Laparoscopic Smart Instrument for Detection of Nearby Anatomy During Prostatectomy Ania Warczyk Shivani Shah Alia Durrani Timothy Chen BME 272 Fall 2007

Problem Statement Construct a laparoscopic smart instrument with a sensor at the tip to detect nerve bundles and deep vessels during prostatectomy Would have the ability to dig into fat Compatibility with the Da Vinci robot

Background: Current Methods Prostatectomy: surgical removal of all or part of the prostate gland Abnormalities such as a tumor or gland enlargement can restrict flow of urine along urethra Open prostatectomy very invasive; involves skin incisions while surgeon visualizes the surrounding anatomy – not foolproof Laparoscopic prostatectomy allows for smaller incisions, less pain, less bleeding, less risk of infection, and faster healing time

Background: Da Vinci Laparoscopic or four small incisions are made in the abdomen, and the entire prostate is removed while attempting to spare nerves A need to discern between anatomy during prostatectomy to avoid surrounding vessels and nerves Robot gives the surgeon much more dexterity than conventional laparoscopy while offering the same advantages over open prostatectomy

Project Goals Design a device can address the problem that occurs during invasive surgery of tools/instruments hitting nerve bundles The device should be capable of the following: Detect for the presence of nerve bundles Map nerve position in relation to other intended targets Coordinate with EM tracking for increased tip-to-target accuracy and real-time guidance during nerve detection Nerve Bundles

Solution Design a laparoscopic tool with a sensor at the tip to detect nerve bundles Utilize stored spikes that are deployed from the instrument once inside the body instead of previously used strain gauges to dig into surrounding fat and come close to a nerve bundle

Completed Work Maintained continuous contact with PI Researched previous methods utilized for prostatectomies and other surgeries Found patents for methods of locating nerve bundles Constantly updated website

Current Work Researching different methods for locating nerves Nerve Mapping Electrical Stimulation Ultrasonography

Future Work Request funds from NIH to obtain materials. These materials will allow us to begin putting together possible prototype designs Observe a prostectomy to understand the use of the device we are creating Da Vinci robotic surgery, preferably

Da Vinci Robotic Surgery

Conclusions Robot-assisted laparoscopic prostatectomy is less invasive and more accurate Discerns between anatomical structures Inaccuracy in prostatectomy can lead to: ED Ruptured blood vessels