Today's surgical robots employ generalized end effectors that directly extend the motions, capabilities, and limitations of a surgeon's own hands. These robots give surgeons the ability to work on very small scales, with great precision, and through smaller incisions. They provide direct visualization through the use of magnified 3-D images and greater accuracy through motion scaling and active filtering of hand tremors. In the specific field of cardiac surgery, minimally invasive robot-assisted (MIRA) procedures show improvements in patient satisfaction and key outcome parameters including decreases in overall hospital stays. Unfortunately, these gains have been offset by significantly increased operative times, resulting in increased overall healthcare costs. Based on East Carolinas University's experience in MIRA mitral valve repairs, patient bypass times are currently increased approximately 60% (2.6 hours with MIRA vs. 1.5 hours using conventional procedures). It is evident that specific technological advancements could significantly decrease MIRA mitral valve repair times. Surgeons and researchers working in this field expect that costs will dramatically decrease as surgeons and medical device manufacturers collaboratively develop robotic tools and technologies specifically suited for MIRA cardiac procedures. Additionally, these procedures could be made less invasive with """"""""totally-endoscopic"""""""" technologies. Accordingly, the specific aims of this multidisciplinary research program focus on developing technologies that facilitate and extend the capabilities of MIRA cardiac surgery. These include: (1) Devices for rapid and secure fixation of suture materials and prosthetic devices: specifically instruments and cartridges that provide """"""""push-button"""""""" fixation for specific procedures (e.g. atrial closure and leaflet repair) using both existing suture materials and advanced clips and staples. (2) Endoscopic retractors to improve visualization of essential cardiac structures: endoscopically-deployable retractors that utilize the superelastic properties of Nitinol to facilitate totally closed surgical procedures. (3) Systems to aid the surgeon in incision planning, robotic navigation, and operative training: technology that can be used to measure and register critical anatomical landmarks with pre-operative and intra-operative spatial data to identify optimal port placement and robot instrument trajectories.
