The present application relates to mechanical actuation via resorbable materials and, more particularly, to resorbable material activated mechanisms for use in a variety of applications, including medical applications such as in repairing pectus excavatum.
The majority of known mechanisms use some input to actuate. Examples of inputs could include motor torque, electricity, input loading, or heat. Passive mechanisms, or a mechanism that actuates without a specific input, are less common. The present disclosure relates to passive mechanisms utilizing resorbable materials.
Resorbable materials are materials that dissolve when exposed to certain environmental conditions. Most common among resorbable materials are water-soluble materials. Resorbable materials have been used extensively to provide temporary mechanisms or structures that resorb into their environment rather than requiring retrieval. Resorbable materials have not been used extensively as an actuation method for mechanisms. The use of resorbable materials to activate mechanisms is the focus of this disclosure.
Principal to the present disclosure is the use of stored energy. A mechanism is placed in a configuration in which it has stored energy. The most easily applicable energy would be strain energy through the use of compliant segments deflected from their initial position. The resorbable material is then used to restrain the mechanism in the energy-stored configuration. The mechanism is then placed in its intended use environment, one where the environment acts as a solvent for the resorbable restraint. As the resorbable material dissolves, the restraining force is either gradually or instantaneously removed and stored energy is used to actuate the mechanism. Therefore no additional inputs are required to activate or actuate the mechanism once placed in the working environment. This provides a distinct advantage for those applications where inputs are difficult to provide. This is shown, in particular, in an illustrative medical implant use for pectus excavatum repair.
A bioresorbable material activated pectus bar to be used for pectus excavatum repair solves several problems of previous methods. First, it provides for a more gradual (and therefore less painful) correction than the popular instantaneous correction Nuss procedure. Second, it maintains the low invasiveness of the Nuss procedure, as compared to the high-invasiveness of other methods such as the Ravitch procedure. The ability to use different bioresorbable materials as the activation for the bar also means that the rate of the bar's deployment is widely alterable pre-operation, which means that each patient could receive a different rate of pectus excavatum repair, providing additional benefit through tailorability. The bar can correct over time with no input required by surgical staff, removing the need for additional surgeries to actuate mechanisms that could have provided a similar gradual correction.
The illustrative device of the present disclosure is not necessarily incorporated into or used in combination with a computer program, although mathematical analyses of both the bar for pectus excavatum repair and for more general resorbable material activated mechanisms have been performed to validate its effectiveness.
Resorption-driven mechanisms have the ability to actuate a mechanism without an active input. As a material resorbs into the working environment, the energy stored in the system will be released and the mechanism will self-actuate. This passive activation removes the need for user input, which is of greatest benefit when user input is difficult, dangerous, expensive, or impossible.
The ability for the actuation to be gradual or all-at-once provides additional benefit. The wide variety of resorbable materials and the research done on these materials provides design freedom for resorption times and mechanics.
Illustrative applications that provide specific benefit include medical implants to avoid the need for additional surgeries to change the configuration of mechanisms, space where actuation and deployment mechanisms are expensive or massive or have reliability issues, or water sources such as deep ocean. The ability to automatically activate could also find specific benefit in reactive systems, such as alarms or valves that open or close or trigger alarms when exposed to a given solvent. To demonstrate a particular benefit in detail, the ability of a gradually changing medical implant for the correction of chest wall deformities is demonstrated.
As noted above, the most common current methods of surgery to correct pectus excavatum (PE) are the Ravitch and Nuss procedures. Both are an immediate method of repair, which require either resection of chest wall tissue or a sustained force of upwards of 230 N applied to the sternum of the patient.
The Ravitch procedure, first performed by Dr. Ravitch in 1949, was the fundamental popularized operation for the correction of PE. It involves cutting the costal cartilage, which holds the sternum in place relative to the rib cage. However, the regenerated cartilage is often “thin, irregular, and commonly rigid”, “irregular and incomplete, occasionally producing a somewhat unstable chest,” and “limits the depth of lung expansion”, so the postoperative flexibility of the chest wall is restricted. The invasiveness of this procedure lead to the development of the now standard approach, the Nuss Procedure.
The Nuss Procedure was performed for the first time in 1987 by Dr. Nuss. It involves creating a laceration on either side of the chest, using a tunneling instrument to insert a tube through the thoracic cavity, using the tube to guide a convex metal bar through the cavity, and rotating the bar until it pushes up against the sternum and pushes it out to flatten the chest. Two or three bars may be used if the indentation in the chest wall is too large for one. The Nuss Procedure provides distinct advantages to the Ravitch method. Primarily, it requires no cartilage resection and rather focuses on helping the patient's body remodel the chest wall naturally. Incision sizes are reduced and moved to the lateral sides of the chest. The Nuss Procedure, however, is highly painful due to the instantaneous correction of the chest wall. Research has suggested that a gradual approach would correct the deformity without acute pain; this is also the approach taken to move bone in other fields, such as orthodontia.
The difficulties involved in designing a gradual corrective device include keeping the device similar enough to the original bar used in the Nuss Procedure for surgeon adoption and engineering an actuation method for the device that will not require additional surgery. The present disclosure presents a novel use of resorbable materials in a bar to be used in a variation of the Nuss Procedure that produces a gradual and customizable correction of PE.
Illustrative bioresorbable materials are nontoxic to the body, dissolve slowly in the presence of bodily fluids, and change mechanical properties (losing mechanical strength and/or volume) as they dissolve. Bioresorbable materials have been a common topic for recent research, especially because of their potential to improve medical procedures. Bioresorbable implants surpass their non-resorbable counterparts in two main ways: first, by eliminating the need for retrieval surgery (they are designed to completely dissolve over time); and second, by allowing for more dynamic treatment, where a load can be gradually transferred from the implant to the surrounding bone or tissue as part of the healing process.
While the majority of the illustrative corrective implant could still contain some non-bioresorbable materials and could therefore still require a retrieval surgery, the ability to gradually transfer a load to the surrounding bone is extremely useful here. The gradual transfer is predicted to significantly decrease the pain characteristic of the Nuss Procedure, and because the bioresorbable bar is still based on the bar used in the Nuss Procedure, it would maintain the minimal invasiveness of the Nuss Procedure.
The use of resorbable materials to actuate mechanisms could have many illustrative applications. A few proposed embodiments of this technology include:
All these illustrative embodiments could be all-at-once transition as the material fails structurally, or a gradual transition from one state to the next, depending on the resorption mechanics of the material used.
According to an illustrative embodiment of the present disclosure, a resorbable material activated device includes a support having a first end section, an opposing second end section, and a center section intermediate the first end section and the second end section. A first resorbable material is positioned intermediate the first end section and the center section of the support. A second resorbable material is positioned intermediate the second end section and the center section of the support. The shape of the support changes in response to dissolving of the first and second resorbable materials.
According to another illustrative embodiment of the present disclosure, a resorbable material activated device includes a compliant segment having opposing first and second ends, and a resorbable material operably coupled to the compliant segment intermediate the first and second ends. At least one of the shape, position or configuration of the compliant segment changes in response to dissolving of the resorbable material.
According to a further illustrative embodiment of the present disclosure, a device for repairing pectus excavatum in a human body includes a support having a first end section, and opposing second end section, and a center section intermediate the first end section and second end section, the support formed of a biocompatible material. A first bioresorbable material is positioned intermediate the first end section and the center section of the support, and a second bioresorbable material is positioned intermediate the second end section and the center section of the support. The center section moves from a first position to a second position in response to dissolving of the first and second bioresorbable materials to exert a force against a sternum of the human body.
According to another illustrative embodiment of the present disclosure, a method of repairing pectus excavating in a human body includes the steps of providing a support having a first end section, an opposing second end section, and a center section intermediate the first end section and the second end section. The method further includes providing a first bioresorbable material intermediate the first end section and the center section of the support, and providing a second bioresorbable material intermediate the second end section and the center section of the support. The method further includes the steps of inserting the support within a rib cage of the human body, and dissolving the first and second bioresorbable materials resulting in the changing of the shape of the support in response to dissolving of the first and second bioresorbable materials.
According to another illustrative embodiment of the present disclosure, a resorbable material activated device includes a first compliant arm extending between a first end and a second end, the first compliant arm including a first curved portion and a second curved portion intermediate the first end and the second end, the first curved portion facing an opposite direction from the second curved portion, and a second compliant arm extending between a first end and a second end, the second compliant arm including a first curved portion and a second curved portion intermediate the first end and the second end, the first curved portion facing an opposite direction from the second curved portion. The second ends of the first compliant arm and the second compliant arm are positioned a first distance apart from each other in a deformed mode, and the second ends of the first compliant arm and the second compliant arm are positioned a second distance apart from each other in a natural, undeformed mode, the second distance being greater than the first distance. A resorbable material insert is positioned intermediate the second ends of the first compliant arm and the second compliant arm in the deformed mode. The resorbable material insert is removed from intermediate the second ends of the first compliant arm and the second compliant arm in the natural, undeformed mode.
According to another illustrative embodiment of the present disclosure, a resorbable material activated device includes an arcuate arm having a first compliant section defining a first pocket, and an end effector supported by the arcuate arm. A first resorbable material insert is supported within the first pocket in a deformed mode, and removed from the first pocket in a natural, deformed mode. The end effector is in a first position in the deformed mode, and the end effector is in a second position in the natural, undeformed mode.
Additional features and advantages of the present disclosure will become apparent to those skilled in the art upon consideration of the following detailed description of the illustrative embodiments exemplifying the disclosure as presently perceived.
The detailed description of the drawings particularly refers to the accompanying figures in which:
For the purposes of promoting an understanding of the principles of the present disclosure, reference will now be made to the embodiments illustrated in the drawings, which are described herein. The embodiments disclosed herein are not intended to be exhaustive or to limit the invention to the precise form disclosed. Rather, the embodiments are chosen and described so that others skilled in the art may utilize their teachings. Therefore, no limitation of the scope of the claimed invention is thereby intended. The present invention includes any alterations and further modifications of the illustrated devices and described methods and further applications of principles in the invention which would normally occur to one skilled in the art to which the invention relates.
With reference initially to
The first top plate 22 illustratively includes a C-channel 32 on the bottom surface 34 that extends a distance L1 (
The second top plate 28 illustratively includes a C-channel 44 on the bottom surface 46 that extends a distance L2 (
As noted above, the inserts 40 and 52 are formed of resorbable material. Resorbable materials have a wide range of material properties and resorption mechanics. Their relative tailorability makes them desirable for a wide range of situations and applications.
Resorbable material selection is an important factor when considering resorbable actuation. The type of resorbable material (PLA, tricalcium phosphate, etc.) as well as the medium in which it dissolves (saline solution, body fluid, water, etc.) greatly affects resorption mechanics. The material may reduce in volume while maintaining material properties (as is the case with rock salt) or may maintain the original volume but lose material properties like tensile strength (as is the case with most polymers). Furthermore, resorption times can range from several seconds to days to years depending on the selected material and solvent. Additional creativity can be achieved when different types of resorbable materials are layered or otherwise combined, allowing for truly unique resorption behavior.
Many resorbable materials dissolve at a rate proportional to the area exposed to the solvent. Thus, shapes with high surface area to volume ratios (SA:V) lead to quicker dissolution and quicker mechanism actuation.
The size of the resorbable material also affects resorption mechanics. The more resorbable material used, the longer it will take to dissolve. Thus if longer time before the mechanism actuation is desired, but a specific resorbable material must be used, the volume of the resorbable material can simply be increased to achieve the objective.
Like other materials, resorbable materials may be loaded in tension, compression, pure bending, torsion, direct shear, and combinations thereof. The loading type often determines the failure mode of the material (abrupt or gradual), which in turn governs the response of the mechanism.
The resorbable material of inserts 40 and 52 of the bar 10 are illustratively bioresorbable materials since they are configured to be positioned within the human body and dissolve as a result of exposure to bodily fluids (e.g., blood). Illustrative bioresorbable materials 40 and 52 are detailed in below Table 1.
These bioresorbable materials may include polyglycolide (PGA), polylactic acid (PLA), poly-L-lactic acid (PLLA), polycaprolactone (PCL), polymethyl methacrylate (PMMA)(also commonly known as acylic), magnesium (Mg), tricalcium phosphate (TCP), cellulose and silk. For example, in medical device applications, polyglycolide (PGA), polylactic acid (PLA), tricalcium phosphate (TCP) and/or calcium carbonate may illustrative be used as bioresorbable materials. The listed dissolution times and times to loss of total strength in Table 1 are provided for illustrative purposes and have been supplied from various experimental sources. The values may vary widely based on the material structure, size, and environmental conditions.
With further reference to
As shown in
As with the resorbable inserts 40 and 52 above, the inserts 74 and 76 are illustratively bioresorbable materials. As such, illustrative bioresorbable materials of the inserts 74 and 76 are detailed in above Table 1. For example, in medical device applications, polyglycolide (PGA), polylactic acid (PLA), tricalcium phosphate (TCP) and/or calcium carbonate could be used as bioresorbable materials.
With further reference to
Table 2 below includes illustrative experimental observations.
The illustrative test set-up 100 includes a tank 102 holding water 104, illustratively 10 gallons at 98.6 F.° defining the bioresorbable solvent and simulate in vivo conditions. A pump 106 is configured to circulate the water 104 within the tank 102. Illustratively two 200 gram weights 108 simulate force of the sternum 92 and are coupled via hooks 110 proximate the center 19 of the support 12.
Table 3 shows illustrative model predictions.
Table 4 shows illustrative observations from the illustrative test set-up 100.
Two different actuation types are further detailed below: gradual and instantaneous (i.e. dynamic). For the instantaneous mechanism 210 of
With further reference now to
The resorbable material insert 218 is positioned intermediate the opposing ends 234 and 236 of the arms 222 and 224. With further reference to
During experiments, the device 210 was manufactured using a conventional additive material three-dimensional (3D) printer. It was tested four times, with almost identical behavior for each test. In all cases, the arms 222 and 224 move slightly as resorbable material of the insert 218 dissolved due to the smaller volume of the obstruction. Upon fracture of the resorbable material of the insert 218, the arms 222 and 224 of the clamp 212 dramatically flared out to the open position. This produced a delayed but sudden actuation of the clamping device 210.
The shape-change mechanism 210 demonstrated the ability to control the location of the breaking point of resorbable material by bearing its cross-sectional geometry. Resorbable inserts 218 having uniform cross-section, as well as inserts 218 that were thinned out in the center (
The instantaneous shape-change mechanism 210: (1) shows that resorbable materials may be loaded in direct shear to actuate a mechanism; (2) shows that resorbable materials may be used to actuate a mechanism at a desired time (degradation time depends on material type, size, and surface area exposed to solvent, and so these qualities can be controlled to retrieve particular results); (3) shows that fracture location and resorbable materials can also be controlled-smallest cross-sectional area varied directly with the amount of time required for the solution (therefore, by creating thinner portions of the cross-section of the material (e.g., dog-bone shape), fracture location to specify for predictable failure); and (4) shows that resorbable material may dissolve at different rates based on their loading conditions.
Due to its nature as an auto-activation mechanism, the shape-change mechanism 210 can be used in a wide variety of situations that are largely removed from human interaction and control. These applications may include biomedical applications (e.g., in vivo actuation (e.g., stents)), self-repair applications (e.g., clamp could stop a leak as it deploys open), and deep sea applications (e.g., releasing a research submarine at specific time during the dive, and/or clamp holds a weight which weighs down the submarine for a specific amount of time until the material dissolves and the submarine is released). Additional potential applications may include space applications (locking onto a tube for a specified amount of time, automatic actuation of a mechanism (e.g., of a deployable solar array), and/or upon leaking of air from the spacecraft, the clamp could open up to stop or slow the leak), and electronics applications (a circuit that closes or opens once at a time determined by the device's internal temperature).
The illustrative arm 412 includes a hook-like feature as an end effector 418. The arm 412 is designed to have first and second compliant sections 420 and 422 having reduced thicknesses, which allow for increased compliance in these areas, so that the end effector 418 has a longer travel distance from start to finish.
A first resorbable material insert 424 is coupled to the arm 412 in a pocket intermediate the inner surface 417 and an outer member 426 at the first compliant section 420. The outer member 426 is pivotably coupled to the arm 412 at a joint or hinge 430. A second resorbable material insert 432 is coupled to the arm 412 in a pocket intermediate the inner surface 417 and an outer member 434. The outer member 434 is pivotably coupled to the arm 412 at a joint or hinge 436.
Once the resorbable material inserts 424 and 432 are inserted into their respective spots in the mechanism 410, the end effector 418 is in a new position, and as resorbable material inserts 424 and 432 dissolve, the end effector 418 rotates and translates to a predictable path back to its original undeformed position (as indicated by arrow 435 in
The mechanism 410 could alternatively be designed to produce a wide variety of motions that fit many different applications by varying the location and the thickness of the compliant sections 420 and 422, undeformed shape, material, and/or by adding more compliant sections 420 and 422.
A gradual shape-change mechanism: (1) shows a resorbable material that may be used in compression to actuate a mechanism; (2) shows that resorption materials may be used to produce gradual actuation, with a specified time interval between beginning and end positions; (3) shows that continuous actuations can be achieved using resorbable materials; and (4) shows that end effector paths may be pre-determined and specified by modifying the shape, size, and type of resorbable material.
Similar to the instantaneous shape change mechanism 210, the gradual shape change mechanism 410 may also be used in a variety of situations where human interaction (e.g., manual activation) is difficult or impossible. Gradual deployment also has many advantages over immediate deployment in several applications. These applications may include biomedical applications (e.g., gradual repair for deformities such as pectus excavatum, palette expansion, or scoliosis correction), and/or robotics applications (e.g., moving the end effector to desired position after a certain amount of time). The shape change mechanism 310 may also be used in space applications, including transitioning a switch between states at a specific time, moving masses outside of the spacecraft, and/or using many of these mechanisms in series to deploy an antenna from its stowed position.
With further reference to
The above shape-change mechanisms 10, 60, 210, 410, 510 represent illustrative mechanical systems that are actuated using resorbable materials. Resorbable materials have significant shape-changing potential when combined with compliance mechanisms 10, 60, 210, 410, 510 like those detailed above. The resorbable material controls the release of the strain energy that acts to restore a bent compliant system to its original shape, which can result in either shapes that snap into place or slowly transforming geometries. Resorbable materials can actuate traditional mechanisms as well, such as the rotating mechanism detailed above.
It has been demonstrated that in tests that actuation of the mechanical systems using resorbable materials is possible and advantageous. It should be appreciated that the principles detailed herein may be utilized in a wide variety of shape change mechanisms.
Although the invention has been described in detail with reference to certain preferred embodiments, variations and modifications exist within the spirit and scope of the invention as described and defined in the following claims.
The present application claims priority to U.S. Provisional Patent Application Ser. No. 63/197,645, filed Jun. 7, 2021, the disclosure of which is expressly incorporated herein by reference.
Filing Document | Filing Date | Country | Kind |
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PCT/US2022/032521 | 6/7/2022 | WO |
Number | Date | Country | |
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63197645 | Jun 2021 | US |