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用于在跳动心脏上进行导航和干预的移动机器人设备的初步评估。

Preliminary evaluation of a mobile robotic device for navigation and intervention on the beating heart.

作者信息

Patronik N A, Zenati M A, Riviere C N

机构信息

The Robotics Institute, Carnegie Mellon University, Pennsylvania 15213, USA.

出版信息

Comput Aided Surg. 2005 Jul;10(4):225-32. doi: 10.3109/10929080500230197.

Abstract

This article describes the development and preliminary testing of a mobile robotic device to facilitate minimally invasive beating-heart intrapericardial intervention. The HeartLander robot will be introduced beneath the pericardium via subxiphoid incision, adhere to the epicardium, navigate to any location, and administer therapy under the control of the physician. As compared to current robotic cardiac surgical techniques, this novel paradigm obviates immobilization of the heart and eliminates access limitations. Furthermore, it does not require lung deflation and differential ventilation and thus could enable outpatient cardiac surgery. The current HeartLander prototypes use suction to maintain prehension of the epicardium and wire actuation to perform locomotion. A fiber optic videoscope displays visual feedback to the physician, who controls the device through a joystick interface. The initial prototype demonstrated successful prehension, turning, and locomotion on open-chest, beating-heart porcine models where the pericardium was removed (N = 3). A smaller second-generation prototype with an injection system demonstrated locomotion and myocardial injection of dye, both performed with the pericardium intact (N = 3). These trials illustrate the feasibility of using a miniature mobile robot to navigate upon the beating heart and perform intrapericardial therapy.

摘要

本文介绍了一种用于促进微创心脏跳动心包内干预的移动机器人设备的开发和初步测试。HeartLander机器人将通过剑突下切口引入心包下方,附着于心外膜,导航至任何位置,并在医生的控制下进行治疗。与当前的机器人心脏手术技术相比,这种新范式无需固定心脏并消除了通路限制。此外,它不需要肺萎陷和不同的通气方式,因此可以实现门诊心脏手术。当前的HeartLander原型使用吸力来维持心外膜的抓持,并通过钢丝驱动来进行移动。光纤视频镜向医生显示视觉反馈,医生通过操纵杆界面控制该设备。最初的原型在去除心包的开胸、心脏跳动猪模型上(N = 3)展示了成功的抓持、转向和移动。带有注射系统的第二代较小原型展示了在心包完整的情况下进行移动和心肌染料注射(N = 3)。这些试验说明了使用微型移动机器人在跳动的心脏上导航并进行心包内治疗的可行性。

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