2010-2011 Projects

Esophageal atresia nonoperative correction Long-gap esophageal atresia is a congenital disorder occurring in approximately 100 newborn infants every year characterized by a discontinuity in the esophagus between the mouth and stomach. This project investigated the use of internal permanent magnets to stretch the proximal and distal esophageal pouches together until anastomosis occurs. The system implements a hydraulic and magnetic mechanism, with optical gap sensing, to apply controlled, adjustable forces from inside the pouches. This could potentially lead to a novel treatment for a tragic condition. Team: Austin L. Oehlerking, James D. Meredith, Ian C. Smith, Phillip M. Nadeau, Teresa Gomez, Zachary A. Trimble, David P. Mooney (Children’s), David L. Trumper	Half of magnet assembly ASME DMD Paper
Improved nasal gastric tube tip and flushing device Nasogastric tubes are commonly used to evacuate the stomach during cases of small obstructive bowel syndrome and surgical operations, unfortunately the tube tip and bore is prone to clogging.  A redesigned tube tip featuring helical slits, rather than holes, reduces clogging by both food particles and suction against the stomach mucosa. Should a clog still occur an in-line flusher has been developed that, with a single squeeze, can disconnect the vacuum, deliver a saline purge and reconnect the vacuum. Reduced clogging and easier flushing will improve patient comfort and reduce nursing staff workload. Team: James A. Ankrum, Alison L. Olechowski, Jose A. Canseco, Elliot E. Greenblatt, Michael P. Roberts, Robert Brick, Dr. Ali Tavakkolizadeh (BWH)	Improved tip and flusher device ASME DMD Paper Patented, Available for License
Single entry tunneler [SET] for hemodialysis graft procedures Vascular tunnelers are used to create a path through subcutaneous tissue for the placement of grafts, particularly for hemodialysis access. Most current designs are rigid and require high forces and multiple incisions to complete even the most simple path geometries. This project investigated a three-stage design consisting of concentric, nested tubes: a straight stainless steel tube; a second pre-curved nitinol tube and a straight nitinol tube. By deploying the stages in this order the device is able to produce an approximately 180◦ looped path through tissue. An illuminated tip provides visual feedback of the tip trajectory under the skin. This has the potential to reduce tissue trauma and the risk of post-operative infection. Team: Madalyn S. Berns, Elizabeth Y. Tsai, Jesse Austin-Breneman, James C. Schulmeister, Edward Sung, Conor J. Walsh, Charles K. Ozaki (BWH)	Curved tunneler and dilator ASME DMD Paper
Innovative renal cooling device for use in minimally invasive surgery Over 58,000 patients suffer from renal cell carcinoma annually in the US and treatment often requires surgical removal of the cancerous tissue via a partial nephrectomy. In open renal surgery, the kidney is placed on ice to increase allowable ischemia time; however there is no method for reducing kidney temperature during minimally invasive surgery. The device consists of a foldable bag that deploys through a 12 mm trocar, unfurls inside the abdomen then wraps around the kidney and is filled with ice slurry. Testing indicates that kidney core cooling to 20°C can be obtained in under 10 minutes, whereupon the water can then be suctioned out and the device removed, leaving the kidney ready for surgery with a longer working time. Team: Edward Summers, Thomas Cervantes, Rachel Batzer, Julia Stark, Raymond Lewis, Christie Simpson, Dr. Nadeem Dhanani (Mt. Auburn)	Cooling bag wrapped around model kidney ASME DMD Paper Patented, Available for License
Somnus Sleep Sensing Shirt - home sleep monitoring Over 1 million sleep studies are performed annually in the US to detect chronic sleep disorders. Currently these require a patient to spend a night in a clinic connected to up to 30 sensors, ranging from brain wave electrodes to blood oxygen trackers. Data from these studies are divided into time segments and which are manually categorized into various sleep states in a costly process. The Somnus Sleep Shirt package is comprised of a snug fitted shirt, embedded with simple capacitive displacement sensors that monitor the respiration of a sleeping patient and a novel software package and algorithm that automates sleep scoring. This combination has been shown to analyze sleep with accuracy comparable to current sleep laboratory methodology, with greatly reduced technical requirements, at low cost and while achieving a higher level of comfort and convenience for the user. Team: Thomas S. Lipoma, Pablo J. Bello, Carson J. Darling, Matthew Bianchi (MGH)	Somnus Shirt in action ASME DMD Paper Winner 2011 DMD 3 in 5 Comp. Startup Funded Nyx Devices Inc.
Pressure sensing laparoscopic grasper Most laparoscopic graspers provide minimal tactile feedback and create pinch points in the grasped region, often resulting in either excessive grasp forces or tissue slippage. Tissue trauma can occur. This research presents a proof-of-concept for a parallel motion, pressure sensing laparoscopic grasper which eliminates pinch points in the grasped region and applies a uniform pressure across the grasper jaws. A low cost pressure sensor provides feedback to the handle when a preset threshold force is applied. Testing results from a 2x scale prototype were close to analytical predictions and allowed grasper pressure to be monitored. Team: Grace S. L. Teo, Mattias S. Flander, Toomas R. Sepp, Manuel Corral, Juan D. Diaz, Alexander Slocum, Khashayar Vakili (Children’s)	Parallel gripper with force detection ASME DMD Paper
Flexural laparoscopic grasper Laparoscopic surgery requires complex manipulation and movement of internal organs. While small incisions make laparoscopic surgery an attractive procedure, current laparoscopic devices hinder surgeons' capabilities with limited degrees of freedom. Specifically, needle nose end effectors pinch organs and can cause tissue perforation. To enhance surgical capacity, a three fingered laparoscopic device was designed, fabricated and tested. Flexures with tendon-like control cables are used to provide three points of articulation in each finger. To integrate with current laparoscopic procedures, the device fits through a 12mm trocar port. An ergonomic handle allows the fingers to be easily actuated and locked in position. Testing the device with organ-like objects revealed an increased ability to grasp, move and otherwise engage items. Harry O'Hanley, Matt Rosario, Yuanyu Chen, Audrey Maertens, John Walton, Mitchell T. Westwood, Jennifer Rosen (BMC)	Gripper with flexural fingers ASME DMD Paper
OneShot One Handed Glucometer Typical blood glucose monitoring systems that consist of glucometers and lancing devices do not account for the needs of diabetics whose physical or mental conditions limit their dexterity. This project proposes an integrated blood glucose monitoring system that operates with a finger press that combines lancing and blood withdrawal into a single fluid step using an electromechanical actuation system, not found in lancing devices or glucometers currently on the market. The complexity of taking a blood glucose measurement is reduced by 40%. Santiago Alfaro, Harrison Bralower, Linda Liu, Jennifer Milne, James Regan (VA Boston)	Comparison showing reduction in steps

Representative Earlier Projects

Robopsy - 2004 Robopsy, a robotic device to assist radiologists performing tumor biopsies was invented by an MIT 2.75 team led by MGH's Rajiv Gupta, MD.  The team has been awarded the 2007 MIT $100K prize, the world's leading entrepreneurship competition and the first-place award at the 2008 ASME Innovation Showcase. See website for all Information ASME IDETC, ASME Biomed, IEEE EMBC, ASME J. Med. Dev.
Enhanced ACL Repair- 2004 Dr. Martha Murray of Children’s Hospital developed a cell-friendly gel containing platelets and collagen to serve as a scaffold to enable torn anterior cruciate ligament (ACL) healing, but needed a way to way mix, warm and inject the gel into the target location.  She turned to CIMIT and 2.75 to develop a handheld “gel gun,” employing a heater and a collapsible augur, which is capable of precisely preparing, metering and arthroscopically injecting the gel through a 1 cm incision. The third generation device and the gel is undergoing testing with results indicating significantly stronger ACL repairs. Dr. Murray is working to turn her technology into a start-up company devoted to improving the treatment of over 200K ACL repair patients per year. Read more here and be sure to watch the video.
Endoscopic Biopsy Needle w/ Flexural Members - 2005 Current endoscopic biopsy needles are relatively unreliable in operation and incapable of preserving the tissue histology. This research developed a new of coring biopsy needle with small laser cut flexural barbs along the inside.  Upon insertion into tissue they bend out of the way and then upon retraction of the needle they firmly grab the tissue sample and sever it.   The needle has been fully prototyped in stainless steel, testing indicated increased sample yield and structural robustness. ASME J. Medical Devices Paper
GRiT Chair Alarm - 2007 The Gesture Recognition Interactive Technology (GRIT) Chair Alarm aims to prevent falls for at risk patients. The alarm uses an array of proximity and pressure sensors to create a map of the patient’s sitting position and then uses gesture recognition algorithms to determine when a patient is attempting to stand up and responds with light and voice alarms and activates the integrated nurse-call function. IEEE EMBS
Endotracheal Tube Placement Sensor - 2007 Placing an endotracheal tube (ETT) at the correct location requires a high level of skill and training.  Our group has developed a hand-held ETT placement sensor which allows a doctor to “see” the tube’s position in the throat. It uses an array of Giant Magnetoresistive sensors to localize the position of a tiny magnet embedded in the ETT. The entire device is rechargeable and designed to fit comfortably into the hand. IEEE EMBS
Osmoregulation - 2007 There is a continued need for a non-invasive method to accurately measure the level of hydration in human beings. Our method uses low power RF energy from 100 kHz to 10 MHz to measure the loss tangent of the frontal is muscle (in the forehead) which is a function of tissue osmolality and hematocrit, which are strong indicators of hydration.
Smartpad - A Wireless, Stickerless EKG System - 2007 During an operation, the patient's vital signs are displayed in the operating room. The large number of wires attached to the patient inhibits the medical team's access and the electrodes may not be placed in convenient locations. We present the SmartPad: a device that displays a patient's electrocardiogram (EKG) signal without adhesives or wires. Instead, our sensors are bonded to a foam mat, on which the patient lies during the operation. IEEE EMBS
Mechanical Needle Clutch - 2009 Current methods of trocar and needle placement into hollow organs rely on a high degree of clinical skill to stop inside the organ and not over penetrate. To address this, a purely mechanical clutch was developed which comprises buckled filament inside an S-shaped tube (the trocar or needle). When pushed against firm tissue the filament buckles and locks within the tube, causing the filament and tube to advance as one. When the needle reaches the target tissue or fluid-filled cavity, the filament unlocks and slides freely into the target region while the tube remains stationary. PNAS Paper

Publications List

• Mitha, A.P., Ahmad, M.S., Cohen, S.J., Lieberman, J.S., Udengaard, M.R., Slocum, A.H., Coumans, J.C.E., 2010, A Modified Footplate for the Kerrison Rongeur, ASME Journal of Medical Devices, March, vol. 4, p. 014502-1 - 014502-4. [PDF]
• Chen, Y., Chang, J., Greenlee, A.S., Cheung, K.C., Slocum, A.H., Gupta, R., Multi-turn, Tension-stiffening Catheter Navigation System, Proc. of 2010 IEEE ICRA, May 3-8, 2010, Anchorage, Alaska. [PDF]
• Petrzelka, J.E., Chatzigeorgiou, D.M., Menon, M.C., Lustrino, M.E., Stefanov-Wagner, C.J., Slocum, A.H., and Agarwal, S.K., 2001, An Articulating Tool For Endoscopic Screw Delivery, Proc. of the 2010 Design of Medical Devices Conference, April 13-15, 2010, Minneapolis, MN, USA. [PDF]
• Slocum Jr., A.H., Duffley, S.C. Moreau, J.G., Watral, A., Spiegel, J.E., Slocum, A.H., Design of a Pressure Measuring Syringe, Proc. of the 2010 Design of Medical Devices Conference, April 13-15, 2010, Minneapolis, MN, USA. [PDF]
• Anderson, S.J., Zimmermann, J.C., Houston, E.F., Farino, K.M., Begg, N.D., 2010, Design of an Endoscopic Lens Shielding Device for use in Laparoscopic Procedures, Proc. of the 2010 Design of Medical Devices Conference, Minneapolis, MN, USA, Mar. 13-15, DMD2010-3849. [PDF]
• Al Husseini, A.M., Lee, H.J., Negrete, J., Powelson, S., Servi, A., Sloucm, A., Saukkonen, J., 2010, Design and Prototyping of a Low-cost Portable Mechanical Ventilator, Proc. of the 2010 Design of Medical Devices Conference, Minneapolis, MN, USA, Mar. 13-15, DMD2010-3845. [PDF]
• del Pozzo, D., Eggenspieler, D., Slocum, A., Deterre, M., Lobovsky, M., Pigula, F., Hydraulically Remote Adjustable Pulmonary Artery Banding, Proc. of the 2010 Design of Medical Devices Conference, Minneapolis, MN, USA, Mar. 13-15, DMD2010-3879. [PDF]
• E.K. Bassett, A.H. Slocum, P.T. Masiakos, H.I. Pryor, O.C. Farokhzadb, J.M. Karp, Design of a mechanical clutch-based needle-insertion device, Proc. of the National Academy of Sciences, 2009 [PDF1, PDF2]
• Knight, H., Lee, J., Ma, H., 2008, Chair Alarm for Patient Fall Prevention based on Gesture Recognition and Interactivity, Proc. 30th Annual International IEEE EMBS Conference, Vancouver, British Colombia, Canada, Dec. 20-24, p. 3698-3701, 978-1-4244-1815-2/08. [PDF]
• Chen, F., Wu, H., Hsu, P., Stronger, B., Sheridan, R., Ma, H., 2008, SmartPad: A Wireless, Adhesive-Electrode-Free, Autonomous ECG Acquisition System, Proc. 30th Annual International IEEE EMBS Conference, Vancouver, British Colombia, Canada, Dec. 20-24, p. 2345-2348, 978-1-4244-1815-2/08. [PDF]
• Wichakool, W., Pierquet, B., Durand, K., Hsu, B., Sheridan, R., Ma, H., 2008, Magnetic Endotracheal Tube Imaging Device, Proc. 30th Annual International IEEE EMBS Conference, Vancouver, British Colombia, Canada, Dec. 20-24, p. 2345-2348, 978-1-4244-1815-2/08. [PDF]

• McEuen, S., Tzeranis, D., Hemond, B., Dirckx, M., Lee, L., Slocum, A.H., 2008, Design of an Endoscopic Full-Thickness Lesion Removal Device,” ASME Journal of Medical Devices, March, vol. 2, p. 015002-1 - 015002-8. [PDF]
• Walsh, C.J., Hanumara, N.C., Slocum, A.H., Shepard, J, Gupta, R., 2008, “A Patient-Mounted, Telerobotic Tool for CT-Guided Percutaneous Interventions,” ASME Journal of Medical Devices, March, vol. 2, p. 011007-1 - 011007-10. [PDF]
• Figueredo, S.L., Brugge, W.R., Slocum, A.H., 2007, Design of an Endoscopic Biopsy Needle with Flexural Members,” ASME Journal of Medical Devices, March, vol. 1, p. 62-69.. [PDF]
• Walsh, C.J., Hanumara, N., Slocum, A., Gupta, R., Shepard, J., 2007 Evaluation of a Patient-Mounted, Remote Needle Guidance System for CT-Guided, Percutaneous Lung Biopsies, Proc. of BioMed Conference, Irvine, CA, USA, June 7-8, BioMed2007-38080. [PDF]
• Hanumara, N.C., Walsh, C.J., Slocum, A.H., Gupta, R., Shepard, J., 2007, Human Factors Design for Intuitive Operation of a Low-cost, Image-Guided, Tele-Robotic Biopsy Assistant, Proc. of the 29th Annual International Conference of the IEEE EMBC, Lyon, France, Aug. 23-26, p. 1257-1260, ThP2D4.7. [PDF]
• Barrett, S.R.H., Hanumara, N.C., Walsh, C.J., Slocum, A.H., Gupta, R., Shepard, J.O., 2005, A Remote Needle Guidance System for Percutaneous Biopsies, Proc. IDETC/CIE Conference, Long Beach, CA, USA, Sept. 24-28, DETC2005-85387. [PDF]