Endoscopic surgery on the beating heart has become a major research objective due to the morbidity associated with median sternotomy and cardiopulmonary bypass. The motion of the beating heart creates significant problems for ac- curate manipulation. In addition, most existing techniques for minimally invasive cardiac surgery involve the use of thoracoscopic incisions and rigid endoscopes, making access to certain parts of the epicardium highly problematic. We hypothesize that for many clinical procedures the problems of beating heart motion and full epicardial access can be solved simultaneously by developing a miniature detachable robotic device that adheres to the heart using suction and travels like an inchworm across the surface, connected to the outside world only by a wire or tether for communication and power. Because this device can move to any desired point on the epicardial surface, a subxiphoid videopericardioscopic approach can be used instead of thoracoscopy. As a result, selective lung ventilation is not needed. By obviating endotracheal intubation, this technology will allow the use of local or regional rather than general anesthesia, creating the potential for ambulatory outpatient cardiac surgery for certain procedures. Potential clinical applications are numerous; as an exemplary application we propose to demonstrate the technology in myocardial injection, such as is used for delivery of myoblasts for cardiac revascularization.
The specific aims are to: 1. Develop a self-contained detachable tethered epicardial crawling device (HeartLander) that can enter the pericardium via endoscope, attach itself to the unconstrained beating heart, and maneuver itself to establish a suitably stable worksite at any location specified by the surgeon. 2. Develop the necessary surgical end-effectors or tools to enable the HeartLander to perform accurate injections into the myocardium. 3. Test the technology preclinical in an anthropomorphic beating-heart phantom or dummy. 4. Test the safety and capability of the technology in vivo in a porcine model.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
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Bioengineering, Technology and Surgical Sciences Study Section (BTSS)
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Baldwin, Tim
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Carnegie-Mellon University
Schools of Arts and Sciences
United States
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Meglan, Dwight A; Lv, Wener; Cohen, Richard J et al. (2017) Techniques for epicardial mapping and ablation with a miniature robotic walker. Robot Surg 4:25-31
Wood, Nathan A; Schwartzman, David; Zenati, Marco A et al. (2017) Physiological motion modeling for organ-mounted robots. Int J Med Robot 13:
Zhu, Yang; Wood, Nathan A; Fok, Kevin et al. (2016) Design of a Coupled Thermoresponsive Hydrogel and Robotic System for Postinfarct Biomaterial Injection Therapy. Ann Thorac Surg 102:780-786
Costanza, Adam D; Breault, Macauley S; Wood, Nathan A et al. (2016) Parallel Force/Position Control of an Epicardial Parallel Wire Robot. IEEE Robot Autom Lett 1:1186-1191
Breault, Macauley S; Costanza, Adam D; Wood, Nathan A et al. (2015) Auto-Calibration for a Planar Epicardial Wire Robot. Proc IEEE Annu Northeast Bioeng Conf 2015:
Breault, Macauley S; Costanza, Adam D; Wood, Nathan A et al. (2015) Toward hybrid force/position control for the Cerberus epicardial robot. Conf Proc IEEE Eng Med Biol Soc 2015:7776-9
Costanza, Adam D; Wood, Nathan A; Passineau, Michael J et al. (2014) A parallel wire robot for epicardial interventions. Conf Proc IEEE Eng Med Biol Soc 2014:6155-8
Wood, Nathan A; Waugh, Kevin; Liu, Tian Yu Tommy et al. (2013) Space-Time Localization and Registration on the Beating Heart. Rep U S 2012:3792-3797
Tortora, Giuseppe; Glass, Paul; Wood, Nathan et al. (2012) Investigation of bioinspired gecko fibers to improve adhesion of HeartLander surgical robot. Conf Proc IEEE Eng Med Biol Soc 2012:908-11
Patronik, Nicholas A; Ota, Takeyoshi; Zenati, Marco A et al. (2012) Synchronization of epicardial crawling robot with heartbeat and respiration for improved safety and efficiency of locomotion. Int J Med Robot 8:97-106

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