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NASA NTRS2006

The Validation of Vapor Phase Hydrogen Peroxide Microbial Reduction for Planetary Protection and a Proposed Vacuum Process Specification

The Jet Propulsion Laboratory, in conjunction with the NASA Planetary Protection Officer, has selected the vapor phase hydrogen peroxide sterilization process for continued development as a NASA approved sterilization technique for spacecraft subsystems and systems. The goal is to include this technique, with an appropriate specification, in NPR 8020.12C as a low temperature complementary technique to the dry heat sterilization process.To meet microbial reduction requirements for all Mars in-situ life detection and sample return missions, various planetary spacecraft subsystems will have to be exposed to a qualified sterilization process. This process could be the elevated temperature dry heat sterilization process (~115 C for 40 hours) which was used to sterilize the Viking lander spacecraft. However, with utilization of such elements as highly sophisticated electronics and sensors in modern spacecraft, this process presents significant materials challenges and is thus an undesirable bioburden reduction method to design engineers. The objective of this work is to introduce vapor hydrogen peroxide (VHP) as an alternative to dry heat microbial reduction to meet planetary protection requirements.The VHP process is widely used by the medical industry to sterilize surgical instruments and biomedical devices, but high doses of VHP may degrade the performance of flight hardware, or compromise material properties. Our goal for this study was to determine the minimum VHP process conditions to achieve microbial reduction levels acceptable for planetary protection.

planetary protection↗

NASA NTRS1977

Tissue macerating instrument

A surgical tissue macerating and removal tool is described which has a rotating rod with a cutting member at one end and which disposed in a tube which is then contained in an extension of the tool handle. A frusto-conical member extends into the extension at the cutter member end of the rotating rod with its small end engaging the tube. The portion of the frusto-conical member outside of the extension forms a tissue engaging member and may be cut-off at an angle to the axis of the rod to form a tissue engaging edge. Apertures are provided in the extension adjacent the frusto-concial member so that treatment fluid supplied in the annular space between the tube and the extension may flow to the operative site. An aperture is provided in the frustoconical member between the extension and the tube so that fluid may also flow into the tube where it mixes with macerated tissue being directed through an aperture in the tube to a passageway which may have suction applied to help remove macerated material.

Baehr, E. F.↗

NASA NTRS1987

Surgical Borescopes Remove Contaminants

Borescope instruments put to use in extracting hard-to-reach particles. Surgical instruments in flexible borescopes used for removing contaminant particles from normally inaccessible places within equipment. Instruments readily enter small openings, turn corners, and reach far.

Vallow, K.↗

NASA NTRS1961

Methods for Determining Blood Flow Through Intact Vessels of Experimental Animals Under Conditions of Gravitational Stress and in Extraterrestrial Space Capsules

Work during the initial six months of this program has proceeded along three lines: (1) technical development of blood flowmeter instrumentation: (2) surgical considerations related to special problems of chronic implantation of flowmeter probes: (3) study of the relationship between levels of blood flow and organ activity. Principal engineering effort has been focused on the fundamental phenomena operative in the flowmeter probe and on probe design. Two probes have been constructed and a third is nearing completion. A previously unrecognized source of zero drift has been discovered and corrected. has been designed, assembled, tested and successfully employed in work on the several probes. A significant innovation which has been introduced is the use of a transformer coupled input for suppression of unwanted common mode signals. New low noise transistor amplifiers with characteristics suitable for space vehicle packaging are being developed. Linearity of the present apparatus has been found to extend at least into the near turbulent flow region. Attention has been directed to the two vascular beds of physiologic interest that present particular problems with regard to chronic implantation of flowmeter probes, the myocardium and the liver. Surgical techniques have been perfected that will permit myocardial and liver blood flow measurement. Two groups of animals have successfully undergone surgery and await the implantation of probes. Studies of the relationship between organ blood flow and levels of physiologic activity have been initiated. The first organ system studied was the heart, For the first time autoregulatory mechanisms have been demonstrated within the myocardial vascular bed which rapidly and precisely maintain coronary blood flow at a level i n keeping with the magnitude of cardiac work, Following a summary statement of the status of the program, the work performed is described, A financial review of expenditures incurred and a proposal for future funding are appended,

Shaw, R. F.↗

NASA NTRS2002

Generalized interactions using virtual tools within the spring framework: cutting

We present schemes for real-time generalized mesh cutting. Starting with the a basic example, we describe the details of implementing cutting on single and multiple surface objects as well as hybrid and volumetric meshes using virtual tools with single and multiple cutting surfaces. These methods have been implemented in a robust surgical simulation environment allowing us to model procedures ranging from animal dissection to cleft lip correction.

Feedback↗

NASA NTRS1977

Corneal seal device

A corneal seal device is provided which, when placed in an incision in the eye, permits the insertion of a surgical tool or instrument through the device into the eye. The device includes a seal chamber which opens into a tube which is adapted to be sutured to the eye and serves as an entry passage for a tool. A sealable aperture in the chamber permits passage of the tool through the chamber into the tube and hence into the eye. The chamber includes inlet ports adapted to be connected to a regulated source of irrigation fluid which provides a safe intraocular pressure.

Baehr, E. F.↗

NASA NTRS2000

High Resolution Multimode Fiber Image Recovery

The research emphasis is on developing a cost-effective method of recovering image information from small, closely confined spaces using multimode fibers. The state-of-the-art good quality-viewing fiber, which can currently be used for performing this function, is a 0.5 mm diameter bundle containing 6000 pixels at a cost of $10,000 per fiber bundle. However, these fiber bundles are very fragile and can easily break during surgical use, thereby making instrument reliability and replacement cost,a major impediment to their routine use in many applications. The advantage of working with a single multimode fiber is that it is significantly less expensive and mechanically more robust. In addition, careful choice of numerical aperture allows a higher image resolution (roughly 750,000 pixels) with a 0.5 mm diameter multimode fiber.

Jackson, Deborah↗

NASA NTRS2015

Utilization of the NASA Robonaut as a Surgical Avatar in Telemedicine

The concept of teleoperated robotic surgery is not new; however, most of the work to date has utilized specialized robots designed for specific set of surgeries. This activity explores the use of a humanoid robot to perform surgical procedures using the same hand held instruments that a human surgeon employs. For this effort, the tele-operated Robonaut (R2) was selected due to its dexterity, its ability to perform a wide range of tasks, and its adaptability to changing environments. To evaluate this concept, a series of challenges was designed with the goal of assessing the feasibility of utilizing Robonaut as a telemedicine based surgical avatar.

Dean, Marc↗

NASA NTRS1991

Surgical force detection probe

The development progress of a precision electro-mechanical instrument which allows the detection and documentation of the forces and moment applied to human tissue during surgery (under actual operation room conditions), is reported. The pen-shaped prototype probe which measures 1/2 inch in diameter and 7 inches in length was fabricated using an aerodynamic balance. The aerodynamic balance, a standard wind tunnel force and moment sensing transducer, measures the forces and the moments transmitted through the surgeon's hand to the human tissue during surgery. The prototype probe which was fabricated as a development tool was tested successfully. The final version of the surgical force detection probe will be designed based on additional laboratory tests in order to establish the full scale loads. It is expected that the final product will require a simplified aerodynamic balance with two or three force components and one moment component with lighter full scale loads. A signal conditioner was fabricated to process and display the outputs from the prototype probe. This unit will be interfaced with a PC-based data system to provide automatic data acquisition, data processing, and graphics display. The expected overall accuracy of the probe is better than one percent full scale.

Tcheng, Ping↗

NASA NTRS1986

Cornea Optical Topographical Scan System (COTSS)

The Cornea Optical Topographical Scan System (COTSS) is an instrument designed for use by opthalmologist to aid in performing surgical procedures such as radial keratotomy and to provide quick accurate data to aid in prescribing contact lenses and eyeglasses. A breadboard of the system was built and demonstrated in June of 1984. Additional refinements to the breadboard are needed to meet systems requirements prior to proceeding with prototype development. The present status of the COTSS instrument is given and the areas in which system refinements are required, are defined.

Source record↗

NASA NTRS1993

Effect of upright tilt on ventricular/vascular coupling in chronically instrumented primates

Studies of the hydraulic loading conditions on the heart in humans, especially pulsatile load, have primarily been limited to the supine state. Therefore, we have chosen a nonhuman primate model, the baboon, to assess left ventricular/vascular coupling in both supine and upright positions. Primate subjects were studied by catheterization under sedation and then after surgical implantation of transducers. This allowed the evaluation of postural stress in the chronically instrumented conscious baboon and then after light dissociative doses of ketamine. Basic hemodynamic variables were evaluated for baboons in supine and upright positions. Fourier analysis was applied to aortic pressure and flow to obtain input and characteristic impedance and the ratio of pulsatile (Wp) to total (Wt) left ventricular power (Wp/Wt). The aortic reflected, or backward, pressure was also calculated. Peripheral resistance increased (P = 0.01) and reflected pressure decreased (17.74 +/- 1.50 vs. 15.21 +/- 2 mmHg; P < 0.01) in upright subjects. Characteristic impedance and Wp/Wt were unchanged. Postoperatively, peripheral resistance increased (2,651 +/- 311 vs. 3,667 +/- 276; P < 0.05) and mean power and Wt decreased (P < 0.01) without changes in reflected pressure. All variables were unchanged after light dissociative doses of ketamine. Thus there is no significant change in efficiency of left ventricular/vascular coupling formulated in terms of Wp/Wt or input impedance with postural stress.

NASA Program Space Physiology and Countermeasures↗

NASA NTRS1991

Fluid handling 2: Surgical applications

The methods proposed for managing fluids and particulate debris during minor surgery on Space Station Freedom (SSF) were investigated and demonstrated. A KC-135 parabolic flight test was performed, in which the flight followed the standard 40 parabola profile with 20 to 25 seconds in near-zero gravity in each parabola. The equipment (suction and laminar flow device) was evaluated. While this equipment performed satisfactorily previously in the dental simulation, the purpose of the current flight was to reconfigure the equipment in support of a minor surgical situation in order to evaluate its efficacy and establish clear requirements for the actual flight hardware. To accomplish the study the Health Maintenance Facility medical restraint system was deployed as for surgical use and mannequin suture arm was restrained to its surface. The surgical area was established as for performing minor surgery with standard tray and suture instruments employed.

Billica, Roger↗

NASA NTRS2000

Robotic Surgery

The Automated Endoscopic System for Optimal Positioning, or AESOP, was developed by Computer Motion, Inc. under a SBIR contract from the Jet Propulsion Lab. AESOP is a robotic endoscopic positioning system used to control the motion of a camera during endoscopic surgery. The camera, which is mounted at the end of a robotic arm, previously had to be held in place by the surgical staff. With AESOP the robotic arm can make more precise and consistent movements. AESOP is also voice controlled by the surgeon. It is hoped that this technology can be used in space repair missions which require precision beyond human dexterity. A new generation of the same technology entitled the ZEUS Robotic Surgical System can make endoscopic procedures even more successful. ZEUS allows the surgeon control various instruments in its robotic arms, allowing for the precision the procedure requires.

Source record↗

NASA NTRS1991

Dental equipment test during zero-gravity flight

The overall objectives of this program were to establish performance criteria and develop prototype equipment for use in the Health Maintenance Facility (HMF) in meeting the needs of dental emergencies during space missions. The primary efforts during this flight test were to test patient-operator relationships, patent (manikin) restraint and positioning, task lighting systems, use and operation of dental rotary instruments, suction and particle containment system, dental hand instrument delivery and control procedures, and the use of dental treatment materials. The initial efforts during the flight focused on verification of the efficiency of the particle containment system. An absorptive barrier was also tested in lieu of the suction collector. To test the instrument delivery system, teeth in the manikin were prepared with the dental drill to receive restorations, some with temporary filling materials and another with definitive filling material (composite resin). The best particle containment came from the combination use of the laminar-air/suction collector in concert with immediate area suction from a surgical high-volume suction tip. Lighting in the treatment area was provided by a flexible fiberoptic probe. This system is quite effective for small areas, but for general tasks ambient illumination is required. The instrument containment system (elastic cord network) was extremely effective and easy to use. The most serious problem with instrument delivey and actual treatment was lack of time during the microgravity sequences. The restorative materials handled and finished well.

Young, John↗

NASA NTRS2003

Simulation System for Training in Laparoscopic Surgery

A computer-based simulation system creates a visual and haptic virtual environment for training a medical practitioner in laparoscopic surgery. Heretofore, it has been common practice to perform training in partial laparoscopic surgical procedures by use of a laparoscopic training box that encloses a pair of laparoscopic tools, objects to be manipulated by the tools, and an endoscopic video camera. However, the surgical procedures simulated by use of a training box are usually poor imitations of the actual ones. The present computer-based system improves training by presenting a more realistic simulated environment to the trainee. The system includes a computer monitor that displays a real-time image of the affected interior region of the patient, showing laparoscopic instruments interacting with organs and tissues, as would be viewed by use of an endoscopic video camera and displayed to a surgeon during a laparoscopic operation. The system also includes laparoscopic tools that the trainee manipulates while observing the image on the computer monitor (see figure). The instrumentation on the tools consists of (1) position and orientation sensors that provide input data for the simulation and (2) actuators that provide force feedback to simulate the contact forces between the tools and tissues. The simulation software includes components that model the geometries of surgical tools, components that model the geometries and physical behaviors of soft tissues, and components that detect collisions between them. Using the measured positions and orientations of the tools, the software detects whether they are in contact with tissues. In the event of contact, the deformations of the tissues and contact forces are computed by use of the geometric and physical models. The image on the computer screen shows tissues deformed accordingly, while the actuators apply the corresponding forces to the distal ends of the tools. For the purpose of demonstration, the system has been set up to simulate the insertion of a flexible catheter in a bile duct. [As thus configured, the system can also be used to simulate other endoscopic procedures (e.g., bronchoscopy and colonoscopy) that include the insertion of flexible tubes into flexible ducts.] A hybrid approach has been followed in developing the software for real-time simulation of the visual and haptic interactions (1) between forceps and the catheter, (2) between the forceps and the duct, and (3) between the catheter and the duct. The deformations of the duct are simulated by finite-element and modalanalysis procedures, using only the most significant vibration modes of the duct for computing deformations and interaction forces. The catheter is modeled as a set of virtual particles uniformly distributed along the center line of the catheter and connected to each other via linear and torsional springs and damping elements. The interactions between the forceps and the duct as well as the catheter are simulated by use of a ray-based haptic-interaction- simulating technique in which the forceps are modeled as connected line segments.

Basdogan, Cagatay↗

NASA NTRS2004

Multimodality instrument for tissue characterization

A system with multimodality instrument for tissue identification includes a computer-controlled motor driven heuristic probe with a multisensory tip. For neurosurgical applications, the instrument is mounted on a stereotactic frame for the probe to penetrate the brain in a precisely controlled fashion. The resistance of the brain tissue being penetrated is continually monitored by a miniaturized strain gauge attached to the probe tip. Other modality sensors may be mounted near the probe tip to provide real-time tissue characterizations and the ability to detect the proximity of blood vessels, thus eliminating errors normally associated with registration of pre-operative scans, tissue swelling, elastic tissue deformation, human judgement, etc., and rendering surgical procedures safer, more accurate, and efficient. A neural network program adaptively learns the information on resistance and other characteristic features of normal brain tissue during the surgery and provides near real-time modeling. A fuzzy logic interface to the neural network program incorporates expert medical knowledge in the learning process. Identification of abnormal brain tissue is determined by the detection of change and comparison with previously learned models of abnormal brain tissues. The operation of the instrument is controlled through a user friendly graphical interface. Patient data is presented in a 3D stereographics display. Acoustic feedback of selected information may optionally be provided. Upon detection of the close proximity to blood vessels or abnormal brain tissue, the computer-controlled motor immediately stops probe penetration. The use of this system will make surgical procedures safer, more accurate, and more efficient. Other applications of this system include the detection, prognosis and treatment of breast cancer, prostate cancer, spinal diseases, and use in general exploratory surgery.

Mah, Robert W.↗

NASA NTRS1999

Exercise Countermeasures for Bone Loss During Space Flight: A Method for the Study of Ground Reaction Forces and their Implications for Bone Strain

Effective countermeasures to prevent loss of bone mineral during long duration space flight remain elusive. Despite an exercise program on MIR flights, the data from LeBlanc et al. (1996) indicated that there was still a mean rate of loss of bone mineral density in the proximal femur of 1.58% per month (n=18, flight duration 4 - 14.4 months). The specific mechanisms regulating bone mass are not known, but most investigators agree that bone maintenance is largely dependent upon mechanical demand and the resultant local bone strains. A plausible hypothesis is that bone loss during space flight, such as that reported by LeBlanc et al. (1996), may result from failure to effectively load the skeleton in order to generate localized bone strains of sufficient magnitude to prevent disuse osteoporosis. A variety of methods have been proposed to simulate locomotor exercise in reduced gravity. In such simulations, and in an actual microgravity environment, a gravity replacement load (GRL) must always be added to return the exercising subject to the support surface and the resulting skeletal load is critically dependent upon the magnitude of the GRL. To our knowledge, GRLs during orbital flight have only been measured once (on STS 81) and it is likely that most or all prior treadmill exercise in space has used GRLs that were less than one body weight. McCrory (1997) has shown that subjects walking and running in simulated zero-G can tolerate GRLs of 1 if an appropriate harness is used. Several investigators have attempted to measure in vivo strains and forces in the bones of humans, but have faced ethical and technical limitations. The anteromedial aspect of the tibial midshaft has been a common site for the placement of strain gauges; one reason to measure strains in the anterior tibia is that this region is surgically accessible. Aamodt et al. (1997) were able to measure strains on the lateral surface of the proximal femur only because their experimental subjects were already scheduled for hip surgery. Lu et al. (1997) used an instrumented massive proximal femoral prosthesis along with electromyographic measurements to demonstrate that femoral forces depend on muscular activity. These analyses of in vivo bone mechanics are valuable. The invasive nature of the procedures involved, however, limits both the number of subjects and the number of strain gauge locations. Further, the results of these studies may be confounded by the inclusion of subjects with pathological conditions. Gross et al. (1992) measured strain at three locations on the equine third metacarpal and used those data to construct a computer model of the internal strain environment of the bone. An analogous placement of multiple gauges in living humans would be difficult and potentially hazardous because of the depth of soft tissue overlying the tibia and femur.

Peterman, M.↗

NASA NTRS2000

Multimodality Instrument for Tissue Characterization

A system with multimodality instrument for tissue identification includes a computer-controlled motor driven heuristic probe with a multisensory tip is discussed. For neurosurgical applications, the instrument is mounted on a stereotactic frame for the probe to penetrate the brain in a precisely controlled fashion. The resistance of the brain tissue being penetrated is continually monitored by a miniaturized strain gauge attached to the probe tip. Other modality sensors may be mounted near the probe tip to provide real-time tissue characterizations and the ability to detect the proximity of blood vessels, thus eliminating errors normally associated with registration of pre-operative scans, tissue swelling, elastic tissue deformation, human judgement, etc., and rendering surgical procedures safer, more accurate, and efficient. A neural network, program adaptively learns the information on resistance and other characteristic features of normal brain tissue during the surgery and provides near real-time modeling. A fuzzy logic interface to the neural network program incorporates expert medical knowledge in the learning process. Identification of abnormal brain tissue is determined by the detection of change and comparison with previously learned models of abnormal brain tissues. The operation of the instrument is controlled through a user friendly graphical interface. Patient data is presented in a 3D stereographics display. Acoustic feedback of selected information may optionally be provided. Upon detection of the close proximity to blood vessels or abnormal brain tissue, the computer-controlled motor immediately stops probe penetration.

Mah, Robert W.↗