

Applications of Nanotechnology

Diagnosis

Intercepting Infections (Thomas Webster Northeastern University)

• Early detection of infected hip prostheses

• Prosthetic Revision rate 15%

• System proposed to release drugs directly on implant site

– Sensor carbon and titanium nanotubes detect bacteria

– Relay of signal to another part of implant where antibiotics are stored

– Release of antibiotcs when infection at early phase

– Could also be used to promote immunomodulation and prevent implant rejection

– Could also be used to promote bone formation

Applications of Nanotechnology

Tracking Treatment – Rheumatoid Disease

Alicia El Haj Professor Regenerative Medicine University of Keele

• Stem cells from fat can suppress the immune response

• Stem cells must be activated deep in joint tissues to be effective

• Stem Cells can be tagged with magnetic nanoparticles

• Magnets can steer them keep them in position and even activate them

Applications of Nanotechnology

Tracking Treatment – Rheumatoid Disease

Alicia El Haj Professor Regenerative Medicine University of Keele

• Superparamagnetic iron oxide nanoparticles (Spions) attached to stem Cells

• Injected into joints of rodents with rheumatoid arthritis

• MRI scans track the labelled cells

• Pulling the nanoparticles activates the cells and leads to tissue regeneration

Application of Nanotechnology

Spermbots

• Mix tiny metallic tubes through bull sperm to produce Spermbots

– Iron and Titanium Tubes trap a single sperm

– Sperm flagella power moves the Spermbot – A Biological Engine

– no external power source required / no toxic power source required

– Spermbots are guided to an ovum using a magnetic field

• Potential use in fertility treatment and IVF

• Another application is related to drug delivery

Application of Nanotechnology

Disappearing Devices – Electroceuticals

John Rogers University of Illinois

• Tiny chip is placed in wound at risk of infection

• Releases heat to kill bacteria

• Silicon nanolayer loses 1-3 nanometres / day

• Device dissolves into silicic acid which naturally occurs in body fluids

• Chips could be loaded with antibiotics with wireless trigger release mechanism

Other Research includes:

• LED Research to control neurons with light – Potential injection into brain

• Nano devices to stimulate nerve and bone growth

• Pacemaker powered by heart beat which distorts and recharges implant

Applications of Nanotechnology

Visualising Viruses

• Gold Nanoparticles coat viruses which do not affect ability to infect/kill cells

• Tagged virus permits EM snapshots

– Attachment

– Cell penetration

– Removing protein coat before replication

• Nanoparticles could be used as Trojan Horse

– to deliver drugs to cells infected by viruses

Self Replicating NanobotsJohn von Neumann

Eric Drexler described the term “Grey Goo” of exponential growth

Royal Society report on Nanoscience 2004 – No “Grey Goo” in foreseeable future

The End?

Thank you for your attention

or - The End of the Beginning?