Detachable Steerable Clip Applier for Dissection of ITA Branches
G.A. Hoogeweegen (TU Delft - Mechanical Engineering)
T. Horeman-Franse – Mentor
J. Dankelman – Mentor
Rob de Lind van Wijngaarden – Graduation committee member
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Abstract
The internal thoracic artery (ITA) is increasingly being recognized as the best conduit for replacement of diseased coronary arteries. As the ITA is the main blood supply for the sternum, harvesting this artery causes a drop in blood flow, increasing the risk of failing to heal, and risking deep sternal wound infection. Current methods of harvesting the ITA are time consuming, and due to hidden arteries the manoeuvrability of the surgeon is limited. In this project the goal is to develop a new instrument for branch sealing and dissection, that increases the maneuverability, minimizes damage to surrounding tissue while beingmore time efficient. A systematical selection process resulted in the solutions for some of the sub-functions, whereas two subfunctions required more thorough analysis and evaluation. Concept selection for the sub-function Tip-Articulation a more in-depth analysis and experimental evaluation (n=19). The selection of the sub-function Handle-Mechanism is done by analysis of proven concepts, choices are based on the requirements that resulted from consultation with an experienced surgeon from LUMC, literature study, and supervision of experienced medical instrument engineers. A preliminary headroom analysis is done, resulting in an estimated drop of 64.45%for the duration of sealing and dissecting of branches with a relatively bigger diameter. Further research should specifically be aimed on the further development of the chosen concepts.