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INSEWING- Development of a robotic manipulator of human tubular tissues for suture ans support in anastomosys surgery interventions.

Responsable: Raúl Suárez Feijóo/ José Antonio Tornero (FP7-231143-ECHORD)

Responsable del projecte: Raúl Suárez Feijóo
Entitat finançadora: COMMISSION OF EUROPEAN COMMUNITIES               
Entitats participants: Institut d'Organització i Control de Sistemes Industrials (IOC)
Institut d'Investigació Tèxtil i Cooperació Industrial de Terrassa (INTEXTER)
Hospital de la Vall d'Hebron (HUVH)
Data inici: 01/10/2010
Data final: 31/03/2012


The aim of the project is to develop a surgical robotic manipulator device focused on the improvement of surgical interventions with anastomosis. These interventions consist basically in doing a cross-cutting of a tubular tissue (usually the intestine) removing a piece of it and uniting again the resulting ends. This is a common procedure in the treatment of cancer of colon, which has big incidence in occidental population. Nowadays, the union of the two extremes of intestine can be done by two different ways:

1. With manual suture, where the surgeon sews with special yarn and needle the ends of the intestine in a complex and long procedure.

2. Using a surgical stapler (special mechanic device) that unites the two extremes with

metallic staples.

The main disadvantages of these methods respectively are:

1. The hand suture is really difficult (needs highly skilled surgeon) and is slow, increasing

significantly the infection risk.

2. The metallic staples are not absorbed by the organism, creating a ring in the intestine with poor elasticity, really below the rest of intestinal tissue, so this can create obstructions that can appear during the rest of the life of the patient. On the other hand, the stapler device is inserted by the closest open-end of the intestine and is rigid, so it has reduced accessibility to many parts of the intestine.

The objective of this project is to develop a manipulator device to unite the two extremes of the intestine by means of a sewing with absorbable yarn, doing it fast, automatically and in a robust way, under supervision of the surgeon. Thus, improving the quality of life of the patient and reducing the risks associated to the surgery intervention. This device will avoid the disadvantages of the existing methods: it will do a fast sewing suture with yarn that can be absorbed again by the organism, thus keeping the affected zone elastic after the intervention. This will avoid obstruction problems and also will improve the regeneration of the tissues in the sewed zone. The sewing task must be done in a problematic environment, with non-regular tissues and changing properties due to muscle effects and viscosity of the material itself. This will made necessary the application of sensors and advance control over the actuators in order to making the device capable to sew the tissues in reliable way.

The project is carried out by two Research Institutes of the UPC, the IOC and the INTEXTER, highly skilled in robotics and sewing technology respectively, and an important hospital with high expertise in the related surgery intervention.

The anastomosis procedure is used in the surgery for treatment of different diseases (like

Crohn’s, polyps or diverticulitis), but the most common is the cancer of colon. It is important to highlight the high incidence of this kind of cancer in the world population. The colorectal cancer is the third most common cancer in European men (after lung and prostate cancers) and the second in women (after breast cancer). This cancer is the second cause of death by cancer in men, behind of the of lung cancer, and behind the breast cancer in women. It is expected that this innovative new surgical device technology will contribute significantly to increase the life expectancy of the population. The success of the study, development and implementation of the new sewing robot, will produce a very positive social impact, not only for patients, also for the national Health Departments. It is intended to achieve better results for the patient, than with the techniques used today, in the evolution of his disease and in the quality of life after the intervention. The patient will not have all the common complications anastomosis interventions like staples rejection by the body and bowel or dehiscence. This reduction of post procedural complications means a reduction of time staying in hospital, and it not only translates into a better and more prompt recovery of the patients, it also means a lower cost for the Health Department.