Automated Knot Tying for Fixation in Minimally Invasive, Robot Assisted Cardiac Surgery

Abstract

Cardiovascular disease (CVD) is the most significant medical problem facing Americans today. While open-heart surgery is still the predominant treatment, great advancements have been made over the last 20 years in the fields of minimally invasive surgery (MIS) and minimally invasive robotic assisted (MIRA) surgery. MIRA techniques offer patients many benefits over open-heart procedures, but have extended the capabilities of MIS at the cost of increased time spent tying knots with the robot. The additional time spent on bypass limits patient access and is the most significant barrier to the widespread adoption of MIRA techniques.

This research seeks to overcome this barrier by creating a device optimized for MIRA cardiac procedures that automates the repetitive and time-consuming task of knotting suture. If this task can be automated while ensuring the delivery of high-quality knots, great progress can be made in transforming the field. MIRA cardiac procedures can move from novel procedures performed by a select group of surgeons on a limited pool of patients to a viable alternative available to the majority of patients suffering from CVD today. This research presents a design history and proposes a final design for a self-contained device that delivers a pre-tied locking knot for surgical fixation. Experimental results suggest that the device is capable of delivering consistent knots at a time savings of 12 and 26 per cent over knots tied manually for trained and untrained users of a surgical robot, respectively.