snakelike robots for heart surgery

8/6/2019 Snakelike Robots for Heart Surgery

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Snakelike Robots for Heart Surgery

Posted by Science Oxford on October 7, 2009 | comments

Im not really a massive fan of snakes, so the idea of robotic snakes that can crawl through your

body to perform surgery is not really very appealing.But this is exactly what a team of scientists is trying to achieve. Watch the video below to get thefull picture or read the article below to find out more!

A snakelike surgical robot from Carnegie Mellon University could let a surgeon performing acritical heart operation make just one incision.

Known as the CardioArm, the curved robot has a series of joints that automatically adjust tofollow the course plotted by the robots head. This provides greater precision than a flexibleendoscope can offer. Its certainly easier to control, says Robert Webster III, a professor atVanderbilt University who works on flexible medical probes and was not involved in the

CardioArm project.

The CardioArm is operated using a computer and a joystick. It has 102 degrees of freedom, threeof which can be activated at once. This allows it to enter through a single point in the chest andwrap around the heart until it reaches the right spot to, say, remove problematic tissue. The nicething about [the] design is that each joint follows where you went in space. Thats not alwayspossible in other designs, says Webster. This kind of control prevents the probe from bumpinginto sensitive tissue. The disadvantage of a jointed robot, however, is that its harder tominiaturize, Webster says.

The smallest version of the device is 300 millimeters long and has a diameter of 12 millimeters.

Eventually, the CMU researchers hope to make a snake small enough to enter the bloodstreamthrough a blood vessel, says Marco Zenati, one of the principal researchers on the CardioArmproject and a professor of surgery at the University of Pittsburgh.

Zenati has used robotic surgical assistants in the past and notes that they all have limitations. Theda Vinci system, for example, cant squeeze into tight locations within the human body andrequires five or six entryways, he says.


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Realizing the need for more-advanced robots for minimally invasive surgery, Zenati teamed upwith Howie Choset, a TR35 honoree known for his work at CMU on crawling robotic snakes,and Alon Wolf, founder and director of the Biorobotics and Biometrics Lab at Technion, theIsrael Institute of Technology.

Known as the CardioArm, the curved robot has a series of joints that automatically adjust tofollow the course plotted by the robots head. This provides greater precision than a flexibleendoscope can offer. Its certainly easier to control, says Robert Webster III, a professor atVanderbilt University who works on flexible medical probes and was not involved in theCardioArm project.

The CardioArm is operated using a computer and a joystick. It has 102 degrees of freedom, threeof which can be activated at once. This allows it to enter through a single point in the chest andwrap around the heart until it reaches the right spot to, say, remove problematic tissue. The nicething about [the] design is that each joint follows where you went in space. Thats not alwayspossible in other designs, says Webster. This kind of control prevents the probe from bumping

into sensitive tissue. The disadvantage of a jointed robot, however, is that its harder tominiaturize, Webster says.

The smallest version of the device is 300 millimeters long and has a diameter of 12 millimeters.Eventually, the CMU researchers hope to make a snake small enough to enter the bloodstreamthrough a blood vessel, says Marco Zenati, one of the principal researchers on the CardioArmproject and a professor of surgery at the University of Pittsburgh.


Realizing the need for more-advanced robots for minimally invasive surgery, Zenati teamed upwith Howie Choset, a TR35 honoree known for his work at CMU on crawling robotic snakes,and Alon Wolf, founder and director of the Biorobotics and Biometrics Lab at Technion, theIsrael Institute of Technology.

For minimally invasive surgery, you either have a linear laparoscope thats rigid or a flexibleendoscope that buckles easily; theres nothing thats both flexible and rigid, says Choset. Butthe CardioArm has the benefits of both, he says.

I think what Howie has is a good platform for getting at the [surgical] site, says Nabil Simaan,an assistant professor at Columbia University who is working on insertable, snakelike probes forthe abdomen.

The team hopes to start testing the CardioArm in natural-orifice surgerya technique wheretissues are removed through existing openings in the body, such as the mouth, to avoidpostoperative pain and reduce recovery time. Zenati aims to have surgeons use CardioArms inunison, like an octopus, with two or three tentacles all entering through one incision and thenbranching out.


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http://www.scienceoxfordonline.com/snakelike-robots-for-heart-surgery

Snakebot gets under your skin - literally, mends your broken heart

y From: news.com.auy February 22, 2011 2:44PM

Slithering through a hole in the solar plexus, Snakebot gets into those hard-to-reach places.Picture: Dr Howie Chosen / Carnegie Mellon University Source: Supplied

American Engineers have built a robotic snake that could change the way heart surgery is

performed.

CardioArm can assist surgeons procedures, slithering into places in the body too tight or

dangerous for ordinary medical tools to enter.

Though its hardly comfortable, Snakebot is revolutionising the way heart surgery is performed,mitigating the need for open heart surgery.

Rather than having to crack open patients ribcage during heart surgery, this slippery little suckerburies itself deep inside your chest via a 2cm hole in your solar plexus and slithers around yourorgans.


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The inventors of CardioArm say this technology has the potential to minimise the time it takesfor patients to recover from heart surgery.

Dr Howie Chosets from the University of Cargenie Mellon in Pennsylvania told Discovermagazine: Instead of cracking open a persons chest we can do a surgery and send patients

home the next day.

With a camera attached to the head, a surgeon controls the movement of the robot using ajoystick allowing it to visually map the parts of the body requiring surgery.

Snakebot has already passed its test on its first human subject - doctors from the Czech Republicused CardioArm to successfully performed a diagnostic heart mapping procedure in Februarylast year, but its inventor has even bigger plans for the 30cm-long serpent.

The roboticist plans to test the device in other surgeries such as ablation, which involves usinglasers to burn away small amounts of heart tissue to correct an abnormal beat.

Surgery isnt the only thing on Dr Chosets' agenda however, the robotics believes Snakebotcould assist in archaeology fields as well.

Dr Chosets told IEEE's Spectrum:Were hoping to use a remote-controlled robot to go throughsmall caves in Egypt and find remains of ancient Egyptian tombs.

Read more: http://www.news.com.au/technology/sci-tech/snakebot-gets-under-your-skin-literally-

mends-your-broken-heart/story-fn5fsgyc-1226010128217#ixzz1JJdyW1BE

http://www.news.com.au/technology/sci-tech/snakebot-gets-under-your-skin-literally-mends-your-broken-heart/story-fn5fsgyc-1226010128217

Snakes on a (Surgical) Plain


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Laparoscopic and robotic surgery has been the standard for a number of abdominal and pelvicsurgical procedures for some time, but researchers are now pushing the envelope further withkeyhole and pinhole surgery using ever smaller and more flexible robotic tools. One recentadvance, called CardioARM(tm), is being developed jointly by Carnegie Mellon University andCardiorobotics, Inc. The CardioARM(tm) is a Cardiac Articulated Robotics MedProbe.

This articulated snake-like robot has a series of joints that automatically adjust to follow thecourse plotted by the robots head. This provides greater precision than any flexible endoscopecan offer. The robot is operated using a computer and a joystick. It reportedly has 102 degrees offreedom, three of which can be activated at once. This allows the snake to enter through asingle point in the chest and wrap around the heart until it reaches the right spot to perform theprocedure. The snake-like design allows each joint to follow exactly where the previous jointwent in 3-dimensional space, so that you can thread your way to the critical location and nothave to worry about the body of the snake bumping into an important anatomic structure ortissue. A working channel or lumen in the probe, allows tools to pass through and performvarious procedures.

At present, the smallest version of the device is 300 millimeters (about 1 foot) long and has adiameter of 12 millimeters (about 1/2 inch). The goal of the Carnegie Mellon Universityresearchers however, is to make a snake small enough to enter the bloodstream through ablood vessel, says Marco Zenati, one of the principal researchers on the CardioArm project and aprofessor of surgery at the University of Pittsburgh. Zenati teamed up with Howie Choset,known for his work at CMU on crawling robotic snakes, and Alon Wolf, founder and director ofthe Biorobotics and Biometrics Lab at Technion, the Israel Institute of Technology. According toChoset, the Cardiorobotics team has performed successful cardiovascular surgeries on nine pigsand two human cadavers. Human trials are scheduled to begin soon.

The quest for smaller and less invasive surgical techniques is advancing rapidly.Microlaparoscopy, or pinhole surgery, uses much smaller surgical instruments (about 1/10th ofan inch in diameter) than are found with laparoscopic techniques (about 1/2 of an inch indiameter). The technology is very new in the United States, and it is currently used primarily fordiagnostic procedures. While laparoscopy usually requires general anesthesia, microlaparoscopycan be done with a local anesthetic and minor sedation. And as the name implies, pinhole surgeryoffers even smaller incisions than are commonly found today with laparoscopy. Blood loss isminimized, there is less tissue damage and recovery time from surgery is greatly reduced. Someof the early pioneers of minimally invasive techniques are found at the MIOT (The MadrasInstitute of Orthopedics and Traumatology) Hospitals in India.

Benefits of pinhole or keyhole robotic snakes include the fact that the human arm and thehuman-controlled instruments have a limited number of degrees of field. So you might be able tomove an arm in/out, rotate or twist, but if you have a lesion that is behind the heart, you actuallyhave to move the heart somehow in order to get behind the heart to remove a tumor or operate ona blood vessel. A robotic device that can articulate and move in many ways that a human armcannot carries great promise. This is only one of several ways in which robots can assist in theoperating room. By reducing the need for direct human intervention, a robotic surgical systemcan help the surgeon endure a long procedure. Many types of surgery can last from 8 to 10 hours.Sitting at a computer console using a joystick instead of standing and repeatedly having to hold


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and manipulate instruments can reduce the fatigue of the operation and can keep the hand andmind steady.

http://newtechmd.com/wordpress/?p=37

A Robotic Snake To Fix Broken Hearts And Organs

Main Category: Heart Disease

Also Included In: Cardiovascular / Cardiology; Medical Devices / Diagnostics

Article Date: 26 Jan 2009 - 5:00 PDT

A snake is probably the last thing you'd ever want crawling around your heart. But in the case of a new

American-Israeli invention called the CardioARM, this medical "snake" device may one day save your

life.

The new Israeli-American invention came by way of some brainstorming between Israel's Dr. Alon Wolf

and his American colleague Prof. Howie Choset, when Wolf was working as a researcher at Carnegie

Mellon University in the US.

"Both Howie and myself are experts in snake robotics," says Wolf, who is now based at the Technion-

Israel Institute of Technology in Haifa. "We are working with robotic snakes for search and rescue

operations. So we started in the back of our minds thinking: if we can send snakes to crawl inside

buildings to look for survivors, then why can't we send the same snake inside our body to fix it?"

A few weeks later, Choset and Wolf had a eureka moment, and found a way to design a robotic snake

small enough, strong enough and flexible enough to fit inside the human body. They partnered with the

world-renowned Italian surgeon Prof. Marco Zenati, now at the University of Pittsburgh School of

Medicine, and formed Cardiorobotics and their first snake-based device, the CardioARM.

A minimally invasive bypass

"It cuts down the need for any 'open' surgery," Wolf tells ISRAEL21c. "More and more surgery done

today is done in minimally invasive ways. Tools in operation rooms are not flexible. The CardioARM is

flexible enough for remote and hard to reach anatomies. The heart is a good example... now we don't

have to cut open the person."

The CardioARM has been used to treat the hearts of pigs, and clinical trials on human patients are

expected to start this year. While robotic devices that enable specialists to perform heart operations in a

minimally invasive way, do exist, the technology has not been refined enough to let more than the

expert perform with it.


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What the new CardioARM does is open up a whole new world, a field where open-heart surgeries can

be done with a small incision; where recovery time will be reduced, and hospital-related infections and

complications due to surgery drastically cut down.

Most of all though, Wolf suspects, it will allow specialists to perform more complex medical procedures.

"There are specialists and there are surgeons. In between specialists and surgeons there is a twilight

zone -- we are trying to bridge this zone," he says.

In the United States alone, there are over one million cardiac procedures performed annually which

could benefit from the CardioARM. But it will take some years before the robotic snake makes an

appearance at a hospital near you.

New medical devices take time until they pass through regulatory bodies in America. Conservatively

speaking, it will take a few years until this new CardioARM is widely used, says Wolf, but it paves the

wave for the day when doctors will never have to cut open the body during surgery.

Snaking through the body like nothing else

Other surgical assistants in the market have severe limitations says the company. One called the da Vinci

system needs five or six entry points, and cannot squeeze through tight locations.

"We are working to just have a single port in the body and from that point being able to reach any

location," said Zenati in an interview. "There is no technology that allows one to do that. The only one is

the CardioARM."

Besides bypass surgeries on the heart, the CardioARM or a modification of it, could be applied in the

areas of laparoscopy, colonoscopy, and arthroscopy, say developers. Like playing a video game, theCardioArm is controlled by a joystick and gives 103 degrees of freedom, and can wrap around organs like

the heart until it finds the problematic tissue.

The central element of the CardioARM technology is a tele-operated probe, which is highly flexible,

either assuming the shape of its surroundings, or reshaped according to the surgeon's needs.

As it moves through the body, it is programmed to "remember" where it was in space and time, to avoid

harming delicate tissues as it retracts from any point. A working channel inside the body of the "snake"

allows surgeons to pass tools to deep regions inside the body, behind organs to reach places that were

otherwise impossible to access without a scalpel and saw.

Based in the United States, the snake-like probe is now being commercialized by Cardiorobotics, which

was co-founded by Wolf, Choset and Zenati. The company was founded in 2005, and about seven

people work for it. Grants from the National Institute of Health, as well as the Pittsburgh Life Science

Greenhouse, have funded the early development stage of the device.

No scalpels in our future?


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A modification of the robotic arm can make the device applicable in abdominal surgery, as well as in the

mouth. The company hopes to one day allow the CardioARM to be inserted through one location, with

several arms like tentacles, so each arm could operate in unison on a different part of the body.

"In the future 100 percent of the surgeries will be done in a non-invasive way," says Wolf. "Who knows

when, maybe 100 or 200 years from now. Our device is one of the steps toward this and will allow

surgeons to do the things they cannot do today."

Written By Karin Kloosterman

Source

http://www.israel21c.org

http://www.medicalnewstoday.com/articles/136677.php

For Goodness SnakeThe pressure is always on medical innovators to find new ways of less-invasive surgery. Howie Choset of

Carnegie Mellon University tells Lorrie Kelly how he and his team are working on a miniaturised snake

robot to cure, not kill.

Date: 30 Mar 2009

Small snake robots used for surgery have captured the imaginations of some of the world's topinnovators. Howie Choset, associate professor of Robotics at Carnegie Mellon University is no

exception. His involvement with the technology began in the 1990s and this year will see histeam conducting their first human clinical trials using a snake robot.

A successful outcome could mean an explosion in the number of minimally invasive cardiacprocedures when these devices reach the market in three years time.

Choset discusses the journey from concept to surgical arena for his breakthrough cardiac snake

CardioARM. Choset's team, at Cardiorobotics Inc, has been developing the CardioARM (Articulated


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Robotic MedProbe) for several years. The device is a teleoperated probe with a non-linear lumen

comprised of a series of highly flexible links, capable of assuming the shape of its surroundings or being

reshaped according to need.

The probe remembers previous configurations as it moves through a three-dimensional volume,

thereby reducing the risk of damaging surrounding tissue when retracting. The links can be madeof almost any material and can also be disposable. But what makes the CardioARM vastlydifferent from other minimally invasive cardiac surgery methods is it requires only a single entrypoint, whereas other surgical systems such as da Vinci can require as many as five or six.

The beginning

"The idea is, if you can make a robot device small enough to enter through the solar plexus,make a 2cm turn one way and then a 2cm turn another way and position this device behind theheart, you can then deliver a whole host of therapies and diagnostics which otherwise wouldhave required that you crack the chest," explains Choset. "So that idea/concept/wish to have a

small snake robot isn't new and one I personally have been thinking about since I went tograduate school at CalTech."

The idea for a small surgical snake robot initially came to Choset from his graduate schooladvisor Joel Burdick, who teamed up with two graduate students, Greg Chirikjian and AndrewBrett Slatkin in an attempt to flesh out the concept. The team was trying to develop a surgicalrobot for minimally invasive surgery on the intestines using a technology they termed "hyper-redundant robotics", meaning the machines have many different degrees of freedom similar toa snake.

Some years later, Marco Zenati, who is now a cardiac surgeon at the University of Pittsburgh,

gave a talk at Carnegie Mellon. He pretty much described a need for a small snake robot. He andChoset got together along with a third colleague, Alon Wolf, now a professor at the Technion inIsrael, and the three started surveying the field.

New discoveries

"At this point, my group had already built a few snake robots largely geared towards urbansearch and rescue, and one we built to do in-situ repairs on naval vessels," says Choset. "Youwant those robots to be as small as possible. They were only 45mm in diameter, which was thebest we could do at the time. It was in between writing the second and third grant that we workedout how to build the small snake robot.

"In fact, it is wonderful. I pretty much sat down and said "I'm going to figure this out right now".Twenty minutes later, the idea came to me. That never happens. I normally have other peoplearound me, distracting me. It may be the most profound thing I've ever figured out."

"The CardioARM uses four cables to "marionette the device", which the surgeon controls through a

computer and joystick."


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What made this revelation a breakthrough is that most people who try to make a small surgicalsnake robot try to develop new kinds of actuator technology, such as electric motors. Themuscles in your arms are actuators and people have even developed microelectromechanicalsystems (MEMS) technology with this in mind.

"Up until this point there were two types of small snake robots," explains Choset. "One groupwere made from novel actuators, which is great work. But these devices are not ready forprimetime, so those robots don't work yet.

"The others are made out of actuators that I call "imaginary actuators" because they don't exist,"he continues. "People say to make a small snake robot just use small motors and of course that"'not realistic. As to the other people who are funded to build small snake robots like iSnake inEngland, we have no idea how they are actuating that robot. Perhaps their application is differentand only limited to the luminal spaces whereas we are moving our robot around in the three-dimensional intracavity spaces.

Regardless, some people think those are just the details, shrink things down. But that is thecritical part, trying to make things small, strong and manoeuvrable, which is what we figured outthat day."

Pulling strings

The CardioARM uses four cables to "marionette the device", which the surgeon controls througha computer and joystick. "We shape the device however we want with these four cables and atthe same time we have a feeder mechanism that pushes the snake into the body," explainsChoset. "The combination of pushing and getting the shape allows us to access the desired area."

The smallest version of CardioARM measures 300mm in length and is 10mm in diameter. Theultimate goal for Choset and his team is a robot snake that can be used by non-surgeons throughsmall incisions.

Cardiorobotics has already completed 14 successful live pig operations as well as two cadaveroperations. The company expects to perform the first human operation by the end of 2009.Barring any unforeseen problems during surgical trials, the CardioARM should reach the marketin the next three years.

The key features of CardioARM are:

y Single-port access for deep anatomical proceduresy Small diameter and radius of curvaturey Unlimited degrees of freedomy Steerable, self-supported, non-linear therapeutic pathy Steerable, self-supported, non-linear visualisation pathy Teleoperated, with "joystick" and "pause" buttony Memory device remembers its configurationy Non-linear lumen


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y MR-compatibley Disposable.

Choset is quick to point out that none of this would have been possible within a universitysetting. Thanks to the advice of his long-time friend, Bill Thomasmyeyer, president of the

National Center for Defense Robotics in Pittsburgh's Tehnology Collaborative, Choset and histeam took the technology from the classroom to the boardroom.

"There is no way, as a professor being supported by government grant dollars, that I could havearrived at this so quickly," explains Choset. "To have this kind of result and success is mindboggling." The move opened up new channels of funding for the project, such as the PittsburghLife Science Greenhouse (PLSG). One of their advisors, Jim Jordan, saw great potential for thetechnology and gave the team a small grant which was used to hire an engineer. Jordan helpedcrystallise what the market could potentially look like, helped with strategy and eventuallyintroduced the team to its first real CEO. Without him, there would not have been a company.

"The ultimate goal for Choset and his team is a robot snake that can be used by non-surgeons throughsmall incisions."

"One of our founders is a cardiac surgeon but, just because he is, it doesn't necessarily mean thetarget application of what the company is looking at will be limited to cardiac," adds Choset. "Itjust so happens that, based on market need or interest, a lot of the applications for thistechnology are cardiac.

"One particular application we are looking at is ablation therapy. Currently, your chest has to becracked open in order to do this. Though there are endo-luminal approaches, they aren't perfect.You can have collateral damage to the oesophagus, and a small chance that a fatal clot could

form. With our device, you can perform an ablation in a completely minimally invasive way,through the subxiphoid process."

Though the initial outlay in terms of cost will undoubtedly be higher at the beginning, Chosetand his team believe the longer-term healthcare expenditure will be significantly reduced throughshorter hospital stays, reduced incidence of infection, faster recovery time and reduced post-operative pain.

What next?

At present, the CardioARM utilises a direct visualisation system that relies on the surgeon's in-

depth knowledge of anatomical structures in order to pinpoint the device's location within thebody. "We have a fibre optic that passes through the body of the snake," says Choset. "We arestarting to work with another company called Bluebelt Technologies. They are developingultrasound visual capabilities that will allow us to look at 3D rendered images with the snake,where we can see what it sees and have additional visualisation that way.

"This visualisation is just one small thing," he explains. "I'm working with another colleagueBaranco Jaramaz. We're trying to get a more refined image which will work for a NOTES


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(Natural Orifice Transluminal Endoscopic Surgery) application. So we can enter the mouth, pokea hole in the stomach, go through the stomach, go to the pancreas remove part of the pancreasand come back out without visible scars. I believe in England last year there were fourappendectomies done with a NOTES approach. But they used a floppy endoscope, whereas ourrobot will be able to access more places.

Choset also sees some use for removing the lymph nodes in the throat. There is one procedurethe team is looking at, for the treatment of hyperhidrosis (excessive sweating). "I bet you that assoon as we do one procedure, in two years you and I will be talking about the ten procedures thatother people thought of that make a lot more sense than what I'm telling you now," he concludes.The future seems bright for such an innovative technology.

http://www.medicaldevice-network.com/features/feature52480/

Friday, April 4, 2008

Robotic Snake May One Day Wrap Around Rod ofAsclepius

Filed under: Surgery

A collaboration between researchers at Carnegie Mellon University, University of Pittsburgh,and Technion University in Israel has produced a miniaturized robotic probe that may one dayreplace traditional laparoscopic devices. The system is being developed by a spin off startupCardiorobotics, Inc.

The CardioArm is operated using a computer and a joystick. It has 102 degrees of freedom, three of

which can be activated at once. This allows it to enter through a single point in the chest and wrap


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around the heart until it reaches the right spot to, say, remove problematic tissue. "The nice thing about

[the] design is that each joint follows where you went in space. That's not always possible in other

designs," says Webster. This kind of control prevents the probe from bumping into sensitive tissue. The

disadvantage of a jointed robot, however, is that it's harder to miniaturize, Webster says.


Zenati has used robotic surgical assistants in the past and notes that they all have limitations. Theda Vinci system, for example, can't "squeeze into tight locations within the human body" andrequires five or six entryways, he says.

Realizing the need for more-advanced robots for minimally invasive surgery, Zenati teamed upwith Howie Choset, a TR35 honoree known for his work at CMU on crawling robotic snakes,

and Alon Wolf, founder and director of the Biorobotics and Biometrics Lab at Technion, theIsrael Institute of Technology.

"We are working to just have a single port in the body and from that point being able to reachany location," says Zenati. "There is no technology that allows one to do that. The only one is theCardioArm."

http://www.medgadget.com/archives/2008/04/robotic_snake_may_one_day_wrap_around_rod_of_as

clepius.html

BiomedicineSnakelike Robots for Heart Surgery

(Page 2 of 2)

y Friday, April 4, 2008y By Kristina Grifantini


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Snakes in hearts: The snakelike CardioArm moves around inside the membrane encasing a

pigs heart.Credit: Amir Degani

"For minimally invasive surgery, you either have a linear laparoscope that's rigid or a flexibleendoscope that buckles easily; there's nothing that's both flexible and rigid," says Choset. But theCardioArm "has the benefits of both," he says.

"I think what Howie has is a good platform for getting at the [surgical] site," saysNabil Simaan,an assistant professor at Columbia University who is working on insertable, snakelike probes forthe abdomen.

The team hopes to start testing the CardioArm in natural-orifice surgery--a technique wheretissues are removed through existing openings in the body, such as the mouth, to avoidpostoperative pain and reduce recovery time. Zenati aims to have surgeons use CardioArms inunison, like "an octopus, with two or three tentacles" all entering through one incision and thenbranching out.

http://www.technologyreview.com/biomedicine/20516/page2/?a=f

Heart Surgeons Recruit Slithering Robot

Posted 7 Apr 2008 at 01:53 UTC by Rog-a-matic

Carnegie Mellon's CardioArm is aimed at helping surgeons perform heart surgery using only asingle, tiny incision. The system outperforms standard endoscopic tools because it can beprogrammed to follow the surgeon-directed head automatically. The 102 joints are able to wraparound organs and slither through narrow pathways avoiding delicate tissue. The benefits will bereduced blood loss, decreased pain and shorter hospital stays. Startup Cardiorobotics is


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perfecting the snake-like robot and has already performed successful surgeries on pigs andhuman cadavers. The ultimate goal is to miniaturize the system to fit inside of blood vessels.

http://robots.net/article/2513.html

Snakebot Worms Its Way Into Your Heart, Literally

POSTED BY: Evan Ackerman / Mon, February 21, 2011

Next time you need heart surgery, this little snakebot is going to make himself right at homedeep inside your chest via a small hole in your solar plexus. It's CardioARM, and don't panic,he's here to help. Developed by CMU's Howie Choset, CardioARM has 102 joints (plus a camerafor a head) and can be directed to slither around your vital organs with the utmost precision,

making it unnecessary to 'crack open your chest,' which is apparently what they normally dowhen your ticker needs an overhaul.

Last February, CardioARM was successfully tested on a human for the first time, performing adiagnostic heart mapping procedure, which sounds like it was probably a pile o' fun for everyoneinvolved. Dr. Choset has bigger plans for his snakebots, though:

"He hopes to test the device in othersurgeries,such as ablationwhich involves burning away asmall amount of heartmuscle to correct an abnormal beat."

Burning? Burning, you say? What, with lasers? We're giving these flesh-burrowing robot snakes

lasers now? What else?!

Were hoping to use a remote-controlled robot to go through small cavesin Egypt, [Choset]

says,and find remains of ancient Egyptian tombs.

http://spectrum.ieee.org/automaton/robotics/medical-robots/snakebot-worms-its-way-into-your-

heart-literally


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Tuesday, April 12, 2011

CardioArm Surgical Snake Will Worm its Way Into Your Heart

A snakelike surgical robot from Carnegie MellonUniversity could let a surgeon performing a critical heart operation make just one incision.

Known as the CardioArm, the curved robot has a series of joints that automatically adjust tofollow the course plotted by the robots head. This provides greater precision than a flexibleendoscope can offer. Its certainly easier to control, says Robert Webster III, a professor atVanderbilt University who works on flexible medical probes and was not involved in theCardioArm project.

The CardioArm is operated using a computer and a joystick. It has 102 degrees of freedom, three

of which can be activated at once. This allows it to enter through a single point in the chest andwrap around the heart until it reaches the right spot to, say, remove problematic tissue. The nicething about [the] design is that each joint follows where you went in space. Thats not alwayspossible in other designs, says Webster. This kind of control prevents the probe from bumpinginto sensitive tissue. The disadvantage of a jointed robot, however, is that its harder tominiaturize, Webster says.



Realizing the need for more-advanced robots for minimally invasive surgery, Zenati teamed upwith Howie Choset, a TR35 honoree known for his work at CMU on crawling robotic snakes,


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and Alon Wolf, founder and director of the Biorobotics and Biometrics Lab at Technion, theIsrael Institute of Technology.

We are working to just have a single port in the body and from that point being able to reachany location, says Zenati. There is no technology that allows one to do that. The only one is

the CardioArm.

The probe is currently being developed by the startup Cardiorobotics, formerly known asInnovention Technologies, which Zenati and Choset founded in 2005. So far, the team hasperformed successful cardiovascular surgeries on nine pigs and two human cadavers, saysChoset. According to the companys website, live human trials should begin later this year.

http://www.techblog.ws/health/cardioarm-surgical-snake-will-worm-its-way-into-your-heart/

Friday, April 4, 2008

Robotic Snake May One Day Wrap Around Rod ofAsclepius

A collaboration between researchers at Carnegie Mellon University, University of Pittsburgh,

and Technion University in Israel has produced a miniaturized robotic probe that may one dayreplace traditional laparoscopic devices. The system is being developed by a spin off startupCardiorobotics, Inc.

The CardioArm is operated using a computer and a joystick. It has 102 degrees of freedom, three of

which can be activated at once. This allows it to enter through a single point in the chest and wrap

around the heart until it reaches the right spot to, say, remove problematic tissue. "The nice thing about


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[the] design is that each joint follows where you went in space. That's not always possible in other

designs," says Webster. This kind of control prevents the probe from bumping into sensitive tissue. The

disadvantage of a jointed robot, however, is that it's harder to miniaturize, Webster says.

The smallest version of the device is 300 millimeters long and has a diameter of 12 millimeters.

Eventually, the CMU researchers hope to make a snake small enough to enter the bloodstreamthrough a blood vessel, says Marco Zenati, one of the principal researchers on the CardioArmproject and a professor of surgery at the University of Pittsburgh.

Zenati has used robotic surgical assistants in the past and notes that they all have limitations. Theda Vinci system, for example, can't "squeeze into tight locations within the human body" andrequires five or six entryways, he says.

Realizing the need for more-advanced robots for minimally invasive surgery, Zenati teamed upwith Howie Choset, a TR35 honoree known for his work at CMU on crawling robotic snakes,and Alon Wolf, founder and director of the Biorobotics and Biometrics Lab at Technion, the

Israel Institute of Technology.

"We are working to just have a single port in the body and from that point being able to reachany location," says Zenati. "There is no technology that allows one to do that. The only one is theCardioArm."

http://medgadget.com/archives/2008/04/robotic_snake_may_one_day_wrap_around_rod_of_asclepiu

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Surgery? Border patrol? Israeli robots can do it all

Karin Kloosterman - 21C, March 17th, 2011


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Down the hall from Shoham at the Technion is the lab of Prof. Alon Tal, whose snake robotfor endoscopic heart surgery is now in commercial development. The snake-like robot can bemaneuvered around organs for better control and vision during keyhole surgical procedures.

CardioArm's unique snake-like robot can be maneuvered around organs for better control and

vision during keyhole surgical procedures.

http://www.israelunitycoalition.org/news/?p=6526

Feb 16

Robotics Take a New TurnLiterally

CardiologyAdd comments

First, there was a three-armed surgical robot. Then, an orthopedic robot came along. Whats

next? A robotic snake? As a matter of fact, yes. Think about being able to reach just about anyregion of the body with one incision. Cardiorobotics was first founded in 2005 and is developingthe cardioARM, a snake robot for minimally-invasive cardiac interventions, such astreatments for patients suffering with heart arrhythmias. With the 10mm diameter computer-controlled device that allows for 105 degrees of freedom, a lot can be achieved.

Since the first voice-controlled endoscope positioning robot (Aesop 3000) was FDA approved inthe late 1990s, the technology has been constantly evolving. Driven by the promise of moreaccurate and less invasive surgical procedures, the market has a projected worth of $1.5 billion inthe US by 2014. Now, with multiple robotic technologies in use, the most asked question is:What added advantage does the cardioARM offer patients and surgeons?

According to studies, the cardioARM is able to reach the entire surface of the heart through asingle port and without the need of X-ray guidance because of its design. Early studies alsoshowed that the cardioARM was able to perform minimally invasive epicardial ablation over allsurfaces of the heart.

I discussed the possibilities of flexible robotic systems with Samuel C. Dudley, Jr., MD, PhD,associate professor of Medicine and Physiology at Emory University, chief of the Division ofCardiology at Atlanta VAMC in Decatur, GA, and a leading researcher in cardiovasculardiseases. He explained, The main use of existing robotics has been for operating at a distanceand minimizing the invasiveness of cardiac surgery procedures. Any catheter that can be steered

and moved in multiple directions would be helpful because there are a lot of bends, turns, andangles that have to be achieved in order to get to some of these places within the body. So, themore adaptable the device, the more therapies it would be helpful for.

What is so compelling is that there is a whole range of exciting new cardiology focused therapiesbeing developed. They encompass a wide range of mapping, cell and ablation therapies, as wellas new mechanical devices. As these systems become available, they will require a moreaccurate delivery platform to be effective. I am anxious to see how this all comes together.


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A robotic snake to fix broken hearts and organs

By Karin Kloosterman

January 12, 2009


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A unique snake-like robot co-developed by Israeli and American researchers gets behind organs, to perform vital surgery

inside the body.

A snake is probably the last thing you'd everwant crawling around your heart. But in the case of a

new American-Israeli invention called the CardioARM, this medical "snake" device may one day save

your life.

The new Israeli-American invention came by way of some brainstorming between Israel's Dr. Alon Wolf

and his American colleague Prof. Howie Choset, when Wolf was working as a researcher at Carnegie

Mellon University in the US.

"Both Howie and myself are experts in snake robotics," says Wolf, who is now based at the Technion-

Israel Institute of Technology in Haifa. "We are working with robotic snakes for search and rescue

operations. So we started in the back of our minds thinking: if we can send snakes to crawl inside

buildings to look for survivors, then why can't we send the same snake inside our body to fix it?"

A few weeks later, Choset and Wolf had a eureka moment, and found a way to design a robotic snake

small enough, strong enough and flexible enough to fit inside the human body. They partnered with the

world-renowned Italian surgeon Prof. Marco Zenati, now at the University of Pittsburgh School of

Medicine, and formed Cardiorobotics and their first snake-based device, the CardioARM.

A minimally invasive bypass

"It cuts down the need for any 'open' surgery," Wolf tells ISRAEL21c. "More and more surgery done

today is done in minimally invasive ways. Tools in operation rooms are not flexible. The CardioARM is

flexible enough for remote and hard to reach anatomies. The heart is a good example... now we don't

have to cut open the person."

The CardioARM has been used to treat the hearts of pigs, and clinical trials on human patients are

expected to start this year. While robotic devices that enable specialists to perform heart operations in a

minimally invasive way, do exist, the technology has not been refined enough to let more than the

expert perform with it.

What the new CardioARM does is open up a whole new world, a field where open-heart surgeries can

be done with a small incision; where recovery time will be reduced, and hospital-related infections and

complications due to surgery drastically cut down.

Most of all though, Wolf suspects, it will allow specialists to perform more complex medical procedures.


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"There are specialists and there are surgeons. In between specialists and surgeons there is a twilight

zone -- we are trying to bridge this zone," he says.

In the United States alone, there are over one million cardiac procedures performed annually which

could benefit from the CardioARM. But it will take some years before the robotic snake makes an

appearance at a hospital near you.

New medical devices take time until they pass through regulatory bodies in America. Conservatively

speaking, it will take a few years until this new CardioARM is widely used, says Wolf, but it paves the

wave for the day when doctors will never have to cut open the body during surgery.

Snaking through the body like nothing else

Other surgical assistants in the market have severe limitations says the company. One called the da Vinci

system needs five or six entry points, and cannot squeeze through tight locations.

"We are working to just have a single port in the body and from that point being able to reach any

location," said Zenati in an interview. "There is no technology that allows one to do that. The only one is

the CardioARM."

Besides bypass surgeries on the heart, the CardioARM or a modification of it, could be applied in the

areas of laparoscopy, colonoscopy, and arthroscopy, say developers. Like playing a video game, the

CardioArm is controlled by a joystick and gives 103 degrees of freedom, and can wrap around organs like

the heart until it finds the problematic tissue.

The central element of the CardioARM technology is a tele-operated probe, which is highly flexible,

either assuming the shape of its surroundings, or reshaped according to the surgeon's needs.

As it moves through the body, it is programmed to "remember" where it was in space and time, to avoid

harming delicate tissues as it retracts from any point. A working channel inside the body of the "snake"

allows surgeons to pass tools to deep regions inside the body, behind organs to reach places that were

otherwise impossible to access without a scalpel and saw.

Based in the United States, the snake-like probe is now being commercialized by Cardiorobotics, which

was co-founded by Wolf, Choset and Zenati. The company was founded in 2005, and about seven

people work for it. Grants from the National Institute of Health, as well as the Pittsburgh Life Science

Greenhouse, have funded the early development stage of the device.

No scalpels in our future?

A modification of the robotic arm can make the device applicable in abdominal surgery, as well as in the

mouth. The company hopes to one day allow the CardioARM to be inserted through one location, with


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snakelike robots for heart surgery

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