1. Pelvic Osteolysis: Evacuation and Filling Felicia Shay Computer Integrated Surgery II Checkpoint Presentation

2. Plan of Action Project Description Project Management Considerations Data Contacts Conclusions Lessons Learned

3. What is the Problem? How does the problem arise? –Location –Necrosed bone Current Situation/Technology Importance of Project Project/Goal Project Description

4. ID material/potential Plan for tool design Explore Options Evaluate Build tools Testing Project Description

5. Deliverables Minimal: Research and documentation of potential material –Tools –Filling Potential tool design with evaluations and considerations Bone filler material and analysis of potential material Expected: Prototyping of instrument and filling Modeling and evaluation of each Potential integration and mechanism for whisking, evacuation and filling Maximal: Integration with robot Project Description

6. Initial Constraints Physiologically Problem In the material: –Biocompatibility –Flexibility to access the material In the shape of lesion In the design and tools needed: –Need for suction and irrigation –Feasibility Project Description

7. Implications Minimally invasive Pre-Operative –More planning time –More cost Post-Operative –Faster healing time –Less likely for infection –Cost distribution to hospital and insurance Most Importantly: Corrects a currently inoperative condition Project Description

8. Plan of Action Project Description Project Management Considerations Data Contacts Conclusions Lessons Learned

9. Initial Proposed Dates 2.22.01 Official Start Date 3.1.01 Meetings scheduled/attended and research on potential evacuation and filler material 3.8.01 Research weight bearing material 3.15.01 Read papers, begin brainstorming on designs, purchase material and background reading. 3.22.01 Model different designs and evaluate according to the constraints theoretically 4.7.01 Begin prototyping and testing of different size tubing and wires with tool constraint, filling 4.14.01 Evaluating different prototypes 5.1.01 Completion of project and documentation Project Management

10. Progress by Checkpoint 2.22.01 Official Start Date 3.1.01 Meetings scheduled/attended and research on potential evacuation and filler material 3.8.01 Research weight bearing material 3.15.01 Read papers, begin brainstorming on designs, purchase material and background reading. 3.22.01 Model different designs and evaluate according to the constraints theoretically Checkpoint Project Management

11. Current Status 4.30.01 Meeting with Dr. Horowitz. 5.1.01 Met with Mark Kuntz, set up lab meeting 5.7.01 Wire material arrives Tubing from Wilmer Oncology (Thanks Aaron) 5.8.01 Mark Kuntz, Undergraduate Design Lab furnace, plate (machine shop), potential testing 5.9.01 Tubing arrives Mechanical setting/testing of wires 5.10.01 Preparation for final presentation Mechanical setting/testing/loading of wires Project Management

12. Relevant Papers Yang, F., Wu, K.H., Pu, Z. J. “The Effect of Strain Rate and Sample Size Effects on the Superelastic Behavior of Superelastic Alloys” Proceedings of the Second International Conference on Shape Memory and Superelastic Technologies. (CA) 1997, p 23-28. Berg, B. “Twist and Stretch: Combined Loading of Pseudoelastic NiTi Tubing” Proceedings of the Second International Conference on Shape Memory and Superelastic Technologies. (CA) 1997, 443-448. Ueki, T., Mogi, H., Horikawa, H. “Torsion Property of Ni-Ti Superelastic Alloy Thin Tubes” Proceedings of the Second International Conference on Shape Memory and Superelastic Technologies. (CA) 1997, 467- 472. Yang, Jianhua. “Fatigue Characterization of Superelastic Nitinol”. Proceedings of the Second International Conference on Shape Memory and Superelastic Technologies. (CA) 1997, 479-484.

13. Plan of Action Project Description Project Management Considerations Data Contacts Conclusions Lessons Learned

14. Considerations Torque Repeat cycling (Compression/Tension) –Strain Rate –Fatigue Angulation to gain access to site Room for tools and evacuation Tight fit vs Loose fit Range of Motion Considerations

15. Additional Considerations after Testing Force Generated –Rotational Mechanism Crank Attachment to drill bit head How can you keep track of the site General Testing Methods Importance of Irrigation/Suction due to Force Generation Considerations

16. Setting and Shaping Superelastic SMA Shape –2 Aluminum plates –30, 45, 90 degree threads drilled as guides –2 bolts Furnace –500C for 15 minutes –Slow cooling time

17. Effects of Rotational Movement Types –Crank –Attachment to drill bit head ~500 rotations/minute –How can you keep track of the site Effects of Cyclic Wear Force Generation

18. Cyclic Strain vs Fracture Considerations

19. Mechanical Testing Methods –Tensile Strength –Force for Compression Parameters –Copper tube Straight 45 degree –Different bends/lengths

20. Current Choices of Angulation in Testing and Considerations Angles of wire end effector/tubing Length of wire/tubing from bend to tip KEY: Accessing all of the site with angles/length Force Generated Cyclic loading/compression/friction with different end effectors and tubing Considerations

21. Plan of Action Project Description Project Management Considerations Data Contacts Conclusions Lessons Learned

22. Parameters Wire Degree Bends: –80 degree bend –40 degree bend –30 degree bend Wire Thickness –0.0020” and 0.0010” Tube Thickness 45 degree bend –0.0028” and 0.0017”

23. Data (10 trials + highest and lowest trial) Angle thickness 0.0020” LengthInsert (lbf)Withdraw (lbf) 80Short-0.415+0.42 40Short-0.38+0.41 30Short-0.050+0.055 80Long-0.385+0.42 40Long-0.062+0.075 30Long-0.019+0.025

24. Design Changes Considerations: –Force Generation –Rotational Movement –Deformity Cyclic wear Tightness down tube Guidewire with Rubber Tubing Considerations

25. New Contacts Made Emanuel Horowitz, Ph.D. Johns Hopkins Material Science and Engineering James B. Spicer, Ph.D. Johns Hopkins Material Science and Engineering Mark Kuntz Johns Hopkins Material Science and Engineering Undergraduate Design Lab and Machine Shop Shape Memory Applications, Inc. www.sma-inc.com Contact: Holly

26. Dependencies Before Receipt of the materials to begin prototyping

27. Dependencies Now TIME Limited testing facilities Certain force testing variability

28. 5.26.01 Potential/Projected Deliverables Completion of Testing Integration of Tubing Finding most suitable Rotational Movement Integration of Suction/Irrigation Final Testing

29. Conclusion Feasibility Effective Just takes more: –Time –Work –Planning –Designs –Testing Designs all need to be tested.

30. Significance TO: –Patient –Surgeons –Insurance Companies –Technology Development Less post op recovery time Treats an existing untreatable condition Introduction of new technology Continued interaction b/n surgeons and engineers to solve existing surgical problems where technology is hindering development

31. Retrospective Don’t be completely dependent on material Can’t plan ahead enough Try to find additional suppliers Although some things are unforeseeable, you can work around it

32. Special Thanks to: Niccole Herbert Mark Kuntz