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Currie ME, Talasaz A, Rayman R, Chu MWA, Kiaii B, Peters T, Trejos AL, Patel R. The role of visual and direct force feedback in robotics-assisted mitral valve annuloplasty. Int J Med Robot 2016; 13. [PMID: 27862833 DOI: 10.1002/rcs.1787] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 08/10/2016] [Accepted: 10/05/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND The objective of this work was to determine the effect of both direct force feedback and visual force feedback on the amount of force applied to mitral valve tissue during ex vivo robotics-assisted mitral valve annuloplasty. METHODS A force feedback-enabled master-slave surgical system was developed to provide both visual and direct force feedback during robotics-assisted cardiac surgery. This system measured the amount of force applied by novice and expert surgeons to cardiac tissue during ex vivo mitral valve annuloplasty repair. RESULTS The addition of visual (2.16 ± 1.67), direct (1.62 ± 0.86), or both visual and direct force feedback (2.15 ± 1.08) resulted in lower mean maximum force applied to mitral valve tissue while suturing compared with no force feedback (3.34 ± 1.93 N; P < 0.05). CONCLUSIONS To achieve better control of interaction forces on cardiac tissue during robotics-assisted mitral valve annuloplasty suturing, force feedback may be required.
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Affiliation(s)
- Maria E Currie
- Division of Cardiac Surgery, Department of Surgery, London Health Sciences Centre, London, Ontario, Canada.,Canadian Surgical Technologies and Advanced Robotics, Lawson Health Research Institute, London, Ontario, Canada.,Medical Imaging Laboratory, Robarts Research Institute, Western University, London, Ontario, Canada
| | - Ali Talasaz
- Canadian Surgical Technologies and Advanced Robotics, Lawson Health Research Institute, London, Ontario, Canada
| | - Reiza Rayman
- Division of Cardiac Surgery, Department of Surgery, London Health Sciences Centre, London, Ontario, Canada.,Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Michael W A Chu
- Division of Cardiac Surgery, Department of Surgery, London Health Sciences Centre, London, Ontario, Canada.,Canadian Surgical Technologies and Advanced Robotics, Lawson Health Research Institute, London, Ontario, Canada.,Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Medical Imaging Laboratory, Robarts Research Institute, Western University, London, Ontario, Canada
| | - Bob Kiaii
- Division of Cardiac Surgery, Department of Surgery, London Health Sciences Centre, London, Ontario, Canada.,Canadian Surgical Technologies and Advanced Robotics, Lawson Health Research Institute, London, Ontario, Canada.,Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Medical Imaging Laboratory, Robarts Research Institute, Western University, London, Ontario, Canada
| | - Terry Peters
- Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Medical Imaging Laboratory, Robarts Research Institute, Western University, London, Ontario, Canada
| | - Ana Luisa Trejos
- Department of Electrical and Computer Engineering, Western University, London, Ontario, Canada.,Canadian Surgical Technologies and Advanced Robotics, Lawson Health Research Institute, London, Ontario, Canada
| | - Rajni Patel
- Department of Electrical and Computer Engineering, Western University, London, Ontario, Canada.,Canadian Surgical Technologies and Advanced Robotics, Lawson Health Research Institute, London, Ontario, Canada.,Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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Siefert AW, Siskey RL. Bench Models for Assessing the Mechanics of Mitral Valve Repair and Percutaneous Surgery. Cardiovasc Eng Technol 2015; 6:193-207. [PMID: 26577235 DOI: 10.1007/s13239-014-0196-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 09/19/2014] [Indexed: 01/01/2023]
Abstract
Rapid preclinical evaluations of mitral valve (MV) mechanics are currently best facilitated by bench models of the left ventricle (LV). This review aims to provide a comprehensive assessment of these models to aid interpretation of their resulting data, inform future experimental evaluations, and further the translation of results to procedure and device development. For this review, two types of experimental bench models were evaluated. Rigid LV models were characterized as fluid-mechanical systems capable of testing explanted MVs under static and or pulsatile left heart hemodynamics. Passive LV models were characterized as explanted hearts whose left side is placed in series with a static or pulsatile flow-loop. In both systems, MV function and mechanics can be quantitatively evaluated. Rigid and passive LV models were characterized and evaluated. The materials and methods involved in their construction, function, quantitative capabilities, and disease modeling were described. The advantages and disadvantages of each model are compared to aid the interpretation of their resulting data and inform future experimental evaluations. Repair and percutaneous studies completed in these models were additionally summarized with perspective on future advances discussed. Bench models of the LV provide excellent platforms for quantifying MV repair mechanics and function. While exceptional work has been reported, more research and development is necessary to improve techniques and devices for repair and percutaneous surgery. Continuing efforts in this field will significantly contribute to the further development of procedures and devices, predictions of long-term performance, and patient safety.
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Affiliation(s)
- Andrew W Siefert
- Exponent Failure Analysis Associates, 3440 Market Street Suite 600, Philadelphia, PA, 19104, USA.
| | - Ryan L Siskey
- Exponent Failure Analysis Associates, 3440 Market Street Suite 600, Philadelphia, PA, 19104, USA
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Canale LS, Mick S, Mihaljevic T, Nair R, Bonatti J. Robotically assisted totally endoscopic coronary artery bypass surgery. J Thorac Dis 2014; 5 Suppl 6:S641-9. [PMID: 24251021 DOI: 10.3978/j.issn.2072-1439.2013.10.19] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 10/29/2013] [Indexed: 01/06/2023]
Abstract
Robotically assisted totally endoscopic coronary artery bypass surgery has emerged as a feasible and efficient alternative to conventional full sternotomy coronary artery bypass graft surgery in selected patients. This minimally invasive approach using the daVinci robotic system allows fine intrathoracic maneuvers and excellent view of the coronary arteries. Both on-pump and off-pump operations can be performed to treat single and multivessel disease. Hybrid approaches have the potential of offering complete revascularization with the "best of both worlds" from surgery (internal mammary artery anastomosis in less invasive fashion) and percutaneous coronary intervention (least invasive approach). In this article we review the indications, techniques, short and long term results, as well as current developments in totally endoscopic robotic coronary artery bypass operations.
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