Robotic Mitral Valve Annuloplasty With Double-Arm Nitinol U-Clips

Reade, Clifton C.; Bower, Curtis E.; Bailey, B.Marcus; Maziarz, David M.; Masroor, Saqib; Kypson, Alan P.; Nifong, L. Wiley; Chitwood, W. Randolph

doi:10.1016/j.athoracsur.2004.02.072

Cited by 21 publications

(17 citation statements)

References 3 publications

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“…This ring can either be sutured or secured with metal anchors, the latter having been shown to produce promising results in atrial septal defect repair [8] (Fig. 1).…”

Section: Sensor Designmentioning

confidence: 99%

A Robust Uniaxial Force Sensor for Minimally Invasive Surgery

Yip

Yuen

Howe

2010

IEEE Trans. Biomed. Eng.

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This paper presents a novel miniature uniaxial force sensor for use within a beating heart during mitral valve annuloplasty. The sensor measures 5.5 mm in diameter and 12 mm in length and provides a hollow core to pass instrumentation. A soft elastomer flexure design maintains a waterproof seal. Fiber optic transduction eliminates electrical circuitry within the heart, and acetal components minimize ultrasound-imaging artifacts. Calibration uses a nonlinear viscoelastic method, and in vitro tests demonstrate a 0-4-N force range with rms errors of 0.13 N (<3.2%). In vivo tests provide the first endocardial measurements of tissue-minimally invasive surgery instrument interaction forces in a beating heart. Index TermsBeating heart surgery; force feedback; minimally invasive surgery (MIS); mitral valve annuloplasty; optical force sensor

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“…This ring can either be sutured or secured with metal anchors, the latter having been shown to produce promising results in atrial septal defect repair [8] (Fig. 1).…”

Section: Sensor Designmentioning

confidence: 99%

A Robust Uniaxial Force Sensor for Minimally Invasive Surgery

Yip

Yuen

Howe

2010

IEEE Trans. Biomed. Eng.

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“…Several centers have introduced the Da Vinci telemanipulation system into minimally invasive mitral surgery [21][22][23][24]. At our department, this system is also available and routinely used for coronary bypass grafting (TECAB, total endoscopic coronary artery bypass surgery).…”

Section: Discussionmentioning

confidence: 99%

Development of a minimally invasive mitral valve surgery program – The Innsbruck experience

2006

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“…Suture-free alternatives such as staples, clips, and glues have proven effective in certain procedures but can have limited applicability. For example, the nitinol U-clip™ (Medtronic® [12]) has been used effectively to secure annuloplasty bands in minimally invasive mitral valve repair [13,14], but cannot be used for leaflet repair. Both pre-tied knots and suture alternatives generally limit tactile assessment and can also lack the strength (resistance to loosening) of conventional surgical knots [15-17].…”

Section: Introductionmentioning

confidence: 99%

A laparoscopic knot-tying device for minimally invasive cardiac surgery☆

Jernigan¹,

Chanoit²,

Veeramani³

et al. 2010

European Journal of Cardio-Thoracic Surgery

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Objectives Intracorporeal suturing and knot tying can complicate, prolong or preclude minimally invasive surgical procedures, reducing their advantages over conventional approaches. An automated knot-tying device has been developed to speed suture fixation during minimally invasive cardiac surgery while retaining the desirable characteristics of conventional hand-tied surgeon's knots: holding strength and visual and haptic feedback. A rotating slotted disk (at the instrument's distal end) automates overhand throws, thereby eliminating the need to manually pass one suture end through a loop in the opposing end. Electronic actuation of this disk produces left or right overhand knots as desired by the operator. Methods To evaluate the effectiveness of this technology, 7 surgeons with varying laparoscopic experience tied knots within a simulated minimally invasive setting, using both the automated knot-tying tool and conventional laparoscopic tools. Suture types were 2-0 braided and 4-0 monofilament. Results Mean knot-tying times were 246 ±116 seconds and 102 ±46 seconds for conventional and automated methods, respectively, showing an average 56% reduction in time per surgeon (p=0.003, paired t-test). The peak holding strength of each knot (the force required to break the suture or loosen the knot) was measured using tensile testing equipment. These peak holding strengths were normalized by the ultimate tensile strength of each suture type (57.5 N and 22.1 N for 2-0 braided and 4-0 monofilament, respectively). Mean normalized holding strengths for all knots were 68.2% and 71.8% of ultimate tensile strength for conventional and automated methods, respectively (p= 0.914, paired t-test). Conclusions Experimental data reveal that the automated suturing device has great potential for advancing minimally invasive surgery: it significantly reduced knot-tying times while providing equivalent or greater holding strength than conventionally tied knots.

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Robotic Mitral Valve Annuloplasty With Double-Arm Nitinol U-Clips

Cited by 21 publications

References 3 publications

A Robust Uniaxial Force Sensor for Minimally Invasive Surgery

A Robust Uniaxial Force Sensor for Minimally Invasive Surgery

Development of a minimally invasive mitral valve surgery program – The Innsbruck experience

A laparoscopic knot-tying device for minimally invasive cardiac surgery☆

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