Tissue morcellator for use during laparoscopic renal surgery

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					Tissue morcellator for use during laparoscopic
                renal surgery

            Group: Rachel Shevchek
                   Bracken King
                   Kareem Mawad

            Mentor: Dr. Jaime Landman

            Instructor: Dr. Joseph Klaesner


      BME 401 Preliminary report presentation
                 February 23, 2004
          Overview
Background
Need
Solutions
Design specifications
Schedule
Group tasks
           Renal anatomy
Located below rib
cage on either side of
spine
Size of a fist
Filters blood to
eliminate waste and
form urine




                         http://ad2004.com/Biblecodes/matimages/anatomy.gif
      Renal disorders
Kidney stones
Polycystic kidney disease (PKD)
End-stage renal disease (ESRD)
Kidney cancer
Treatment options
– Dialysis
– Transplantation
– Nephrectomy
  Laparoscopic Surgery
Pioneered in early 1990’s1
Minimally invasive
Faster recovery, reduced scarring




    Open surgery            Laparoscopic
                           http://www.lij.edu/lijh/urology/laparoscopy/nephrectom
     Removing the kidney

                       Open surgery2
                        – 25-50 cm incision
                       Hand-assisted laparoscopy
                        – 6-8 cm incision
                       Laparascopic morcellation
                        – 1 cm incision

Morcellation—the grinding and removal of tissue


                                http://www.safeconduct.com/product/LSH.htm
        Electric Morcellators

Kidney isolated in bag
– LapSac or Endocatch
Used blades to grind
tissue, suction to
remove
Proven unsafe
because bag easily
punctured
              Electric Morcellators



Cook morcellator 5,275,609             Steiner morcellator 6,572,632




                   Coherent morcellator 6,156,049
           Existing Solutions
Manual morcellation4 (LapSac)
– Use ring forceps to extract specimens through 12
  mm incision
– Mean time: 9.24 mins (in vitro)
– Mean fragment size: 1.47 grams

Modified manual morcellation (EndoCatch II)
–   Extra 3 cm incision to view tissue being extracted
–   Mean time: 3.24 mins (in vitro), 11 mins (clinical)
–   Mean fragment size: 4.46 grams
      Design Specifications:
             Safety
No damage to bag (LapSac)
– Less than 1% puncture rate during in vitro
  trials by trained surgeon
– Retain impermeability properties

No damage to body
– Must not add to recovery time
– No additional incisions
– Biocompatible
         Design Specifications:
           Instrumentation
Breaks down tissue
Works with available facilities
– Suction: 200 mmHg; Voltage: 110 V
Removes tissue from modified trocar
–   Mean fragment diameter: 9 mm
–   Mean fragment weight: 4.0 grams
Allows pathological evaluation
Time for morcellation (< 15 mins)
Comfortable for use
– Weight: < 1 kg; Volume: 1 ft3 box
                                          Schedule
                Date   2/23   3/1   3/8   3/15   3/22   3/29   4/5   4/12   4/19   4/26   4/28

  1st Paper/
 Presentation

  Concept
 Generation

  Concept
  Research

  Decision
  Matrices

  Concept
  Selection

  2nd Paper/
 Presentation

Manufacturing
  Research

Embodiment


Optimization


 Fabrication

  3rd Paper/
 Presentation
 Group responsibilities
Bracken King
– Material properties
– Computer programming
Kareem Mawad
– Electronics
– AutoCad
Rachel Shevchek
– Web design
– Contact, marketing
                      References
Clayman RV, Kavoussi LR, Soper NJ: Laparoscopic nephrectomy: initial
case report. J Urol 146: 278-282, 1991.
Landman J, Collyer W, Olweny E, Andreoni C, McDougall E, Clayman R:
Laparoscopic renal ablation: an in vitro comparison of currently available
electrical tissue morcellators. Urology 56: 677-681, 2000.
Clayman RV, Shalhav A, Hoenig D, "Laparopscopic Nephrectomy for
Benign and Malignant Renal Disease," in Laparoscopic Surgery, Cueto-
Garcia J, Jacobs M, Gagner M, New York: McGraw Hill, 2003, 549-565.
Landman J, Venkatesh R, Kibel A, Vanlangendonck R: Modified renal
morcellation for renal cell carcinoma: laboratory experience and early
clinical application. Urology 62: 632-635, 2003.
Personal communication with Dr. Landman, Dr. Lieber, Dr. Venkatesh

For patent search http://www.uspto.gov
Questions?

				
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