HeartLander:  an Epicardial Crawling Robot for Beating-Heart Surgery

Cameron Riviere, Ph.D.

The Robotics Institute

Carnegie Mellon University

Marco Zenati, M.D.

University of Pittsburgh Medical Center

Abstract:

The goal of accurate minimally invasive surgery on the beating heart presents considerable challenges.  The heart beats roughly once per second, and the amplitude of its motion can be over 25 mm.  Access is also difficult:  the heart is under pressure from the surrounding organs, and any instrument inserted into the pericardial sac must create its own working space.  The approach used by many instruments, entering between the ribs, is undesirable because it requires partial deflation of the left lung for access to the heart.  To address these challenges, we have developed HeartLander, a tethered miniature mobile robot that adheres to the epicardium using suction, and navigates via inchworm-like locomotion, using flexible nitinol pushwires connected to motors located outside the patient.  Due to its flexibility, HeartLander can be inserted through a small incision below the xiphoid process of the sternum, avoiding any interference from the lungs.  Clinical procedures envisioned for the system include myocardial injections, epicardial lead placement, and epicardial ablation.  In closed-chest beating-heart experiments in vivo in a porcine model, HeartLander has demonstrated acquisition of preselected target locations with average error of 1.7 mm.  Ongoing work includes research to optimize the locomotion for minimum treatment time and minimum slippage in the wet intrapericardial environment.

References:

1. 1.N. A. Patronik, T. Ota, M. A. Zenati, and C. N. Riviere.  A miniature mobile robot for navigation and positioning on the beating heart.   IEEE Transactions on Robotics, 25(5):1109-1124, 2009.
   

2. 2.T. Ota, N. A. Patronik, D. Schwartzman, C. N. Riviere, and M. A. Zenati.  Minimally invasive epicardial injection using a semi-autonomous robotic device.   Circulation, 118:S115-120, 2008.
   

3. 3.C. N. Riviere, J. Gangloff, and M. de Mathelin.  Robotic compensation of biological motion to enhance surgical accuracy.   Proceedings of the IEEE, 94(9):1705-1716, 2006.
   

The HeartLander epicardial crawling robot on a Chamberlain Group heart model.

Relevant Links:  www.cs.cmu.edu/~heartlander/ ,  www.heartlandersurgical.com