Source: https://patents.google.com/patent/US20040033477
Timestamp: 2018-04-26 18:45:32
Document Index: 575246156

Matched Legal Cases: ['art.\n2', 'art.\n3', 'art.\n4', 'art.\n6', 'art.\n7', 'art.\n12', 'art.\n20', 'art.\n36']

US20040033477A1 - Computer-controlled tissue-based simulator for training in cardiac surgical techniques - Google Patents
Computer-controlled tissue-based simulator for training in cardiac surgical techniques Download PDF
US20040033477A1
US20040033477A1 US10405809 US40580903A US2004033477A1 US 20040033477 A1 US20040033477 A1 US 20040033477A1 US 10405809 US10405809 US 10405809 US 40580903 A US40580903 A US 40580903A US 2004033477 A1 US2004033477 A1 US 2004033477A1
US10405809
US7798815B2 (en )
Ramphal Paul S.
Craven Michael P.
[0016]FIG. 1 illustrates the inventive beating heart simulation system of the present invention used in a surgical theatre environment.
[0017]FIG. 2 illustrates a porcine heart as used in the present invention with latex rubber balloons inserted through atrioventricuar valves.
[0018]FIG. 3 is an illustration of a prototype of the inventive computer-controlled electromechanical pump based on linear actuator driving a diaphragm.
[0019]FIG. 4 is a block diagram illustrating the components of the inventive simulator system.
[0020]FIG. 5 is a cross-sectional view of the diaphragm pump used in the present invention.
[0021]FIG. 6 illustrates software architecture for the inventive simulator system.
[0022]FIG. 7 is a block diagram illustrating the components of the Low-level virtual machine (VM-L) of the present invention.
[0023]FIG. 8 illustrates an embodiment in which the right ventricular balloon is knotted to create a right ventricular outflow tract.
[0024]FIG. 9 illustrates a simulated vital signs monitor display.
[0033]FIG. 4 illustrates components of the simulated surgical environment. As shown, surgical trainee 412 is trained by instructor surgeon 411 in training surgical theater 400. Operating table 415 with mock chest cavity 416 similar to the one illustrated in FIG. 1 is connected to simulator pumping system 300. As discussed above, the tubing that connects the pumping system to the ventricular balloons is positioned such that it is not visible to the trainee surgeon.
[0038]FIG. 3 illustrates a prototype of a pulsatile diaphragm-type air pump driven by a linear actuator, according to the present invention. The linear activator is fitted with a high torque stepper motor, capable of providing the relatively large thrust force required to produce sufficient air pressure. In one configuration, the motor provides a thrust of about 450N to produce an air pressure of about 100 mm Hg gauge, up to a maximum of about 150 mm Hg gauge. The operation of the stepper motor is controlled by signals from an external driver microprocessor board. A number of the motion parameters, such as length of stroke, frequency and acceleration are user selectable, as will be discussed below.
[0040]FIG. 5 illustrates a cross-sectional view of a diaphragm-type pneumatic pump 323 that may be used with the inventive system. As shown, the pump is comprised of metal casing 501 and metal clamps 510 around a rubber seal 505. The diaphragm 520 is activated by actuator 535 through shaft 540. Port 550 is used to connect the pump to the intra-ventricular balloons through tubing.
The inventive pulsatile pump can reproduce a range of normal and abnormal cardiac rhythms in a preserved in vitro porcine heart, by inflating and deflating the intra-ventricular balloons inserted inside the heart by changing the actuator configuration. A beats-per-minute pumping frequency f can be set by selecting a stroke length s, acceleration a, and pitch k of the actuator thread. In one embodiment, the formula used to calculate beats-per-minute (bpm) frequency f, is f={square root}[(ka)/s].
In a preferred embodiment, software provided with the actuator allows the actuator driver to be configured. The actuator attempts to ensure a constant preset acceleration from its extreme up to mid-extension or retraction, followed by constant deceleration, thereby approximating a quadradic form. Therefore, by changing the stroke length and acceleration, various beating patterns in the porcine heart can be produced.
In one embodiment of the inventive system, the maximum f is 148 bpm for a 1″ stroke of the actuator, which is more than adequate for normal heart beating, 222 bpm for a 0.5″ stroke which is adequate for fast abnormal rhythm (e.g. tachycardia), and a 0.2″-0.1″ stroke enables authentic simulation of ventricular fibrillation, up to 400bpm. By enabling the simulated beating heart to beat at these three types of rhythms allows authentic simulation of a beating heart during surgery—both normal and abnormal rhythms typically encountered in beating heart cardiac surgery.
[0053]FIG. 7 illustrates the components of VM-L and the relationship between the components. In particular, VM-L consists of three storage areas, one for each of the three components of a mode command—waveforms 710, period duration 720, and amplitude 730. The components of a mode combine to produce a periodic function in time. Each waveform generator is normalized to have a maximum displacement of 1, and a value of 0 for time values outside the range between 0 and 1. A periodic waveform is produced by dilating the generator in time by the period and vertically by the amplitude and convolving the result with an impulse train with unit magnitude and period as specified. The result is the same as pasting copies of the scaled generator in succession to produce a periodic function in time. The resulting waveforms can be rendered graphically through display signals 630, and appropriate signals to replicate the waveform can be delivered to the motor through motor commands.
1. A method of simulating a beating heart in a mock chest cavity in an operating room environment for training a trainee surgeon on cardiac surgical techniques, comprising:
providing a simulator heart in the mock chest cavity, with at least one balloon being inserted into the heart;
providing a pumping system connected said at least one balloon, said pumping system operative to inflate and deflate the at least one balloon, thereby simulating heartbeats in the simulator heart;
providing a control computer, said control computer connected to said pumping system;
wherein the control computer controls and manages the pumping system and thereby the simulator heart.
2. The method of claim 1, wherein said providing a simulator heart comprises providing a porcine heart.
3. The method of claim 2, wherein said providing a simulator heart additionally comprises providing simulator coronary arteries with the porcine heart.
4. The method of claim 3, wherein said simulator coronary arteries are bovine arteries.
5. The method of claim 1, additionally comprising providing a simulator heart with at least two balloons inserted into the simulator heart.
6. The method of claim 5, additionally comprising providing a simulator heart with a first balloon inserted into the left ventricular cavity of the simulator heart, and a second balloon inserted into the right ventricular cavity of the simulator heart.
7. The method of claim 6, said first balloon being connected to the pumping system through a first pneumatic pump line, and said second balloon being connected to the pumping system through a second pneumatic pump line.
8. The method of claim 1, wherein said pumping system includes a pulsatile pump for pumping the simulator heart in a rhythm manner to simulate a heartbeat, an infusion pump to pump fluid to the simulator heart to simulate coronary perfusion, and a suction pump to remove fluid from the chest cavity.
9. The method of claim 8, wherein the control computer drives the pulsatile pump, the infusion pump and the suction pump.
10. The method of claim 1, wherein the pumping system includes a pulsatile pump, and the pulsatile pump is a diaphragm-type pneumatic pump driven by a linear actuator.
11. The method of claim 1, additionally comprising a simulator display in the operating room environment connected to the control computer, wherein the control computer causes the simulator display to display simulated vital signs corresponding to a state of the simulator heart.
12. The method of claim 1, wherein the pumping system simulates a range of normal and abnormal heart rhythms.
13. A beating heart simulation system for simulating a beating heart for training a surgeon on cardiac surgical techniques, comprising:
a pumping system;
a simulator heart connected to the pumping system;
a simulator display; and
a computing device for controlling the pumping system, wherein the computing device is connected to the pumping system and the simulator display and controls the pumping system such that the pumping system causes the simulator heart to beat in a realistic manner.
14. The system of claim 13, wherein said simulator display displays at least one simulated vital sign selected from the group consisting of ECG, blood pressure, oxygen saturation and temperature.
15. The system of claim 13, wherein said pumping system comprises:
a ventricular pump;
a infusion pump; and
16. The system of claim 15, said ventricular pump being a pneumatic pump.
17. The system of claim 13, wherein said computing device is comprised of a high-level system and a low-level system.
18. The system of claim 17, wherein said high-level system accepts and translates instructor surgeon instructions, and directs the low-level system to cause the pumping system to pump the simulator heart according to the translated instructions.
19. The system of claim 17, wherein said high-level system accepts manual input, wherein said manual input directs the low-level system to cause the pumping system to change a beating mode of the simulator heart.
20. The system of claim 17, wherein said high-level system accepts sensor feedback, and directs the low-level system to cause the pumping system to pump the simulator heart according to sensor feedback.
21. The system of claim 20, wherein said sensor feedback includes feedback from a pressure sensor in the simulator heart, and the high-level system directs the low-level system to cause the pumping system to pump the simulator heart in a ventricular fibrillation mode is the pressure feedback is greater than a predetermined level.
22. The system of claim 21, wherein said predetermined pressure level is manually input into the high-level system.
23. The system of claim 17, wherein said low-level system generates and manages driver commands and feedback to and from the pumping system.
24. The system of claim 23, wherein said pumping system includes a ventricular pump, wherein ventricular pump is an actuator-driven diaphragm-type pneumatic pump, and said low-level system generates actuator driver commands.
25. A pneumatic pump for use in a beating heart simulation system that uses a porcine heart, said pneumatic pump connected to said porcine heart through tubing, said pump being a diaphragm-type pneumatic pump driven by a linear actuator.
26. The pump of claim 25, wherein said linear actuator is integrated with a stepper motor.
27. The pump of claim 25, wherein said actuator is controlled by an external driver microprocessor board.
28. The pump of claim 27, said actuator driver accepts at least one motion parameter, wherein said motion parameter is selected from the group comprising length of stroke, frequency and acceleration.
29. The pump of claim 28, wherein said at least one motion parameter is used to configure the actuator to simulate a beating heart pattern.
30. The pump of claim 28, wherein said at least one motion parameter is used to configure the actuator to simulate a normal heart rhythm, an abnormal heart rhythm and a ventricular fibrillation heart rhythm.
31. A beating heart simulator apparatus, comprising:
a. a preserved porcine heart to simulate a human heart;
b. preserved bovine coronary arteries to simulate human saphenous veins;
c. at least one balloon inserted into the porcine heart, wherein said at least one balloon is connected to a pulsatile pump operative to inflate and deflate the at least one balloon in a rhythm that simulates a human heart beating rhythm.
32. The apparatus of claim 31, wherein said apparatus is used in a beating heart surgery training simulation system.
33. The apparatus of claim 32, wherein said training simulation system is used to train surgeons to perform CABG procedures.
34. The apparatus of claim 32, wherein at least two balloons are inserted into the porcine heart, a first balloon being inserted into the left ventricular cavity of the porcine heart, and a second balloon being inserted into the right ventricular cavity.
35. The apparatus of claim 32, wherein said at least one balloon is knotted before being inserted into the porcine heart.
36. The apparatus of claim 33, wherein said knotted balloon is inserted into the right ventricular cavity of the porcine heart.
US10405809 2002-04-03 2003-04-03 Computer-controlled tissue-based simulator for training in cardiac surgical techniques Active 2028-02-18 US7798815B2 (en)
US36932502 true 2002-04-03 2002-04-03
US10405809 US7798815B2 (en) 2002-04-03 2003-04-03 Computer-controlled tissue-based simulator for training in cardiac surgical techniques
US20040033477A1 true true US20040033477A1 (en) 2004-02-19
US7798815B2 US7798815B2 (en) 2010-09-21
ID=31720350
US10405809 Active 2028-02-18 US7798815B2 (en) 2002-04-03 2003-04-03 Computer-controlled tissue-based simulator for training in cardiac surgical techniques
US (1) US7798815B2 (en)
WO2017022619A1 (en) * 2015-08-03 2017-02-09 テルモ株式会社 Technique simulator
WO2017076717A1 (en) * 2015-11-02 2017-05-11 Centre National De La Recherche Scientifique Medico-surgical simulator and medico-surgical simulation method
WO2017176857A1 (en) * 2016-04-08 2017-10-12 KindHeart, Inc. Thoracic surgery simulator for training surgeons
US5877146A (en) * 1994-03-28 1999-03-02 Baxter International Inc. Therapeutic use of hemoglobin in the treatment of blood vessel blockage
US20060078550A1 (en) * 2002-02-07 2006-04-13 Gary Levy Porcine fgl2
FR3053822A1 (en) * 2015-11-02 2018-01-12 Centre Nat Rech Scient medical-surgical simulator and medico-surgical simulation process
US7798815B2 (en) 2010-09-21 grant
Hoppensteadt et al. 2012 Modeling and simulation in medicine and the life sciences