Symposium on surgical robotics — Invited talks: Robotic percutaneous beating-heart intracardiac surgery

Image-guided minimally invasive surgery has revolutionized the standard of care throughout the body. The use of catheters in cardiology, for example, has substantially reduced the risk and trauma for the patient in comparison to open-heart surgery. Many intracardiac repairs, however, require manipulating tissue in ways that cannot be achieved by catheters and so still require open surgery. In this talk, I will describe a robotic technology and surgical tool set that my group is developing to convert these intracardiac repairs to percutaneous, beating-heart interventions. The robotic technology is based on concentrically combining pre-curved elastic tubes. Coordinated motorized control of individual tube rotations and translations enables the robot to be navigated through the vasculature and into the heart. Once the surgical site is reached, the distal sections of the robot can deploy and manipulate tools to perform the repair. The robot forms a slender curve comparable in cross section to a catheter, but with a substantially higher tip stiffness. We have developed tools for the fundamental surgical tasks of tissue removal and tissue approximation. Our surgical tools are manufactured using a metal MEMS process that produces fully assembled, millimeter-scale devices with micron-scale features. The potential of these technologies as well as our current challenges will be illustrated through ex vivo and in vivo experimental results.