GyroLock: Stabilizing the Heart With Control Moment Gyroscope (CMG)—From Concept to First In Vivo Assessments

We present herein an original solution to actively stabilize the epicardium in the context of beating-heart coronary artery bypass grafting. Our solution uses a control moment gyroscope to generate the compensation torque and an accelerometer for sensing. This approach makes the designed system completely independent from the stabilizing instrument, as well as independent from any external measurement. We compare two control approaches in a simulation: The first one uses a Kalman filter with a harmonic disturbance model, and the second one uses an adaptive algorithm. Results highlight the superiority of the adaptive control for our application. The first in vivo assessments are presented, showing the efficiency of the principle under real conditions. Using only accelerometric measurements, targeted cardiac motion harmonics are reduced on the order of 68%. With an optical sensor, the reduction exceeds 90%. This constitutes an improvement compared with prior solutions, despite the presence of nonnegligible uncertainties and distant sensing.

[1]  Robert D. Howe,et al.  An active motion compensation instrument for beating heart mitral valve surgery , 2007, 2007 IEEE/RSJ International Conference on Intelligent Robots and Systems.

[2]  P D Verdouw,et al.  Reduction in thrombotic events with heparin-coated Palmaz-Schatz stents in normal porcine coronary arteries. , 1996, Circulation.

[3]  Yoshihiko Nakamura,et al.  Heartbeat synchronization for robotic cardiac surgery , 2001, Proceedings 2001 ICRA. IEEE International Conference on Robotics and Automation (Cat. No.01CH37164).

[4]  S. Pauker,et al.  A meta-analysis of randomized controlled trials comparing coronary artery bypass graft with percutaneous transluminal coronary angioplasty: one- to eight-year outcomes. , 2003, Journal of the American College of Cardiology.

[5]  Hiroo Iwata,et al.  Development of a non-grounded haptic interface using the gyro effect , 2003, 11th Symposium on Haptic Interfaces for Virtual Environment and Teleoperator Systems, 2003. HAPTICS 2003. Proceedings..

[6]  Volkmar Falk,et al.  Comparison of stenting with minimally invasive bypass surgery for stenosis of the left anterior descending coronary artery. , 2002, The New England journal of medicine.

[7]  R. Brodman,et al.  Technique for harvesting the radial artery as a coronary artery bypass graft. , 1995, The Annals of thoracic surgery.

[8]  P M Rautaharju,et al.  Arterial wall thickness is associated with prevalent cardiovascular disease in middle-aged adults. The Atherosclerosis Risk in Communities (ARIC) Study. , 1995, Stroke.

[9]  Edouard Laroche,et al.  An active cardiac stabilizer based on gyroscopic effect , 2009, 2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[10]  R. A. Shenoi,et al.  A new active gyrostabiliser system for ride control of marine vehicles , 2007 .

[11]  Edouard Laroche,et al.  Methodological Insights for Online Estimation of Induction Motor Parameters , 2008, IEEE Transactions on Control Systems Technology.

[12]  Edouard Laroche,et al.  A cardiac motion compensation device based on gyroscopic effect , 2009 .

[13]  L. W. Tsai,et al.  Robot Analysis: The Mechanics of Serial and Parallel Ma-nipulators , 1999 .

[14]  V. Falk,et al.  Feasibility, safety, and efficacy of totally endoscopic coronary artery bypass grafting: multicenter European experience. , 2007, The Journal of thoracic and cardiovascular surgery.

[15]  Edouard Laroche,et al.  A Heart Stabilization Device Exploiting Gyroscopic Actuation: Design and Control , 2010 .

[16]  Scott C. Douglas,et al.  Adaptive algorithms for the rejection of sinusoidal disturbances with unknown frequency , 1996, Autom..

[17]  W. Boyd,et al.  Off-pump surgery decreases postoperative complications and resource utilization in the elderly. , 1999, The Annals of thoracic surgery.

[18]  Marc Bodson,et al.  Performance of an adaptive algorithm for sinusoidal disturbance rejection in high noise , 2001, Autom..

[19]  Luc Soler,et al.  Active filtering of physiological motion in robotized surgery using predictive control , 2005, IEEE Transactions on Robotics.

[20]  Robert H. Anderson,et al.  Anatomy of the pig heart: comparisons with normal human cardiac structure , 1998, Journal of anatomy.

[21]  Chao Liu,et al.  Three-dimensional Motion Tracking for Beating Heart Surgery Using a Thin-plate Spline Deformable Model , 2010, Int. J. Robotics Res..

[22]  V. Falk Manual control and tracking--a human factor analysis relevant for beating heart surgery. , 2002, The Annals of thoracic surgery.

[23]  Vaios Lappas,et al.  Attitude control for small satellites using control moment gyros , 2002 .

[24]  Edouard Laroche,et al.  Cardiolock: an active cardiac stabilizer. First in vivo experiments using a new robotized device. , 2007, Medical image computing and computer-assisted intervention : MICCAI ... International Conference on Medical Image Computing and Computer-Assisted Intervention.

[25]  Jacques Gangloff,et al.  Towards robotized beating heart TECABG: Assessment of the heart dynamics using high-speed vision , 2006, Computer aided surgery : official journal of the International Society for Computer Aided Surgery.

[26]  Volkmar Falk,et al.  Limitations for manual and telemanipulator-assisted motion tracking--implications for endoscopic beating-heart surgery. , 2003, The Annals of thoracic surgery.

[27]  Matthias Kirsch,et al.  Computer-assisted coronary surgery: lessons from an initial experience. , 2005, Interactive cardiovascular and thoracic surgery.

[28]  T. Ura,et al.  Zero-G Class Underwater Robots: Unrestricted Attitude Control Using Control Moment Gyros , 2007, IEEE Journal of Oceanic Engineering.

[29]  Edouard Laroche,et al.  GyroLock - first in vivo experiments of active heart stabilization using Control Moment Gyro (CMG) , 2011, 2011 IEEE International Conference on Robotics and Automation.

[30]  Jean-Claude Tardif,et al.  Resting heart rate in cardiovascular disease. , 2007, Journal of the American College of Cardiology.

[31]  Edouard Laroche,et al.  Active Cardiac Stabilization Using H Infinity Control Methodology , 2008 .

[32]  Mohinder S. Grewal,et al.  Global Positioning Systems, Inertial Navigation, and Integration , 2000 .

[33]  Philippe Cattin,et al.  Trajectory of coronary motion and its significance in robotic motion cancellation. , 2004, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[34]  Yukihiko Kazao,et al.  Characteristics of active vibration control system using gyro-stabilizer , 1998 .

[35]  Robert D. Howe,et al.  Robotic Motion Compensation for Beating Heart Intracardiac Surgery , 2009, Int. J. Robotics Res..

[36]  N A Patronik,et al.  Preliminary evaluation of a mobile robotic device for navigation and intervention on the beating heart , 2005, Computer aided surgery : official journal of the International Society for Computer Aided Surgery.

[37]  Ana Luisa Trejos,et al.  On the Feasibility of a Moving Support for Surgery on the Beating Heart , 1999, MICCAI.

[38]  Edouard Laroche,et al.  Active heart stabilization using adaptive noise cancelling techniques with gyroscopic actuation , 2010, 2010 3rd IEEE RAS & EMBS International Conference on Biomedical Robotics and Biomechatronics.

[39]  Edouard Laroche,et al.  Motion Prediction for Computer-Assisted Beating Heart Surgery , 2009, IEEE Transactions on Biomedical Engineering.

[40]  Shie Mannor,et al.  A Kalman Filter Design Based on the Performance/Robustness Tradeoff , 2008, IEEE Transactions on Automatic Control.

[41]  M. Lemma,et al.  Do cardiac stabilizers really stabilize? Experimental quantitative analysis of mechanical stabilization. , 2005, Interactive cardiovascular and thoracic surgery.

[42]  M. Mack,et al.  Improved outcomes in coronary artery bypass grafting with beating-heart techniques. , 2002, The Journal of thoracic and cardiovascular surgery.