Technology

Scientists have created a self-managed robot surgeon for heart surgery

Specialists from the Boston Children's Hospital (USA)developed and successfully tested a flexible, autonomous robotic catheter capable of independently navigating inside the heart and reaching the heart valves. Verification of the invention for autonomous detection of heart valves was carried out on the living hearts of pigs. On the advanced development of scientists reports an article published in the journal Science Robotics.

Currently, cardiac surgerySurgeons are performed in two different ways: minimally invasive, when the sternum is not cut, and all actions are performed through a small puncture between the ribs, and by the transsternal method, when access to the heart is opened through the cut sternum. The latter case requires a longer recovery period and can sometimes be accompanied by complications. Minimally invasive operations, in turn, are performed using guided flexible catheters with minimal surgical intervention. The most difficult thing in such operations is orientation within the cardiovascular system and the heart. Such operations are performed without stopping the heart, and the movement of blood greatly complicates visual orientation. The control of catheter advancement is usually performed using echocardiography, but the method is not capable of providing clear visualization.

Scientists from the United States conducted a flexible testa robocatheter capable of self-orientation in the heart cavity to the touch thanks to a special sensor installed at its end, as well as a special computer algorithm developed using machine learning and measuring the amount of pressure exerted on the walls of the organ. The device is able to distinguish the muscular walls of the heart and connective tissue, as well as explore the condition of the valves.

Verification of the invention was carried out on the heartsseveral Yorkshire pigs who were replaced by artificial valves of the aorta. At the same time, during the operation to simulate paravalvular leakage, that is, forcing a part of blood through the gap between the aortic wall and the valve itself, the scientists deliberately installed the new valves incorrectly. The researchers explain that such intersections can occur, for example, in infectious lesions of zones after the installation of artificial valves.

After the introduction of the robocatheter through the surgicalpuncture closer to the apex of the heart, it was switched to offline mode. After the device independently reached the desired valve by touch, the robocatheter was transferred to manual control, in which the doctor-operator installed a special device to close the gaps between the valve and the vascular wall. According to the researchers, the autonomous method of valve detection showed 95 percent accuracy, but the accuracy of following the aortic ring during the examination was only 66 percent.

In general, experts note thatOffline catheter speeds valve detection. And researchers explain the relatively low accuracy of the aortic ring search for sensor sensitivity, which is too high for experiments, at which the catheter only slightly touched the walls of the organ.

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