The Robotic Sleeve is a Medical Acheivment The robotic sleeve is the next big step in medical equipment, with high potential to save many lives

GLOSSARY

  • Mechanotherapy- It is the use of mechanical means to cure disease through rehabilitation. It is employs mechanotransduction in which uses mechanical stimulus to convert into electrochemical activity. This process focuses on conversion of mechanical movement into physical healing.
  • VAD- or a Ventricular Assist Device, is a mechanical pump that supports heart function and blood flow in people who have weakened hearts. It can be used to assist both ventricles.
  • Ventricle- A hollow part or cavity in the heart that carries blood flow. It is one of two large chambers that collect and expel blood received from an atrium towards the body and lungs.
  • Socks- Like a pacemaker that covers almost the entire heart and sends shocks to get the hearts beat back to normal. But, a ‘heart sock’ can do what current defibrillators cannot currently: measure and match the heart’s electrical activity and physical changes, over its entire surface and in real time.
  • Conduit or Driveline- It is a cable used in LVAD’s. To function, it connects from the pump inside the body to a controller and a power source that is worn outside of the body.
  • Soft Robotic- soft robots are made out of soft and deformable materials like rubber, springs, fabric, plastic,and silicon. It can be implemented into the environment and undergo large deformations due to their morphological features.
  • Silicone- Synthetic materials that are polymers with a chemical structure based around chains of alternating silicon and oxygen atoms, with organic groups attached to the silicon atoms. They are temperature resistant and are used to make rubber, plastics, lubricants, and polishes.
  • Actuators- devices that require a source of energy and a control signal. It uses the control signal into converting the energy into mechanical motion.
Who invented the robotic sleeve and how successful is it?

Image Above: biomedical engineers at work

Ellen T. Roche, Biomedical Engineer

Harvard University's Ellen T. Roche, a biomedical engineer, led the remarkable progress on the robotic sleeve, giving it high potential for future application. Research done on the sleeve by the School for Engineering and Applied Sciences, Wyss Institute, and the Boston Children’s Hospital was collaboratively published in a medical journal. “United States: Soft Robotic” states that the journal was published on Jan. 18, 2017 in Science Translational Medicine with Roche as the top author. This is because her progress has changed the field of soft robotics. The “work represents an exciting proof of concept result for this soft robot, demonstrating that it can safely interact with soft tissue and lead to improvements in cardiac function. We envision many other future applications where such devices can deliver mechanotherapy both inside and outside of the body,” says Connor Walsh, a professor of Engineering and Applied Sciences at SEAS (“Soft Robot Helps the Heart Beat”). Due to Roche’s success, other things that function on mechanotherapy can be backed up to be produced. In order for her to get this far, she used previous research done on different inventions for the heart.

Journal cover for Science Translational Medicine
What are similar inventions made before the robotic sleeve, and how do they work?

Image Above: Left Ventricular Assist Device

One such invention is called a VAD, or a ventricular assist device. A VAD is used to assist in the malfunction of a heart using pumps that make direct contact with the heart. There is two kinds, pulsatile pumps, that mimic the natural pulsing action of the heart, and continuous flow pumps, state's Jeff Lagerquist of CTVNews. The VAD uses a device called a conduit or driveline that connects power into the body to run the pump. The pumps are meant to direct and move blood flow, but most VADs implanted lead to blood clotting problems due to interaction with the blood. "Socks” were invented to avoid interacting with the blood. The silicone material that they are made out of, wrap around the heart like a sleeve / sock. They use electric shocks -like a pacemaker- to shock the specific areas needed to get the heart moving again. Those shocks however, could shock the right place at the wrong time due to the smallest miscalculation and send sharp painful feelings to the user. The robotic sleeve combines the ideas from these two into a better working soft robot. Ellen -the inventor- states that the robotic sleeve can boost the amount of blood being pumped more than a VAD (Wenzke). Boosting the amount of blood means a healthier heart that can beat faster and get oxygen to the body quicker. Without the concrete bases of the VAD and “Sock”, it would have been significantly more difficult for researchers and scientists to build the robotic sleeve they are developing right now.

Image Below: robotic sleeve in pigs heart

How does the robotic sleeve work and what tests have been done with it so far?

Video Below: visuals and quick explanation

This very successful soft robotic made out of silicone has been tested in 6 pigs so far and is fitted snugly to each heart like a sleeve. It does not interact with the blood, unlike the VAD. It twists and contorts to the heart like an artificial muscle using air powered soft actuators. Signals from a pacemaker inside the heart tell the sheath when and how to move. It is tethered to an external cord that powers and controls the actuators. Also, there is a silicone implant that attaches to the heart muscles to keep it in place. The air powered sleeve uses two layers that expand and contract, one that moves concentrically, and one that moves helically to fit the unique movement of the heart; that somewhat replicates wringing a towel (“Robotic sleeve"). Due to all the twisting and moving, the friction on the sleeve causes inflammation on the heart. SEAS and Wyss engineers worked with surgeons at Boston Children's Hospital, and they said the best way to combat this was to use “a combination of a suction device, sutures, and a gel interface” (“Soft Robot Helps the Heart Beat”). These substances were then used when it was time to go onto the sleeves first real test: living subjects. The test used six pigs with a constant of 47% function rate. The sleeves were shown to restore blood flow up to 97%. This testing is the basis for human use, so that medical professionals can save more human lives.

Video Below: robotic sleeve in action

How many people could it benefit and how would it benefit them?

Image Above: doctors consulting a patient

This device could benefit the multiple people with heart failure and can not get a heart transplant, and hopefully it can improve or stabilize a patient's heart condition. Heart failure affects many elderly and adults with heart problems,: such as, heart attacks. Over 5 million Americans and 41 million people worldwide suffer heart failure, notes Luaran Neergaard of the Winnipeg Free Press. With so many people having heart failure, there is a wide variety of reasons why the heart is not functioning properly and where it could be happening. Fortunately, the pump can be tuned to a patient's specific needs, improving a specific part of the heart that is failing. Rame, a medical director of the mechanical circulatory device program at the University of Pennsylvania Health System, in Philadelphia., said that the metabolic profile -or the way the body uses energy- changes when the heart changes and improving the heart could hopefully restore that back to normal (“United States: Soft Robotic”). The recovery of the metabolic profile could change the state of the body from being sickly, to that of a healthy one. Although further testing to see if it is suitable for long term human use is required, the inventions future looks bright.

What is the future of this device and how does this relate to the future of medical technology?

Image Above: Johnny Matheny wearing prototype robotic arm powered by thought

"We envision many other future applications where such devices can deliver mechanotherapy both inside and outside of the body”- Connor Walsh

This device will pave the way for more use of soft robotics and mechanotherapy. In the future, it will be tested in different experiments to see if it can be perfected for human use. If perfected, it could quickly help those who are in need of a replacement heart and can’t get a heart transplant. Roche states that her design is dramatic from today’s therapies and might almost replace heart transplants all together due to it potentially spurring healing in a patient’s heart (“Soft Robot Helps the Heart Beat”). The medical field has been changing with soft robotics that are constructed using a combination of elastomers, fibers, and other filler materials. This has led the way for more mechanotherapy, soft robotics, and other augmentations that can have intimate relationships with humans. Other medical robotics are being created right now; such as, the mind controlled arm, bionic spine to move robotic limbs powered by thought, and an exoskeleton to allow a paralyzed person to walk at the World Cup (“Robotic sleeve”). The robotic sleeve is one out of the many revolutionary inventions, proving to us that futuristic technologies are within our grasp.

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