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At least 73 records · Page 4

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NASA NTRS1997

NASA Robotic Neurosurgery Testbed

The detection of tissue interface (e.g., normal tissue, cancer, tumor) has been limited clinically to tactile feedback, temperature monitoring, and the use of a miniature ultrasound probe for tissue differentiation during surgical operations, In neurosurgery, the needle used in the standard stereotactic CT or MRI guided brain biopsy provides no information about the tissue being sampled. The tissue sampled depends entirely upon the accuracy with which the localization provided by the preoperative CT or MRI scan is translated to the intracranial biopsy site. In addition, no information about the tissue being traversed by the needle (e.g., a blood vessel) is provided. Hemorrhage due to the biopsy needle tearing a blood vessel within the brain is the most devastating complication of stereotactic CT/MRI guided brain biopsy. A robotic neurosurgery testbed has been developed at NASA Ames Research Center as a spin-off of technologies from space, aeronautics and medical programs. The invention entitled "Robotic Neurosurgery Leading to Multimodality Devices for Tissue Identification" is nearing a state ready for commercialization. The devices will: 1) improve diagnostic accuracy and precision of general surgery, with near term emphasis on stereotactic brain biopsy, 2) automate tissue identification, with near term emphasis on stereotactic brain biopsy, to permit remote control of the procedure, and 3) reduce morbidity for stereotactic brain biopsy. The commercial impact from this work is the potential development of a whole new generation of smart surgical tools to increase the safety, accuracy and efficiency of surgical procedures. Other potential markets include smart surgical tools for tumor ablation in neurosurgery, general exploratory surgery, prostate cancer surgery, and breast cancer surgery.

Mah, Robert↗

NASA NTRS2003

The Right Track for Vision Correction

More and more people are putting away their eyeglasses and contact lenses as a result of laser vision correction surgery. LASIK, the most widely performed version of this surgical procedure, improves vision by reshaping the cornea, the clear front surface of the eye, using an excimer laser. One excimer laser system, Alcon s LADARVision 4000, utilizes a laser radar (LADAR) eye tracking device that gives it unmatched precision. During LASIK surgery, laser During LASIK surgery, laser pulses must be accurately placed to reshape the cornea. A challenge to this procedure is the patient s constant eye movement. A person s eyes make small, involuntary movements known as saccadic movements about 100 times per second. Since the saccadic movements will not stop during LASIK surgery, most excimer laser systems use an eye tracking device that measures the movements and guides the placement of the laser beam. LADARVision s eye tracking device stems from the LADAR technology originally developed through several Small Business Innovation Research (SBIR) contracts with NASA s Johnson Space Center and the U.S. Department of Defense s Ballistic Missile Defense Office (BMDO). In the 1980s, Johnson awarded Autonomous Technologies Corporation a Phase I SBIR contract to develop technology for autonomous rendezvous and docking of space vehicles to service satellites. During Phase II of the Johnson SBIR contract, Autonomous Technologies developed a prototype range and velocity imaging LADAR to demonstrate technology that could be used for this purpose.

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NASA NTRS1997

Physiological Anatomical Rodent Experiment (PARE): 04 Flight Support

Rats were shipped to Kennedy Space Center (KSC), Florida, on day 2 of gestation [(G2) (day 1 = morning on which spermatozoa are present in the vagina)] and laparotomized on G7 to determine the number of implantation sites in each uterine horn. On G8, ten pregnant rats meeting flight criteria (at least five implantation sites each horn) were placed into NASA flight cages (animal enclosure modules, AEMS, five rats per cage), loaded onto the mid-deck of the space shuttle Atlantis, and on G9 (November 3, 1994) they were launched into orbit. On gestation day 20, (November 14, 1994) the shuttle returned to Edwards Air Force Base, California and the flight animals were recovered from the shuttle and subjected to unilateral hysterectomy to provide fetal material from one horn to investigators identified by NASA to study selected fetal parameters. After unilateral hysterectomy, the animals were allowed to recover and deliver vaginally. There were three groups (n = 10 each group) of control animals housed at KSC in the study. A synchronous control group, delayed 24 hours with reference to the flight group, received the same surgeries and was housed five rats per AEM and exposed to all flight conditions (identical temperatures, lighting and humidity) except microgravity. Vivarium control group I did not receive any surgery and was housed in the vivarium in clear polycarbonate cages. Vivarium control group 2 received only a unilateral hysterectomy on day 20 of gestation but otherwise was housed like the vivarium control group 1. Control groups were allowed to complete their pregnancy and deliver fetuses from the remaining horn (Synchronous control and vivarium control group 2) or horns (Vivarium control group 1). After surgery, the dams were euthanized and tissues recovered, and the neonates were assigned to foster dams.

Burden, Hubert W.↗

NASA NTRS1992

A Tool for Medical Research

California Measurements, Inc.'s PC-2 Aerosol Particle Analyzer, developed by William Chiang, a former Jet Propulsion Laboratory (JPL) engineer, was used in a study to measure the size of particles in the medical environment. Chiang has a NASA license for the JPL crystal oscillator technology and originally built the instrument for atmospheric research. In the operating room, it enabled researchers from the University of California to obtain multiple sets of data repeatedly and accurately. The study concluded that significant amounts of aerosols are generated during surgery when power tools are employed, and most of these are in the respirable size. Almost all contain blood and are small enough to pass through surgical masks. Research on the presence of blood aerosols during oral surgery had similar results. Further studies are planned to determine the possibility of HIV transmission during surgery, and the PC-2H will be used to quantify blood aerosols.

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NASA NTRS1971

Experimental system for the control of surgically induced infections

The results are presented of the development tests performed on the experimental system for the control of surgically induced infections. Tests were performed on the portable clean room to demonstrate assembly, collapsability, portability and storage. Collapsing, relocating and storing within the surgery room can be accomplished in 12 minutes. The storage envelope dimensions are 1.64 m x 4.24 m x 2.62 m high. The disassembly transfer to another room, and reassembly were demonstrated. The laminar air flow velocity profile within the enclosure was measured. In the undisturbed area of the enclosure the air flow met the Federal Standard 209a requirements of 27.45 meters per minute + or - 6.10 meters per minute. Smoke tests with simulated surgery equipment and personnel in the enclosure did not indicate any detrimental air flow patterns. It is concluded that the system as designed will perform the functions required for its intended use.

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NASA NTRS1972

Experimental system, and its evaluation for the control of surgically inducted infections

The effect is reported to design, fabricate, test and evaluate a prototype experimental system for the control of surgically induced infections. The purpose is to provide the cleanest possible environment within a hospital surgery room and eliminate contamination sources that could cause infections during surgery. The system design is described. The system provides for a portable laminar flow clean room, a full bubble helmet system with associated communications and ventilation subsystems for operating room personnel, and surgical gowns that minimize the migration of bacteria. The development test results consisting of portability, laminar flowrate, air flow pattern, electrostatic buildup, noise level, ventilation, human factors, electrical and material compatibility tests are summarized. The conclusions are that the experimental system is effective in reducing the airborne and wound contamination although the helmets and gowns may not be a significant part of this reduction. Definitive conclusions with regard to the infection rate cannot be made at this time.

Tevebaugh, M. D.↗

NASA NTRS1979

Flow-compensating pressure regulator

Pressure regulator developed for use with cataract-surgery instrument controls intraocular pressure during substantial variations in flow rate of infusion fluid. Device may be applicable to variety of eye-surgery instruments.

Baehr, E. F.↗

NASA NTRS1991

Fluid handling 2: Surgical applications

The methods proposed for managing fluids and particulate debris during minor surgery on Space Station Freedom (SSF) were investigated and demonstrated. A KC-135 parabolic flight test was performed, in which the flight followed the standard 40 parabola profile with 20 to 25 seconds in near-zero gravity in each parabola. The equipment (suction and laminar flow device) was evaluated. While this equipment performed satisfactorily previously in the dental simulation, the purpose of the current flight was to reconfigure the equipment in support of a minor surgical situation in order to evaluate its efficacy and establish clear requirements for the actual flight hardware. To accomplish the study the Health Maintenance Facility medical restraint system was deployed as for surgical use and mannequin suture arm was restrained to its surface. The surgical area was established as for performing minor surgery with standard tray and suture instruments employed.

Billica, Roger↗

NASA NTRS1991

Surgical force detection probe

The development progress of a precision electro-mechanical instrument which allows the detection and documentation of the forces and moment applied to human tissue during surgery (under actual operation room conditions), is reported. The pen-shaped prototype probe which measures 1/2 inch in diameter and 7 inches in length was fabricated using an aerodynamic balance. The aerodynamic balance, a standard wind tunnel force and moment sensing transducer, measures the forces and the moments transmitted through the surgeon's hand to the human tissue during surgery. The prototype probe which was fabricated as a development tool was tested successfully. The final version of the surgical force detection probe will be designed based on additional laboratory tests in order to establish the full scale loads. It is expected that the final product will require a simplified aerodynamic balance with two or three force components and one moment component with lighter full scale loads. A signal conditioner was fabricated to process and display the outputs from the prototype probe. This unit will be interfaced with a PC-based data system to provide automatic data acquisition, data processing, and graphics display. The expected overall accuracy of the probe is better than one percent full scale.

Tcheng, Ping↗

NASA NTRS1994

A force-controllable macro-micro manipulator and its application to medical robots

This paper describes an 8-degrees-of-freedom macro-micro robot. This robot is capable of performing tasks that require accurate force control, such as polishing, finishing, grinding, deburring, and cleaning. The design of the macro-micro mechanism, the control algorithms, and the hardware/software implementation of the algorithms are described in this paper. Initial experimental results are reported. In addition, this paper includes a discussion of medical surgery and the role that force control may play. We introduce a new class of robotic systems collectively called Robotic Enhancement Technology (RET). RET systems introduce the combination of robotic manipulation with human control to perform manipulation tasks beyond the individual capability of either human or machine. The RET class of robotic systems offers new challenges in mechanism design, control-law development, and man/machine interface design. We believe force-controllable mechanisms such as the macro-micro structure we have developed are a necessary part of RET. Work in progress in the area of RET systems and their application to minimally invasive surgery is presented, along with future research directions.

Marzwell, Neville I.↗

NASA NTRS1995

Hip Implant Modified To Increase Probability Of Retention

Modification in design of hip implant proposed to increase likelihood of retention of implant in femur after hip-repair surgery. Decreases likelihood of patient distress and expense associated with repetition of surgery after failed implant procedure. Intended to provide more favorable flow of cement used to bind implant in proximal extreme end of femur, reducing structural flaws causing early failure of implant/femur joint.

Canabal, Francisco, III↗

NASA NTRS2002

Non-Invasive Evaluation of Corneal Abnormalities Using Static and Dynamic Light Scattering

A preliminary study of corneal abnormalities in intact bovine eyes is presented. Twenty-one eyes were treated with chemicals, cotton swabs, and radial and photo-refractive surgeries. Dynamic and static light scattering was performed as a function of the penetration depth into the corneal tissue. Topographical maps of corneal refractive power from untreated and treated corneas were also obtained using videokeratoscopy and results compared. The ultimate aim is to develop the technique of dynamic light scattering (DLS) for clinical applications in early evaluation of corneal complications after laser-assisted in situ keratomileusis (LASIK) surgeries and other corneal abnormalities.

Ansari, Rafat R.↗

NASA NTRS1999

Biotelemeters for Space Flights and Fetal Monitoring

Pill-shaped biotelemeters originally designed for space flight applications will soon be used for monitoring the health of a fetus during and after in-utero fetal surgery. The authors developed a family of biotelemeters that are not only small enough for rodent studies on board the space shuttle or international space station, but also fit through a 10 mm trocar, a plastic tube that is used in endoscopic fetal surgery to obtain minimally invasive access to the fetus. The first 'pill' measures pressure and temperature, and is currently undergoing long-term leakage and biocompatibility tests. A second pill under development measures pH and temperature. A prototype of the 'pH-pill' has been built and successfully tested and is presently being miniaturized into the same dimensions as the 'pressure pill'. Additional pills measuring heart rate, ECG, other ions such as calcium and potassium, and eventually glucose and blood gases, will follow. All pills are designed for ultra-low power consumption yielding lifetimes of up to 10 months in order to meet the requirements of fetal monitoring, but also to provide the capability of long-term space station experiments. Each pill transmits its pulse-interval-modulated signal on a unique carrier frequency in the frequency range of 174-216MHz. A custom-designed multi-channel receiver demodulates and decodes each pill signal and sends the data to a LabVIEW program that performs real-time data analysis and display. A patent for the pill family and its data analysis system is pending.

Mundt, Carsten W.↗

NASA NTRS1994

A Third Arm for the Surgeon

In laparoscopic surgery, tiny incisions are made in the patient's body and a laparoscope (an optical tube with a camera at the end) is inserted. The camera's image is projected onto two video screens, whose views guide the surgeon through the procedure. AESOP, a medical robot developed by Computer Motion, Inc. with NASA assistance, eliminates the need for a human assistant to operate the camera. The surgeon uses a foot pedal control to move the device, allowing him to use both hands during the surgery. Miscommunication is avoided; AESOP's movement is smooth and steady, and the memory vision is invaluable. Operations can be completed more quickly, and the patient spends less time under anesthesia. AESOP has been approved by the FDA.

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NASA NTRS1990

Laser Angioplasty

The principal method of dealing with coronary artery blockage is bypass surgery. A non-surgical alternative available to some patients is balloon angioplasty. For several years, medical researchers have been exploring another alternative that would help a wider circle of patients than the balloon treatment and entail less risk than bypass surgery. A research group is on the verge of an exciting development: laser angioplasty with a 'cool' type of laser, called an excimer laser, that does not damage blood vessel walls and offers non-surgical cleansing of clogged arteries with extraordinary precision. The system is the Dymer 200+ Excimer Laser Angioplasty System, developed by Advanced Intraventional Systems. Used in human clinical tests since 1987, the system is the first fully integrated 'cool' laser capable of generating the requisite laser energy and delivering the energy to target arteries. Thirteen research hospitals in the U.S. have purchased Dymer 200+ systems and used them in clinical trials in 121 peripheral and 555 coronary artery cases. The success rate in opening blocked coronary arteries is 85 percent, with fewer complications than in balloon angioplasty. Food and Drug Administration approval for the system is hoped for in the latter part of 1990. * Advanced Intraventional Systems became Spectranetics in 1994 and discontinued the product.

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NASA NTRS1981

Space Derived Health Aids (Cardiac Pacemaker)

St. Jude Medical's Cardiac Rhythm Management Division's (formerly known as Pacesetter Systems, Inc.) pacer is a rechargeable cardiac pacemaker that eliminates the recurring need for surgery to implant a new battery. The Programalith is an advanced cardiac pacing system which permits a physician to reprogram a patient's implanted pacemaker without surgery. System consists of a pacemaker, together with a physician's console containing the programmer and a data printer. Signals are transmitted by wireless telemetry. Two-way communications, originating from spacecraft electrical power systems technology, allows physician to interrogate the pacemaker as to the status of the heart, then to fine tune the device to best suit the patient's needs.

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NASA NTRS2003

Noninvasive, near infrared spectroscopic-measured muscle pH and PO2 indicate tissue perfusion for cardiac surgical patients undergoing cardiopulmonary bypass

OBJECTIVE: To determine whether near infrared spectroscopic measurement of tissue pH and Po2 has sufficient accuracy to assess variation in tissue perfusion resulting from changes in blood pressure and metabolic demand during cardiopulmonary bypass. DESIGN: Prospective clinical study. SETTING: Academic medical center. SUBJECTS: Eighteen elective cardiac surgical patients. INTERVENTION: Cardiac surgery under cardiopulmonary bypass. MEASUREMENTS AND MAIN RESULTS: A near infrared spectroscopic fiber optic probe was placed over the hypothenar eminence. Reference Po2 and pH sensors were inserted in the abductor digiti minimi (V). Data were collected every 30 secs during surgery and for 6 hrs following cardiopulmonary bypass. Calibration equations developed from one third of the data were used with the remaining data to investigate sensitivity of the near infrared spectroscopic measurement to physiologic changes resulting from cardiopulmonary bypass. Near infrared spectroscopic and reference pH and Po2 measurements were compared for each subject using standard error of prediction. Near infrared spectroscopic pH and Po2 at baseline were compared with values during cardiopulmonary bypass just before rewarming commenced (hypotensive, hypothermic), after rewarming (hypotensive, normothermic) just before discontinuation of cardiopulmonary bypass, and at 6 hrs following cardiopulmonary bypass (normotensive, normothermic) using mixed-model analysis of variance. Near infrared spectroscopic pH and Po2 were well correlated with the invasive measurement of pH (R2 =.84) and Po2 (R 2 =.66) with an average standard error of prediction of 0.022 +/- 0.008 pH units and 6 +/- 3 mm Hg, respectively. The average difference between the invasive and near infrared spectroscopic measurement was near zero for both the pH and Po2 measurements. Near infrared spectroscopic Po2 significantly decreased 50% on initiation of cardiopulmonary bypass and remained depressed throughout the bypass and monitored intensive care period. Near infrared spectroscopic pH decreased significantly during cardiopulmonary bypass, decreased significantly during rewarming, and remained depressed 6 hrs after cardiopulmonary bypass. Diabetic patients responded differently than nondiabetic subjects to cardiopulmonary bypass, with lower muscle pH values (p =.02). CONCLUSIONS: Near infrared spectroscopic-measured muscle pH and Po2 are sensitive to changes in tissue perfusion during cardiopulmonary bypass.

Non-NASA Center↗

NASA NTRS2002

Subcutaneous administration of insulin-like growth factor (IGF)-II/IGF binding protein-2 complex stimulates bone formation and prevents loss of bone mineral density in a rat model of disuse osteoporosis

Elevated serum levels of insulin-like growth factor binding protein-2 (IGFBP-2) and a precursor form of IGF-II are associated with marked increases in bone formation and skeletal mass in patients with hepatitis C-associated osteosclerosis. In vitro studies indicate that IGF-II in complex with IGFBP-2 has high affinity for bone matrix and is able to stimulate osteoblast proliferation. The purpose of this study was to determine the ability of the IGF-II/IGFBP-2 complex to increase bone mass in vivo. Osteopenia of the femur was induced by unilateral sciatic neurectomy in rats. At the time of surgery, 14-day osmotic minipumps containing vehicle or 2 microg IGF-II+9 microg IGFBP-2/100g body weight/day were implanted subcutaneously in the neck. Bone mineral density (BMD) measurements were taken the day of surgery and 14 days later using a PIXImus small animal densitometer. Neurectomy of the right hindlimb resulted in a 9% decrease in right femur BMD (P<0.05 vs. baseline). This loss in BMD was completely prevented by treatment with IGF-II/IGFBP-2. On the control limb, there was no loss of BMD over the 14 days and IGF-II/IGFBP-2 treatment resulted in a 9% increase in left femur BMD (P<0.05). Bone histomorphometry indicated increases in endocortical and cancellous bone formation rates and in trabecular thickness. These results demonstrate that short-term administration of the IGF-II/IGFBP-2 complex can prevent loss of BMD associated with disuse osteoporosis and stimulate bone formation in adult rats. Furthermore, they provide proof of concept for a novel anabolic approach to increasing bone mass in humans with osteoporosis.

NASA Discipline Regulatory Physiology↗