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. …
Every year, about 2,100 people receive heart transplants in the U.S., while 5.7 million suffer from heart failure. Given the scarcity of available donor hearts, clinicians and biomedical engineers from Boston Children’s Hospital and Harvard University have spent several years developing a mechanical alternative.
Heart failure occurs when one or both of the heart’s ventricles can no longer collect or pump blood effectively. Ventricular assist devices (VADs) are already used to sustain end-stage heart failure patients awaiting transplant, replacing the work of the ventricles through tubes that take blood out of the heart, send it through pumps or rotors and power it back into a patient’s bloodstream. But while VADs extend lives, they can cause complications. …
Can a robotic talking bear have therapeutic value? “The Bear,” part of a New York Times video series called Robotica, offers a glimpse of Huggable’s potential when Beatrice Lipp, a child with a chronic medical condition, visits the hospital, nervous about what’s to come.
“We want to offer kids one more way of helping them to feel OK where they are in what’s otherwise a really stressful experience,” explains Dierdre Logan, PhD, director of Psychological Services for Pain Medicine at Boston Children’s Hospital.
Huggable, a creation of the MIT Media Lab’s Personal Robots Group and the Boston Children’s Simulator Program, comes into Beatrice’s room to chat, play games like “I Spy” and tell jokes. The session is recorded on video, and a bracelet called a Q Sensor collects Beatrice’s physiologic data–changes in skin conductance, temperature and motion that may indicate distress. Researchers at Northeastern University are analyzing these data to gauge the robot’s effect. Eventually, Huggable will be able to react to the data and respond accordingly—offering relaxation exercises and guided imagery, for example, if a child remains anxious.
Currently, Huggable is voiced by Child Life staff, but the ultimate goal is for it to work autonomously. Beatrice is part of a 90-child study comparing Huggable, an ordinary teddy bear and a tablet Huggable image.
I admit: My immediate thought on seeing Huggable was that kids would immediately see him (her?) as a fake, but the bear’s robotic nature doesn’t seem to faze them. As Logan says in the video:
I think there’s a way of connecting with kids that’s different than what grownups have to offer. They have incredible imaginations. And they can really suspend disbelief. There can be a true relationship that develops between Huggable and a patient.
Our ability to use the thumb as an opposable digit is a critical part of what sets us apart as a species. “That’s how you’re holding a pen,” Leia Stirling, PhD, a senior staff engineer at the Wyss Institute for Biologically Inspired Engineering told me recently as we talked about the Wyss’ latest collaboration with Boston Children’s Hospital. “That’s how you hold your phone; that’s how you open a door; that’s what makes us unique.”
It’s also an ability that children who have suffered a stroke or have cerebral palsy or hemiplegia (paralysis on one side of the body) can lose or fail to develop in the first place.
Stirling, along with Hani Sallum, MS, and Annette Correia, OT, in Boston Children’s departments of Physical and Occupational Therapy, are the architects of a robotic device that may improve functional hand use. The device assists children with muscle movements, using small motors called “actuators” placed over the hand joints, while giving them sensory and visual feedback. It’s called the Isolated Orthosis for Thumb Actuation, or IOTA. …
When Patrick Codd, MD, removed a toddler’s deep brain tumor not long ago at Massachusetts General Hospital, he first put a catheter inside the boy’s head to drain the excess fluid that had built up. He and the neurosurgery team then removed a large portion of the child’s skull, exposed the brain and dissected through the brain tissue, using a microscope, until he could reach the tumor, which the team then removed.
The boy is doing fine, but Codd and his mentors at Boston Children’s Hospital—Joseph Madsen, MD, and Pierre Dupont, PhD, chief of Pediatric Cardiac Bioengineering—had a vision: Could the tumor have been removed via the same catheter that he used to drain the fluid, leaving the rest of the brain intact?
Standard surgical techniques—and even newer ones that use lasers or go into the brain through the nose—require surgeons to bore through brain tissue to get to their destination. This carries a risk of injuring sensitive areas as they pass through, like the structures involved in language, as well as a risk for wound infections and complications from extended anesthesia times. …
Hospital innovators are beginning to turn to robotic systems – some as simple as a cell phone that enables video conferencing between doctor and patient – to enhance patient care and lower costs (see yesterday’s post). The Child Life department at Children’s Hospital Boston asked kids staying at the hospital to share their ideas for robots that could help them and assist their doctors and nurses. A few hospital staff got in the spirit, too. At left and below are a few of their submissions. Click to enlarge them.
>>>Designed first with legos, “Harold” has two antennae that function both as hands and an FM radio, so it can help carry things around the hospital while rockin’ to some tunes. …
Countless scientific epiphanies never leave the bench – unless there’s the kind of serendipitous encounter that set Children’s Hospital Boston psychologist Gene Goldfield on a path he never expected to follow.
One in eight babies are born prematurely, putting them at greater risk for cerebral palsy, an inability to fully control their muscles. Goldfield saw these children being wheeled around the hospital, and was convinced that they did not have to be wheelchair-bound.
During early infancy, he knew, the developing brain naturally undergoes a rewiring of its circuits, including those that control the muscles. Could some type of early intervention encourage more typical motor development by replacing damaged circuits with more functional connections?
At Children’s Innovators’ Forum last week, Goldfield discussed his envisioned solution: the use of programmable robots …
It began as a proof-of-principle demonstrated with LEGOs – a surgical biopsy needle whose motor is driven solely by a clinical MRI scanner:
The above demo shows that an MRI machine’s magnetic field can be programmed to produce enough force to control a robotic instrument — an accomplishment with broad potential in medicine. In the demo, the scanner’s magnetic field swings a rotating arm, and a set of gears convert that motion into the motion of a biopsy needle, strong enough to puncture the tough outer tissue of an animal heart and then withdraw. All parts exposed to the magnetic field are metal-free and MRI-compatible.
While MRI-compatible robots have been built before, this was the first demo of a motor powered by MRI, says Pierre Dupont, chief of Pediatric Cardiac Bioengineering at Children’s Hospital Boston. His engineering team was one of five finalists for Best Paper Award — out of 790 papers presented — at last week’s International Conference on Intelligent Robots and Systems (IROS 2011). …