A new minimally invasive heart surgery instrument for atrial fibrillation treatment: first in vitro and animal tests.
BACKGROUND
The paper presents a new robotic system for beating heart surgery. The final goal of this project is to develop a tele-operated system for the thoracoscopic treatment of patients with atrial fibrillation. The system consists of a robot that moves an innovative end-effector used to perform lines as in the Cox-Maze technique.


METHODS
The device is an electrode mesh that is introduced in the thorax through a trocar and is deployed inside the left atrium, where it can create selective ablation lines at any atrial region, using radio frequency. The current version of the umbrella has 22 electrodes. Using visual feedback from an ultrasound based navigation system, the surgeon can choose which electrodes on the mesh to activate. Once the umbrella is in contact with the endocardium of the left atrium, at the expected position, the surgeon activates the chosen electrodes sequentially. The umbrella can then be moved to another position.


RESULTS
In vitro and in vivo animal tests have been carried out in order to test and improve the instrument, the robotic system and the operative procedure.


CONCLUSIONS
The performed trials proved the ability of the system to treat atrial fibrillation. More in vivo tests are currently being performed to make the robot and its device ready for clinical use.
Abadie
J
J
Laboratoire d'Automatique de Besançon UMR CNRS 6596, ENSMM, Université de Franche-Comté, France. jabadie@ens2m.fr
Faure
A
A
Chaillet
N
N
Rougeot
P
P
Beaufort
D
D
Goldstein
J P
JP
Finlay
P A
PA
Bogaerts
G
G
D000818:Animals; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005240:Feasibility Studies; D006801:Humans; D066298:In Vitro Techniques; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D010865:Pilot Projects; D012371:Robotics / Q000295:instrumentation* / Q000379:methods; D012756:Sheep; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D017216:Telemedicine / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome; D014584:User-Computer Interface