Cardiolock: an active cardiac stabilizer. First in vivo experiments using a new robotized device

Area of Science:

• Cardiovascular Surgery
• Robotic Surgery
• Biomedical Engineering

Background:

• Off-pump coronary artery bypass grafting (CABG) remains technically challenging, especially with minimally invasive surgery (MIS) approaches.
• Existing mechanical stabilizers for cardiac procedures exhibit residual motion, compromising surgical accuracy.
• Minimally invasive surgery (MIS) necessitates advanced stabilization techniques for complex cardiac operations.

Purpose of the Study:

• To introduce and evaluate a novel active stabilizer designed for off-pump coronary artery bypass grafting (CABG) in minimally invasive surgery (MIS).
• To address the limitations of current mechanical stabilizers by compensating for residual heart motion.
• To demonstrate the efficacy of an active stabilization system for enhancing surgical precision.

Main Methods:

• Experimental evaluation of a commercial totally endoscopic stabilizer to assess its performance.
• In vivo assessment of heart-stabilizer interaction using an animal model.
• Development and testing of a prototype active stabilizer utilizing high-speed vision-based control and a piezo-actuated compliant mechanism.

Main Results:

• Commercial stabilizers showed unsatisfactory performance with significant residual heart motion.
• The novel active stabilizer prototype demonstrated effective compensation for cardiac motion during in vivo experiments.
• Vision-based control of the piezo-actuated mechanism proved efficient for active stabilization.

Conclusions:

• Active stabilization is crucial for improving accuracy in minimally invasive off-pump coronary artery bypass grafting (CABG).
• The proposed active stabilizer architecture is compatible with minimally invasive surgery (MIS) and effectively reduces cardiac motion.
• This technology holds significant potential for enhancing the safety and efficacy of complex cardiac surgical procedures.