Surgeons have used robots operated by joysticks for more than a decade, and teams have shown that tiny robots can be steered through the body by external forces such as magnetism. Now, a paper in Science Robotics describes a robotic catheter that can navigate autonomously — the surgical equivalent of a self-driving car.
Bioengineers at Boston Children’s Hospital demonstrated a robotic catheter that found its way along the walls of a beating, blood-filled heart to a leaky valve in an animal model, without a surgeon’s involvement.
Surgeons at Boston Children’s Hospital have long sought a better solution for long-gap esophageal atresia, a rare birth defect in which part of the esophagus is missing. The current state-of-the art operation, called the Foker process, uses sutures anchored to children’s backs to gradually pull the unjoined ends of esophagus until they’re long enough to be stitched together. To keep the esophagus from tearing, children must be paralyzed in a medically induced coma, on mechanical ventilation, for one to four weeks. The lengthy ICU care means high costs, and the long period of immobilization can cause complications like bone fractures and blood clots.
Now, a Boston Children’s Hospital team has created an implantable robot that could lengthen the esophagus — and potentially other tubular organs like the intestine — while the child remains awake and mobile. As described today in Science Robotics, the device is attached only to the tissue being lengthened, so wouldn’t impede a child’s movement. …
Once a drug is injected systemically, can you steer it to where you want it under MRI guidance? Pierre Dupont, PhD, and colleagues saw this as an engineering problem. Solving it could enable concentrated drug delivery to, say, a deep tumor in the lungs while simultaneously taking images.
Labeling drugs with magnetized particles is the first step, allowing the MRI scanner’s magnetic pulses to propel them. The next step is to be able to actively steer the particles through a series of branching vessels to a desired location. But getting a scanner to both image and propel particles forcefully enough to overcome the force of the blood flow is easier said than done. …
Tertiary care centers such as the Boston Children’s Hospital Heart Center have led the way in groundbreaking surgical innovations for years, pushing boundaries and correcting ever more complex abnormalities.
But innovation is also making a difference when it comes to more “common” procedures.
“We’re always trying to make the less complex procedures shorter and less invasive,” says Sitaram Emani, MD, director of the Complex Biventricular Repair Program at the Heart Center. “Making surgery and recovery less painful and disruptive for all of our patients is a priority.”
MRI is a staple of surgical imaging, but it has the potential to do much more than take pictures. In 2011, bioengineer Pierre Dupont, PhD, and colleagues demonstrated that an MRI machine’s magnetic field could power a motor strong enough to control a robotic instrument, in this case driving a needle into an organ to do a biopsy.
But Dupont, head of the Pediatric Cardiac Bioengineering Lab at Boston Children’s Hospital, wants to go further. “We had this idea, admittedly fanciful: What if you could swim robots through the body?” he says. “If you could inject something systemically and steer it to just hit your target, that would be a cool application.” …
When surgeons perform image-guided minimally invasive procedures using an endoscope, some aspects of visualization and image quality are typically compromised as compared with open surgeries in which the physician can peer into the body. However, a new pressure-sensing material, placed over an endoscope, may someday provide surgeons with additional guidance and protect healthy tissue during these procedures.
“Neurosurgeons, especially pediatric neurosurgeons, are increasingly using neuroendoscopy to perform minimally invasive brain and spine surgery,” notes Patrick Codd, MD, from the Department of Neurosurgery at Boston Children’s Hospital, who was the lead author on a study evaluating this new material.
“Whenever you move to image-guided minimally invasive surgery, there is typically a tradeoff between the resolution of the image and the field of view,” where you have one but not the other, says Pierre Dupont, PhD, chief of Pediatric Cardiac Bioengineering at Boston Children’s and senior author on the study. …