Virtuele prototypes

BRN nieuwsradio (Dutch news radio>
Programma: Eyeopeners, technieuwtjes uit binnen- en buitenland
Presentator: Meindert Schut

Ewout Arkenbout, BITE alumni, was te gast bij BNR naar aanleiding van zijn promotie onderzoek over multi-vertakte instrumentatie, en de toegepaste ontwerp methodologie om zonder prototypes te bouwen toch inzicht te krijgen in instrumenten stuurtechnieken.

Beluister het interview (in het Nederlands) via de volgende link:

Pressure Wave Catheter for Coronary Interventions

This research project is funded by the Netherlands Organization for Scientific Research NWO.

Crossing heavily calcified occlusions, such as Chronic Total Occlusions (CTOs), is challenging, resulting in undesirably low success rates between 50% and 90% depending on the operator’s experience and the characteristics of the CTO. The most common failure mode observed in the preferred treatment, the Percutaneous Coronary Intervention (PCI), is the inability to cross the occlusion due to buckling of the guidewire. The inability to cross the CTO often leads to procedural failure and can cause damage to the blood vessel wall.

In order to prevent buckling of the crossing tool and improve the procedural success rates of PCI, we developed a novel, well-working catheter prototype that can apply a mechanical impulse, defined as the integral of a peak force over a small time interval, on the CTO during the crossing procedure. Using an impulse to dynamically load the CTO  is advantageous as the impulse strongly decreases the buckling effect and the static forces on the CTO and its environment, minimizing the risk of damage to the blood vessel wall and the surrounding tissues.

During this TTW demonstrator project we will develop our patented catheter prototype further into a  handheld clinical prototype incorporating an  adjustable tip section as well as a dedicated input mechanism allowing for generating a single impulse as well as continuously vibrating motions. The efficiency and effectiveness of the clinical prototype will be evaluated on CTO models and during ex-vivo and in-vivo animal evaluations.

 

Assignment: Design, fabrication and evaluation of  an adhesion-based medical gripping instrument

Tissue manipulation during surgery is currently done with a grasping forceps. This pinching instrument is prone to errors related to the force that is applied on the gripped tissue. Using too much force may lead to tissue damage, whereas applying too little force may result in tissue slipping out of the forceps.

One way to realize firm yet gentle grip could be by means of an instrument that relies on adhesive forces rather than pinching forces. In this line, we are developing adhesive pads that can generate high friction forces on soft substrates, such as biological tissue.

In this research project you will be designing a medical instrument that integrates such an adhesive pad for tissue manipulation. One of the challenges herein is that such pads are optimized for high friction, which means that the range and type of movements for tissue manipulation may differ from these of a conventional gripper.

You will work towards the design and experimental evaluation of a prototype of an adhesion-based gripping medical instrument. This includes evaluation of the functional requirements of an adhesion-based instrument to be used in minimal invasive surgery, design and fabrication of a prototype thereof, and testing of its performance with phantoms and ex vivo.

Contact: Peter van Assenbergh, s.p.vanassenbergh@tudelft.nl

Ovipositor needle II – self-propelling & steering through tissue

Developed in 2016, diameter 1.2 mm (tip) & 0.75 mm (body).

A wasp ovipositor is a needle-like structure composed out of three elements, called valves. A female wasp uses this structure to drill into wood or fruit and deposit eggs inside a living host. The propagation of the ovipositor through the substrate is achieved by a push-pull mechanism, in which one of the valves is pushed while the other two are pulled.

Inspired by the ovipositor of parasitoid wasps, we developed a new Ovipositor Needle with a diameter of 1.2 mm at the tip and 0.75 mm along the body. The needle consists of six superelastic Nickel Titanium (NiTi) wires (Ø 0.25 mm, length 160 mm) concentrically arranged around a seventh NiTi wire. The seven wires are interconnected at the tip with a flower-shaped ring (Ø 1.2 mm, length 2.0 mm), manufactured for minimal resistance during propulsion. The ring has a central hole to which the central wire is glued and six holes through which the six other wires can slide back and forth.

Each proximal end of the six movable wires is connected to a stepper motor, in which a leadscrew-slider mechanism converts rotational motion into linear motion. During an experiment, the needle was inserted in a stationary tissue-mimicking phantom, placed on a cart with low-friction wheels. The wires were sequentially moved back and forth inside the phantom, generating a net pulling motion of the phantom towards the actuation unit, and resulting in the needle moving forward inside the phantom. Different sequences of wire actuation were used to achieve both straight, curved and S-shaped trajectories.

In a follow-up prototype we changed the shape of the interlocking ring from cylindrical to conical to investigate the effect of pre-curved wires. We found out that pre-curved wires facilitate steering, however, at the drawback of a slightly larger tip diameter due to the use of a conical flower-ring.

Ovipoistor Needle II is, to our knowledge, world’s thinnest self-propelled-steerable needle. Our novel bio-inspired steering and propulsion mechanism allows for the design of extremely long and thin needles that can be used to reach deep targets inside the body without a risk of buckling and with the possibility to correct the trajectory.

Ovipositor Needle II is part of the WASP project that focuses on the development of steerable needles for localized therapeutic drug delivery or tissue sample removal (biopsy). We are currently  working on further miniaturization to diameters <0.5 mm.

(Picture at the top adapted from “Braconid Wasp Ovipositing” by Katja Schulz is licensed under CC BY 2.0.)

Publications:

Interventional Ductoscopy – the EVAPORATE study

This research project is funded by the Netherlands Organization for Scientific Research NWO and the Dutch Foundation of Cancer Research KWF.

Ductoscopy is a minimally invasive micro-endoscopic technique that allows for direct visualization of the milk ducts of the breast through their natural orifices in the nipple. It can be performed under local anesthesia in daily outpatient routine and has proven to be safe with a very low risk on (mild) complications.

Nowadays, ductoscopy is only used as a diagnostic tool in patients suffering bloody nipple discharge, usually caused by small intraductal lesions, such as papillomas. Ductoscopy has the potential to become a preventive interventional approach to detect premalignant lesions,  but this is hampered by the limitations of the currently available instrumentation and the small size of the ducts. In collaboration with the UMC Utrecht we will develop a set of novel instruments for ductoscopy aimed at discovering, diagnosing and removing premalignant lesions in milk ducts of high risk women, thus possibly preventing them from getting breast cancer.

Novel Shooting Mechanism for Tissue Puncturing

In nature multiple animals have developed intriguing shooting mechanisms for food capture, defence, and reproductive reasons. Think for example on the amazing tongue shooting capability of the chameleon and the appendage strike of the mantis shrimp.

For a full overview of innovative and interesting shooting mechanisms in nature, we would like to refer to: Shooting Mechanisms in Nature: A Systematic Review by Sakes et al. [2016]

These shooting mechanisms can offer inspiration for new ideas on the technological development of fast acceleration mechanisms in medicine. High-speed shooting mechanisms can, for example, be used for the endovascular treatment of Chronic Total occlusions (CTOs). CTOs are heavily calcified and are thus difficult to puncture and cross with the small (0.36 mm) guidewire. The required force to puncture the CTO is often higher than the buckling force of the guidewire due to the low bending stiffness (EI) and long (unsupported) length (L). As a result, the guidewire often buckles. Buckling in turn causes procedural failure since the CTO cannot be crossed. Buckling of the crossing tool may be prevented by using a high-speed crossing tools as this increases the buckling resistance of the guidewire and potentially minimizes the puncture force of the CTO.

With this in mind an innovative high-speed crossing tool was developed using nature’s shooting mechanisms as inspiration. The crossing tool (OD 2 mm) incorporates an innovative spring-driven indenter and decoupling mechanism for high-speed puncturing of the proximal cap. First tests have been very promising. The prototype hit the CTO with an average speed of 3.4 m/s and was able to deliver a maximum force of 20 N (without buckling), which is well over the required 1.5 N to puncture the CTO. Additionally, the device was tested on CTO models made out of calcium and gelatine of different consistency. Puncture was achieved with on average 2.5 strikes for heavily calcified (77 wt% calcium) CTO models.

We feel that with continued development of this technique it will become possible to deliver high forces in ultra thin devices, such as guidewires, and as such increase the success rate of the the endovascular treatment of CTOs and other minimal invasive applications.

For a video of the prototype hitting a fixed surface, please see: Velocity_Max_10fps (Converted), which is slowed down 1000x.

3D Printed Hand: FA3D

The FA3D hand is a 3D printed Hand printed with a flexible filament. The fingers of the hand have multiple joints, allowing for adaptive gripping. The fingers have elastic joints and can be printed as one part. Therefore assembly of the finger phalanxes is not necessary.

FA3D Hand
FA3D Hand

Due to its adaptive gripping, the FA3D Hand can hold a broad range of objects.

FA3D Hand holding paper cup

The FA3D Hand consists of 8 3D-printed parts. The parts can be  connected with standard bolts and nuts. Steel cables are used to actuate the fingers.

Parts of the FA3D Hand
Parts of the FA3D Hand

The hand is body powered. It can be controlled by pulling the control cable, by using a shoulder strap.

User wearing the FA3D Hand
User wearing the FA3D Hand