Octopus-based Instrument used for first time in OR

The ‘mechanical octopus’, a steerable laparoscopic instrument used for minimally invasive surgery in the abdominal cavity, has been used for the first time in an operating room.

Surgeons at the Haags Medisch Centrum are positive about the benefits that the innovative technology in the LaproFlex gave them during a gynaecological operation. The technology behind the instrument was conceived by Paul Breedveld, professor of Medical Instruments & Bio-Inspired Technology. Jules Scheltes, who also obtained his PhD at TU Delft in the field of medical product development and who co-founded the Dutch company DEAM, has been working these past two years to market the product. Following an exciting period, he received CE certification earlier this summer for the LaproFlex and is producing and selling it in Europe.

Paul Breedveld
‘The LaproFlex is an example of research at a university finding its way into industry.’

Jules Scheltes
‘Co-founder Wimold Peters and I are especially proud that we have managed to pull this off with our team. Surgeons have indicated that the instrument is providing them with a better view of the organ they are operating on, and that they can access it from an optimal approach route and are not inconvenienced by intersecting instruments in their field of operation anymore. This is great news. This is exactly what we’ve been working towards.’

What makes this instrument special is that it has a flexible tip. This is made possible by an ingenious steering system based on the anatomy of an octopus’ tentacle, the so-called cable crane mechanism, which ensures that the scissors or grasper can be steered in every direction. Paul Breedveld and the researchers in his Bio-Inspired Technology Group (BITE) have further developed this technology, which has now been globally patented, into a large number of prototypes of steerable surgical instruments. DEAM is a spin-off company of the BITE group that develops steerable precision instruments for minimally invasive interventions. DEAM collaborates with a number of universities of technology and university medical centres. The LaproFlex is the first commercially available instrument using a cable crane mechanism and is considered to be a particularly affordable, disposable alternative for the extremely pricey Da Vinci operation robot.

Media

Pulze Hammer II: Catheter

We want to go deeper into the human body, using incisions that are smaller or even non existent. For this purpose we need small flexible tools that are able to deliver sufficient forces without buckling.

In an effort to facilitate high force delivery in a small flexible medical instrument, the pulze catheter prototype (2 mm) has been developed. Buckling is prevented by using a dynamic loading method, in which a high-speed indenter collides with the non-moving target. The flexible prototype consists of a distal spring-loaded indenter, which is manually actuated using a compliant (re)load mechanism, allowing for loading, locking, and (re)loading of the prototype while inserted in the body.

We are currently testing this catheter ex-vivo.

Further development of this crossing prototype may in time allow for performing surgery deep inside the body.

Complete Pulze Hammer Catheter Prototype

Publications

Design of instruments for veterinary interventions

If you are looking for a challenging assignment that combines bio-inspiration with actual animals, I have currently multiple projects available directed towards veterinary research. The projects are in collaboration with the Rotterdam Zoo and Faculty of Veterinary Medicine of the University Utrecht. Projects are aimed at surgical interventions of different types of animals, including elephants, rhinos, birds, and horses. A selection of the projects is illustrated below:

  • Suturing abdomen of larger animals

Suturing of the abdomen of larger animals is difficult and often results in ripping along the suture line due to the large force on the stitches. This ripping will in most cases lead to death of the animal. Since operations, such as caesarean sections, can be necessary at time to safe both the mother as well as the offspring, a solution should be found for this problem.

  • Design of an stand-up aid for horses after surgery

When horses suffer a bone fracture, the bone needs to be surgically stabilised using screws and plates. In many cases this is done successfully. However, after the horse wakes up after surgery, they are often very tense and tend to panic, which can result in refracture of the bone. The goal of this project is to design a device that can help the horse to stand up safely after the surgery.

  • Design of a bullet removal device in Elephants and Rhinos

In Africa, elephants and rhinos are often hunted for their tusks. Luckily, on some occasions, the elephants and rhinos are able to get away. However, they often sustain severe damage due to bullet wounds. The main challenge the veterinarians face is the removal of these bullets. These bullets are often very deep inside the animal and, therefore, difficult to reach. Furthermore, they often migrate through the body to deeper locations, potentially becoming life threatening. In this assignment, you will develop a bullet removal device for elephants and rhinos that can be used in the field.

  • Design of a tusk extraction device for Elephants

When an elephant’s tusk breaks off, the living tissue inside the tusk will become exposed. If it is not possible to safe the tusk, the best option is to extract it to prevent further harm to the elephant. However, current methods for removing tusks are difficult to perform. Therefore, in this assignment you will develop a new type of instrument that allows for easy and fast task extraction.

  • Design of a smart hatch for animals in Rotterdam Zoo (internship)

In Rotterdam Zoo, they would like to build a smart hatch system for their Wallabies. This system will allow them to keep track of which animal is where and also allows them to capture specific animals with minimal stress.

  • Design of a tusk protection device for Elephants in Rotterdam Zoo (internship)

On some occasions, an elephant tusk might get damaged and a crack may form. On these occasions, veterinarians often place a metal ring around the tusk to protect the living tissue inside the tusk and prevent further damage. However, these rings are heavy and do not offer full protection. Therefore, in this assignment you will design a new type of tusk “ring”.

Contact: Aimée Sakes, a.sakes@tudelft.nl

3D Printed medical devices

This research is part of EU Interreg 2 Seas Mers Zeeën 3D MED: Development and streamlined integration of 3D printing technologies to enable advanced medical treatment and its widespread application.

The goal of this project is to research the possibilities of 3D printing for the advanced design and production of medical devices, in order to improve affordability and accessibility of medical treatment. The benefit of 3D printing is that complex shapes can be created in one single production step, which offers great potential for easy manufacturing and added functionality. The focus will be on developing design methods for complex medical devices with internal mechanisms used in eye surgery, which can be printed as one functioning assembly. This research is executed in collaboration with DORC, the Dutch Ophthalmic Research Centre.

4TU – Soft Robotics

This programme is a collaboration of the four technical universities of the Netherlands (4TU): Eindhoven University of Technology, University of Twente, Wageningen University, and Delft University of Technology.

Conventional robots operate in pre-programmed environments, enabling the execution of repetitive tasks at superhuman speed and accuracy, based on a design of interlinked rigid segments that are position controlled. A radically different approach is required to enable robots to safely interact with organic matter (which is inherently vulnerable and unpredictable) or to operate in human-inhabited environments. Robots should be soft and compliant, but designing, manufacturing, modelling and controlling them brings many scientific and technological challenges. These challenges have recently begun to be addressed in the emerging research community of ‘soft robotics’.

Our soft robotics programme aims to establish a leading soft robotics community in the Netherlands, that will establish an integrated design approach for soft robotic hardware, control and actuation, inspired by nature. Unlike conventional robots, humans and animals are soft and flexible, and adaptive. While in conventional robots components such as motors, sensors, beams and computer are stacked, in animals functionalities such sensing, control, and actuation are fully integrated, distributed, and robust (i.e., failure of parts does not lead to a non-functional system). In biology the nervous system is distributed over the entire body, and the ‘design’ of the biomechanical motion systems reduces the control demands for the nervous system. For this reason, we want to unravel the solutions found in nature, and use them as inspiration for the design of Soft Robots.

Novel non-assembly 3D printed structures will be explored to integrate electronics and embedded micro-actuators. Additionally, we will investigate bio-inspired power cable structures that can withstand extreme stretch due to their shape. In close collaboration with Wageningen University, we will combine bio-to-techno transfer with techno-to-bio transfer, whereby knowledge of biological functionality is gained from building soft robotic devices.

For more information about this project, please contact Aimée Sakes, a.sakes@tudelft.nl

Design of a Self-Propagating Tree-Root Inspired Needle

Tree roots are able to find their way through the soil towards a water source. They do this by growing their roots in a special way. First, they extend the middle part of the root into the soil. Second, they thicken the roots.

In this assignment, you will develop a soft tree-root inspired needle that is able to propel itself through the body in a minimally invasive way. The challenge will mainly lie in how you can propagate yourself through the body.

If you are interested in this assignment, please contact: Aimée Sakes, a.sakes@tudelft.nl

Tree-Frog Inspired Wall-Climbing Robot

The tree-frog is able to adhere to multiple surfaces. It does this by employing several strategies, one of which is the use of special “suction-cup” feet.

Based on this principle, in this assignment, you will develop a robotic foot inspired by the tree-frog. This robotic-foot can be used for many different applications. Think, for example, on medical applications, where you need to attach and detach quickly, but also on a wall-climbing robot!

If you are interested in this assignment, please contact: Aimée Sakes, a.sakes@tudelft.nl

Design and characterization of a soft gripper for slippery tissue

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.

Inspired by tree frogs, here, we will investigate whether firm but gentle grip on slippery tissue can be generated with grippers containing soft pads. With such a grasper, grip is still friction-based, but does no longer depend on the applied normal load. This probably

In this project, we will implement soft pads into 3D-printed graspers. The grasper design has to be adapted in order to generate load-independent grip. The project includes characterization of a prototype on biological tissues.

Start: January-February 2019

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

The Nothern Clingfish, Bio-inspired Suction Cup

The northern clingfish (Gobiesox maeandricus) is able to adhere to slippery, wet, and irregular surfaces in the marine environment. A study by Wainwright et al. (2013) found that the fish can adhere to surfaces with a broad range of surface roughness, from the finest of sandpaper, to highly irregular surfaces such as rocks. The fishes outperform manmade suction cups, which as many of us know, only adhere to smooth surfaces.

Clingfish are able to adhere to these wet and irregular surface due to their highly sophisticated suction disc. This suction disc consists of a cup with at the edge of the cup structured microvilli, similar to those of geckos. When the fish attaches to a surface, water is forced out from under the suction disc by rocking the pelvic girdle and an area of sub-ambient pressure is created. The microvilli at the edge of the disc, subsequently prevent slip of the cup or premature release by creating friction between the cup and the surface.

In this assignment we will focus on the design of a special bio-inspired suction pad for use in medical application to grip and release slippery, wet and soft tissue without damaging the structure.

If you are interested in this assignment, please contact: Aimée Sakes, a.sakes@tudelft.nl

Non-assembly 3D printed hand prosthesis

In developing countries, the accessibility to prosthetic devices is low due to the limited healthcare conditions, a general lack of technical knowledge and poorly equipped workshops. The introduction of 3D printing technologies has permitted new cheap and personalized hand prosthetic designs by bypassing many of the current manufacturing limitations of traditional prostheses. Although innovative and accepted in different settings around the world, these active 3D printed prostheses still require extra parts and assembly steps, thus reducing the overall accessibility. We have developed the first functional non-assembly prosthetic hand fabricated with the material extrusion technology; the most accessible 3D printing technique. The process is reduced to a single printing job and an extra step of support material removal. No extra parts, materials or complex assembly steps are required.

During the design process, we have also adopted ten design guidelines that led to a successful working mechanism, we encourage future designers with 3D printing to follow our non-assembly approach.

Publications

Media

Ten Guidelines for Non-Assembly A Prosthetic Hand is 3D Printed in One Piece with No Need for Assembly

Contact: Juan Cuellar (J.S.CuellarLopez@tudelft.nl)