title: Evaluation of a synergistic handheld instrument for resternotomy controlled by an integrated optical sensor.
abstract: Re-Sternotomy is an important part of many interventions in cardiac or thoracic surgery. It is performed close to critical structures such as the ascending aorta or the heart with an inherent high risk of serious damage. In this paper, a system for improving the safety of this surgical procedure is presented. A soft tissue preserving saw is combined with automatic depth regulation. The depth is controlled on the basis of the optical characteristics (visible light) of the tissue aligned to the saw blade, which is analyzed using a color sensor. Detection of the blades' position in the bone during the cutting process is possible through the integration of an optical fiber into the tip of the saw blade. The automatic depth control is realized using a hysteresis controller running on a real time system. To show the feasibility of this approach, the sensor technology was integrated into a prototypal sternal saw and evaluated on artificial bone. As part of the experiments the influence of water for cooling and dust particles from the process on the systems control stability were analyzed. The system performed stable and accurate. Future research will focus on the control algorithm and cadaver trials.
authors.affiliation: Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University, 52074 Aachen, Germany. akorff@hia.rwth-aachen.de
authors.forename: Alexander
authors.initials: A
authors.lastname: Korff
authors.forename: Thomas
authors.initials: T
authors.lastname: Jalowy
authors.forename: Meiko
authors.initials: M
authors.lastname: Mueller
authors.forename: Tobias
authors.initials: T
authors.lastname: Fuertjes
authors.forename: Guido
authors.initials: G
authors.lastname: Dohmen
authors.forename: Klaus
authors.initials: K
authors.lastname: Radermacher
authors.forename: Axel
authors.initials: A
authors.lastname: Follmann
mesh_terms: D055100:Optical Fibers; D055095:Optics and Photonics / Q000295:instrumentation*; D056346:Sternotomy / Q000295:instrumentation* / Q000379:methods*; D013249:Sternum / Q000601:surgery