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Robotic Trans-oesophageal Ultrasound Probe for Guiding Cardiac Interventions

Study investigates Ingestion of caffeine on the efficacy of drugs commonly administered to patients referred for cardiac magnetic resonance.

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Transesophageal echocardiogram (TOE) is a key imaging approach routinely used to guide the minimally-invasive treatment of many forms of heart disease.

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Hypertrophic cardiomyopathy (HCM) is a condition where the heart muscle becomes thickened. This condition affects about one in 500 people.

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The aim of the project is to develop a commercially available 3D ultrasound technique for accurate measurement

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Transesophageal echocardiogram (TOE) is a key imaging approach routinely used to guide the minimally-invasive treatment of many forms of heart disease. TOE uses ultrasound to produce high quality and live images of a patient’s heart, valves and the surrounding vessels. It uses an ultrasound probe which passes into the oesophagus (the pipe joining the mouth to the stomach) and is held behind the heart.

During minimally invasive, keyhole surgery an incision is made in the neck or groin to admit a catheter (a thin tube like instrument). The catheter is guided to the heart using x-ray imaging. The operation is carried out using this catheter in combination with TOE and x-ray imaging. TOE provides clear images of the heart in real time which are necessary to guide catheters during minimally invasive surgery. Previously surgeons depended solely upon x-ray imaging and so the use of TOE has resulted in the reduction in radiation exposure in patients. TOE requires a skilled operator such as a nurse or cardiologist to hold the probe within the patient for the duration of the operation.

One drawback of using TOE during surgery is that the nurse operating the probe needs to stand close to the x-ray source often for several hours for each time they assist in this type of surgery. This project aims to design, construct and test a robotic TOE system that would allow the nurse to control the probe away from the x-ray source. Robotic control of the probe will improve image quality by giving a high degree of stability for long periods of time which has the potential of impacting the operating time for the patient. The robot will be controlled from a computer using a special controller.

In summary, the development of such a system would lead to better safety for patients and staff through less exposure to ionising radiation and potentially quicker procedure times.

The project is being carried out in collaboration with Xtronics Ltd., a UK based manufacturer of bespoke industrial robotic systems. Through this collaboration the Cardiovascular HTC anticipates improving patient care, supporting UK business and improving staff safety.

To date a prototype TOE remote robotic control system. This prototype has been tested in a laboratory (bench-top testing) to test the correct working of the mechanism and controls. Part of this work has involved developing a model for the robot to predict how the mechanisms move this will allow a more sophisticated automatic control to be created.

In the future, this robot will enable the operator to remotely control the standard TOE probe in a zero radiation environment with a comfortable posture for the long period cardiac procedures.

This project has been supported through the Cardiovascular HTC through the allocation of pump prime funding and the support of its staff. The project team will apply for research council funding to continue developing this innovative work.