Modular snake robots in advancing minimally invasive cardiac

surgeries
Qin (Camilla) Xu

Departments of Mechanical and Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA

Introduction

Methods

Conclusion

Motivation: Reduction of post-surgery recovery times

and hospital stays
About 7588 thousand inpatient cardiovascular
operations were performed in 2010 in the US 2
Up to 65 days of post-surgery follow-up to ensure
there are no health-care associated infections 5

Testing of deployment speed and amount of resistance

of beating heart and intact pericardium1
Large healthy pigs of either sex were anesthetized
and used in the experiment
HARP remotely guided to slide
through incisions to pericardial
space

Benefits:
Can be both flexible and rigid, allow a range of
surgical possibilities1
Reduces post-surgical discomfort1

Approach: Use of robot for expanding surgical reach of

minimally invasive surgeries.
Can go into areas previously unreachable by MIS
due to obstruction of sight1
Less soft tissue disruptionsreduces post-surgical
pain and prompts better recovery1

Background

One 2 cm incision on the

Figure 3: Setup of the experiment
pericardium

with arrow 1 being incision and 2

beingradiofrequency
thoracoscope7
irrigated
guided

8 Fr. Catheter with

through working port of robot

Performed epicardial ablation (40W, 15s) at two or three

points

Two properties of traditional MIS devices1:

Rigid and straightlaparoscope
Flexible and buckle easilyendoscope
Robot-Assisted Cardiac Surgery4
Enhances surgical ability and precision
Repairs structural heart conditions

One small 20 mm incision on

the skin at the subxiphoid

Mitral valve plasty

Atrial septal defect closure
Cardiac tumour resection
ThoraCAB
TECAB
Figure 1: A highly articulated
robotic probe flexed in a rigid
position8

Medical snake robot7

Highly articulated robotic probe (HARP)
Encompasses best of both worlds of tradition MIS
surgical devices
Aims to perform epicardial intervention in a less
invasive manner

Blood pressure and ECG monitored

Hemodynamic influences
Electrophysiological influences

Thoracoscope inserted from left thoracic wall for

visualization of left side of the heart through
pericardium

Figure 4: Tip of HARP and ablation catheter seen through

pericardium. S is tip of HARP, arrow indicates catheter, LA is
left atrium8

Results

Animals survived through entire process8

Pathways through heart and oblique sinus successful
Hemodynamic status stable and no other adverse events
Diaphragms not paralyzed under the spontaneous
respiration
Active bleeding caused by HARP noted

Medrobotics Corp. began selling the Flex Robotics

system to hospitals for surgical use3

Limitations:
The amount of links limits its flexibility to a small
degree of freedom1
The robot itself can not extend tools to perform
surgery1

Acknowledgements
The author would like to thank Dr. Conrad Zapanta for
his discussion of the topic and review of the poster
design and layout.

References
1. Wolf, Alon, and Marco A. Zenati. Highly Articulated Robotic Probe
for Minimally Invasive Surgery. 2006 IEEE International Conference
on Robotics and Automation (ICRA): Orlando, Florida, 15-19 May,
2006. By Amir Degani and Howie Choset. Piscataway, NJ: IEEE,
2006. 4167-172. Print.

No damage to surrounding structures

Figure 2: Typical gait sequence of a medical snake robot

No mechanical actuation on board the deviceno

electricity inside patients body1

University Hospital of Marburg successfully removed

cancerous tumor from female patient in broadcasted
procedure using Flex System in September 20143
Cleared by FDA for use during transoral procedures in
July 2015.3

2. The American Heart Association. "Heart Disease and Stroke

Statistics--2014 Update." Circulation (n.d.): n. pag. American Heart
Association. American Heart Association, 18 Dec. 2013. Web. 12
Nov. 2015.
3. "About Medrobotics." Medrobotics. Medrobotics Corp., 2015. Web.
12 Nov. 2015.
4. Ishikawa, Norihiko, and Go Watanabe. "Robot-Assisted Cardiac
Surgery." ATCS Annals of Thoracic and Cardiovascular Surgery Ann
Thorac Cardiovasc Surg 21.4 (2015): 322-28. Web. 4 Dec. 2015.
5. Badhwar, Vinay, and Jeffrey P. Jacobs. "Infections Following Cardiac
Surgery." Journal of the American College of Cardiology 65.1 (2015):
24-26. Web. 4 Dec. 2015.
6. Degani, Amir, Howie Choset, Brett Zubiate, Takeyoshi Ota, and
Marco Zenati. "Highly Articulated Robotic Probe for Minimally
Invasive Surgery." 2008 30th Annual International Conference of the
IEEE Engineering in Medicine and Biology Society (2008): n. pag.
Web.
7. Digital image. Robotics Institute. Carnegie Mellon University, n.d.
Web. 4 Dec. 2015.
<http://biorobotics.ri.cmu.edu/robots/images/medSnake/3DArtic2.jp
g>.