Report on Replacement of Heart bypass surgery by NAnorobots


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A report on the use on nanomedicine and its application in field on Heart bypass surgery

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Report on Replacement of Heart bypass surgery by NAnorobots

  1. 1. Replacement of Bypass Surgery by Nanorobots1. INTRODUCTION The heart bypass surgery reroutes the blood supply around clogged arteries toimprove blood flow and oxygen to the heart. The arteries that bring blood to the heartmuscle (coronary arteries) become clogged by plaque (a buildup of fat, cholesteroland other substances). This can slow or stop blood flow through the hearts bloodvessels, leading to chest pain or a heart attack. Increasing blood flow to the heartmuscle can relieve chest pain and reduce the risk of heart attack. So the surgeons gofor this surgery by taking a segment of a healthy blood vessel from another part of thebody usually from leg and make a detour around the blocked part of the coronaryartery. The surgery involves an incision in the middle of the chest and separation ofthe breastbone and after detouring, the breastbone is joined using wire and theincision is sewed. The entire surgery can take 4-6 hours. After the surgery, the patientis taken to the Intensive Care Unit. For a few days after the surgery, the patient isconnected to monitors and tubes.Patient may experience side effects such as:• Loss of appetite, constipation.• Swelling in the area from which the segment of blood vessel was removed.• Fatigue, mood swings, feelings of depression, difficulty in sleeping.• Muscle pain or tightness in the shoulders and upper back. The incision in the chest or the graft site (if the graft was from the leg or arm) can beitchy, sore, numb, or bruised. The surgery may also lead to loss of memory and mentalclarity. To overcome all these problems that are involved in the bypass surgery, a nanorobotis used, which can replace this techniques efficiently and effectively. This nanorobot willremove the clot without any surgical procedure. Just a small incision is made into the femoralartery to insert this Nanorobot, from where it is moved to the site of the plaque by the use ofits nano components that are attached to it.Department of Biomedical engineeringKLE Dr.M.S.Sheshgiri College of Engineering and Technology Page 1
  2. 2. Replacement of Bypass Surgery by Nanorobots2. STRUCTURE OF THE HEART: The heart is an amazing organ. It beats thousands of times each day, every day,for the entire life. In the process, it pumps about 5 million gallons of blood through theentire body. The human heart resembles the shape of an upside down pear. It is ahollow muscle that pumps blood throughout the blood vessels by repeated, rhythmiccontractions. An adult human heart has a mass of between 250 and 350 grams and isabout the size of a fist. It is located anterior to the vertebral column and posterior to thesternum. The heart is enclosed in a double-walled sac called the pericardium. It hastwo leaflets, the superficial is called the parietal pericardium and the inner one is thevisceral pericardium. The outer wall of the human heart is composed of three layers.The outer layer is called the epicardium, or visceral pericardium since it is also theinner wall of the pericardium. The middle layer is called the myocardium and iscomposed of cardiac muscle which contracts. The inner layer is calledthe endocardium and is in contact with the blood that the heart pumps. The humanheart has four chambers, two superior atria and two inferior ventricles. The atria are thereceiving chambers and the ventricles are the discharging chambers.Department of Biomedical engineeringKLE Dr.M.S.Sheshgiri College of Engineering and Technology Page 2
  3. 3. Replacement of Bypass surgery by Nanorobots2.1. BLOOD FLOW IN HEART: The heart is a complex organ, using four chambers, four valves and multiple bloodvessels to provide blood to the body. The flow through the heart is equally complex, withblood moving through the heart, then the lungs, before returning again to the heart.Blood returns to the heart from the body via two large blood vessels, called the superiorvena cava and the inferior vena cava. This blood carries little oxygen, as it is returningfrom the body where oxygen is used. Fig. Circulation of Blood flow in HeartDepartment of Biomedical engineeringKLE Dr.M.S.Sheshgiri College of Engineering and Technology Page 3
  4. 4. Replacement of Bypass surgery by Nanorobots The blood first enters the right atrium. It then flows through the tricuspid valveinto the right ventricle. When the heart beats, the ventricle pushes the blood through thepulmonic valve into the pulmonic artery. This artery is unique. It is the only artery in thehuman body that carries oxygen-poor blood. The pulmonic artery carries blood to the lungs where it “picks up” oxygen, andleaves the lungs and returns to the heart through the pulmonic vein. The blood enters theleft atrium, and then descends through the mitral valve into the left ventricle. The leftventricle then pumps blood through the aortic valve, and into the aorta, the blood vesselthat leads to the rest of the body. The valve at the top of each ventricle opens to allow it to fill, while the valve at thebottom makes sure the blood doesn’t leak out. When the ventricle is full, the top valvecloses and the bottom valve opens. The ventricle squeezes the blood out forcefullythrough the bottom valve. Essentially, the valves keep the blood flowing in the correctdirection through the heart.Department of Biomedical engineeringKLE Dr.M.S.Sheshgiri College of Engineering and Technology Page 4
  5. 5. Replacement of Bypass surgery by Nanorobots3. BYPASS SURGERY AND ITS NEED: Heart bypass surgery is used to treat heart disease when the coronary arteries areblocked. The doctor treats the problem by giving the blood a new pathway to the heart.Hence the name Bypass surgery. There are two main coronary arteries--the right coronaryartery and the left coronary artery. The right coronary artery splits off into two morearteries, known as the right marginal artery and the posterior descending artery. The leftcoronary artery splits into two additional arteries as well--the circumflex artery and the leftanterior descending artery. This makes six total arteries in the human heart.If one of these outer arteries gets blocked, it causes a heart attack. A blockage like this isnormally caused by fatty deposits that build up in the hearts arteries over the course ofmany years. When one of the hearts arteries gets blocked and a person has a heart attack,one common procedure is to perform heart surgery and sew in a new piece of blood vesselto bridge over (bypass) the blockage. In many cases, the surgeon will fix not only theimmediate problem, but also other arteries on the heart that are starting to look blocked.In some cases, the surgeon can perform this operation while your heart is still beating.This is called "off-pump" coronary bypass surgery.Fig. Coronary artery Bypass graftDepartment of Biomedical engineeringKLE Dr.M.S.Sheshgiri College of Engineering and Technology Page 5
  6. 6. Replacement of Bypass surgery by NanorobotsIf the surgeon repairs three of the arteries, it is called a triple bypass. If four arteries arerepaired, its a quadruple bypass. The blood vessel used to create the bypass is taken fromthe chest or the leg as the body has several vessels that can be removed without doingharm. Arteriosclerosis is a common arterial disorder characterized by thickening, loss of elasticity, and calcification of arterial walls, resulting in a decreased blood supply. Atherosclerosis is a common arterial disorder characterized by yellowish plaques of cholesterol, lipids, and cellular debris in the inner layer of the walls of large and medium-sized arteries.Department of Biomedical engineeringKLE Dr.M.S.Sheshgiri College of Engineering and Technology Page 6
  7. 7. Replacement of Bypass surgery by Nanorobots4. ROUTINE PROCEDURE OF BYPASSS SURGERY:The patient is brought to the operating room and moved on to the operating table.An anesthetist places a variety of intravenous lines and injects a painkilling agent followedwithin minutes by an induction agent to render the patient unconscious.An endotracheal tube is inserted and secured by the anesthetist and mechanicalventilation is started. General anesthesia is maintained by a continuous very slowinjection.The chest is opened via a median sternotomy and the heart is examined by the surgeon.The bypass grafts are harvested – frequent conduits are the internal thoracic arteries, radialarteries and saphenous veins. When harvesting is done, the patient is given heparin toprevent the blood from clotting.In the case of "off-pump" surgery, the surgeon places devices to stabilize the heart.If the case is "on-pump", the surgeon sutures cannulae into the heart and instructsthe perfusionist to start cardiopulmonary bypass (CPB). Once CPB is established, thesurgeon places the aortic cross-clamp across the aorta and instructs the perfusionist todeliver cardioplegia (a special potassium-mixture, cooled) to stop the heart and slow itsmetabolism. Usually the patients machine-circulated blood is cooled to around 84°F (29 °C)One end of each graft is sewn on to the coronary arteries beyond the blockages and theother end is attached to the aorta.The heart is restarted; or in "off-pump" surgery, the stabilizing devices are removed. Incases where the aorta is partially occluded by a C-shaped clamp, the heart is restarted andsuturing of the grafts to the aorta is done in this partially occluded section of the aortawhile the heart is beating.Chest tubes are placed in the mediastinal and pleural space to drain blood from around theheart and lungs.The sternum is wired together and the incisions are sutured closed.The patient is moved to the intensive care unit (ICU) to recover.Department of Biomedical engineeringKLE Dr.M.S.Sheshgiri College of Engineering and Technology Page 7
  8. 8. Replacement of Bypass surgery by NanorobotsNurses in the ICU focus on recovering the patient by monitoring blood pressure, urine outputand respiratory status as the patient is monitored for bleeding through the chest tubes. If thereis a chest tube clogging, complication such as cardiac tamponade, pneumothorax or death canensue. Thus nurses closely monitor the chest tubes and undertake methods to prevent cloggingso bleeding can be monitored and complications can be prevented. After awakening and stabilizing in the ICU (approximately one day), the person is transferred to the cardiac surgery ward until ready to go home (approximately four days). Department of Biomedical engineering KLE Dr.M.S.Sheshgiri College of Engineering and Technology Page 8
  9. 9. Replacement of Bypass surgery by Nanorobots5. NANOROBOTS: Nanorobots are theoretical microscopic devices measured on the scale ofnanometers (1nm equals one millionth of 1 millimeter). When fully realized from thehypothetical stage, they would work at the atomic, molecular and cellular level to performtasks in both the medical and industrial fields. Nanomedicine’s nanorobots are so tiny thatthey can easily traverse the human body. Scientists report the exterior of a Nanorobot willlikely be constructed of carbon atoms in a diamondoid structure because of its inertproperties and strength. Super-smooth surfaces will lessen the likelihood of triggering thebodys immune system, allowing the nanorobots to go about their business unimpeded.Glucose or natural body sugars and oxygen might be a source for propulsion and theNanorobot will have other biochemical or molecular parts depending on its task.5.1. ELEMENTS OF NANOROBOT: Carbon will likely be the principal element comprising the bulk of a medicalNanorobot, probably in the form of diamond or diamondoid/fullerene nano composites.Many other light elements such as hydrogen, sulphur, oxygen, nitrogen, fluorine, silicon,etc. will be used for special purposes in nanoscale gears and other components.Morphological examination revealed no physical damage to either fibroblasts ormacrophages, and human osteoblast like cells confirming the biochemical indication thatthere was no toxicity and that no inflammatory reaction was elicited in vitro. Thesmoother and more flawless the diamond surface, the lesser is the leukocyte activity andfibrinogen adsorption.The exterior surface with near-nanometer smoothness results in very low bioactivity. Dueto the extremely high surface energy of the passivated diamond surface and the stronghydrophobicity of the diamond surface, the diamond exterior is almost completelychemically inert.Department of Biomedical engineeringKLE Dr.M.S.Sheshgiri College of Engineering and Technology Page 9
  10. 10. Replacement of Bypass surgery by Nanorobots5.2. NANOROBOTS IN MEDICAL FIELD:Nanomedicine is the medical application of nanotechnology. The approaches towardsnanomedicine range from the medical use of nonmaterial’s, to nanoelectronic biosensors,and even possible future applications of molecular nanotechnology. Medical nanodevicescould augment the immune system by finding and disabling unwanted bacteria andviruses. When an invader is identified, it can be punctured, letting its contents spill out andending its effectiveness. If the contents were known to be hazardous by themselves, thenthe immune machine could hold on to it long enough to dismantle it more completely.5.3. NANOROBOTS IN HEART SURGERY:Heart blockings are occurring more and more. The most common methods of surgery forheart attacks are By-Pass surgery and Angio Plaster. But these methods are risky and bringseveral side-effects with them. Surgery with nanorobots is safer and the surgeon doesn’teven have to touch the patient. Nanorobots as a heart surgeon could replace thementioned, current surgeries and thus manage the same result without the side effects. Theprocedure would consist of locating and serving the block. After locating the blockade,nanolasers could be used to tackle the block after getting confirmation by the practitioners.Department of Biomedical engineeringKLE Dr.M.S.Sheshgiri College of Engineering and Technology Page 10
  11. 11. Replacement of Bypass surgery by Nanorobots6. PROPERTIES OF THE NANOROBOT USED IN BYPASS SURGERY:The nanorobots structure will have two spaces that will consist of an interior and exterior.The exterior of the nanorobot will be subjected to the various chemical liquids in ourbodies but the interior of the nanorobot will be a closed, vacuum environment into whichliquids from the outside cannot enter. A nanorobot will prevent itself, from being attackedby the immune system by having a passive, diamond exterior. The diamond exterior willhave to be smooth and flawless to prevent Leukocytes activities since the exterior ischemically inert and have low bioactivity. An electric motor is attached to this nanorobotfor its propagation inside the circulatory system in the blood vessels. The microprocessor,artery thermometer, camera, rotating needle are also incorporated in this nanomachine,which perform the vital role of the nanorobot. The microprocessor controls the overalloperation of this nanorobot .The radioactive material is impregnated and is made as a partof the exterior surface, which helps us to trace the nanorobot at any period of time. Themagnetic switch is also provided to switch on and off the nanorobot at any point of time.Fig. Nanorobot in blood cellsDepartment of Biomedical engineeringKLE Dr.M.S.Sheshgiri College of Engineering and Technology Page 11
  12. 12. Replacement of Bypass surgery by Nanorobots7. INTRODUCTION OF NANOROBOT IN TO THE BODY AND THESOURCE OF MOVING:Nanorobot gets access into the body through a large diameter artery so that it may moveeasily without being too destructive in the first place. This artery should be traversedeasily to gain access to most areas of the body in minimal time. The obvious candidate isthe femoral artery in the leg. This is in fact the normal access point to the circulatorysystem for operations that require access to the bloodstream for catheters, dye injections,etc.Fig. Nanorobot and its structureDepartment of Biomedical engineeringKLE Dr.M.S.Sheshgiri College of Engineering and Technology Page 12
  13. 13. Replacement of Bypass surgery by NanorobotsThe circulatory system allows the device to move about. But to get access to the site ofoperation of the nanorobot, it must have active propeller. Therefore, an electric motor isused. This electric motor will have a shrouded blade design so as to avoid damage to thesurrounding tissues (and to the propellers) during the inevitable collisions. Long-rangesensors are used to navigate to the site of the plaque closely enough so that the use ofshort-range sensors is practical. These sensors would be used during actual operations, toallow the device to distinguish between healthy and unwanted tissue. A small amount ofradioactive substance is impregnated as part of the micro robot. This would allow itsposition to be tracked throughout the body at all times. After reaching the site of locationthe internal sensor is used to find out the exact location of the plaque and also by using TVcamera the plaque can be more precisely located. The area where the temperature exceedsthan the maximum limit set in the nanorobot, will be operated on by the Nanorobot i.e.that part will be cut by the rotator needle attached to the nanorobot. A TV camera in thedevice helps in transmitting the picture outside the body to a remote control station,allowing the people operating the device to steer it and also to view the internalenvironment of the circulatory system.Department of Biomedical engineeringKLE Dr.M.S.Sheshgiri College of Engineering and Technology Page 13
  14. 14. Replacement of Bypass surgery by Nanorobots8. TREATMENT OF PLAQUE AND MEANS OF REMOVAL OFNANOROBOT:As the nanorobot detects the site of plaque using camera and thermometer, it will activatethe rotating needle. The diamond chipped burr grinds the plaque into micro particles,which then travel harmlessly through the circulatory system and are eventually eliminatedby the body. Cutting procedure is monitored using the camera and care is taken that it willnot cut the surrounding tissue. This care is taken by the magnetic switch that has beenprovided in it. Once the nanorobot has been inserted into the body, it starts the operationonly when a bar magnet is moved over it. This movement of magnet in one direction onlymakes the magnetic switch in on condition, and the nanorobot becomes active. Hence ifany problem occurs during the task of removal of plaque and shutting of the nanorobot isthe only solution, then by making the magnetic switch off by moving the bar magnet againwill terminate all the running functions of this nanomachine .After the nanorobot hasremoved the plaque, and its function is over, it has to be removed from the body. This canbe made possible by guiding the Nanorobot to anchor a blood vessel that is easilyaccessible from outside, and perform a small surgical operation is performed to remove it.Fig:A sample picture of the bypass surgeryDepartment of Biomedical engineeringKLE Dr.M.S.Sheshgiri College of Engineering and Technology Page 14
  15. 15. Replacement of Bypass surgery by Nanorobots9. SOURCE OF POWER FOR THE ROBOT:The nuclear power is carried onboard to supply required amount of energy for theoperation of the device. This would be relatively easy to shield given the amount of fuelinvolved, and it has other advantages as well. The same radioactive material could be usedfor power and tracking, since the casing must be hotter than body temperature to producepower and there would be no worries about running out of power, or insufficient power toget the job done. At the micro scale, shielding and power conversion are relatively easy,making this method extremely practical.Fig:Sample image of a nanorobot inside the red blood cells.Department of Biomedical engineeringKLE Dr.M.S.Sheshgiri College of Engineering and Technology Page 15
  16. 16. Replacement of Bypass surgery by Nanorobots10. ADVANTAGES AND DISADVANTAGESADVANTAGES:The nanorobots do not generate any harmful activity as they work only in specific site astold by the physician.Rapid elimination of diseases.Nanorobots might also reproduce copies of themselves to replace worn out unit, a processcalled self replication.The major advantage of Nanorobot is the durability which in theory is thought be for boutdecades and centuries.DISADVANTAGES:The Nanorobot should be very accurate otherwise harmful events may occur.The initial design cost is very high.The design of this robot is very complicated.Hard to interface, customize and design.Department of Biomedical engineeringKLE Dr.M.S.Sheshgiri College of Engineering and Technology Page 16
  17. 17. Replacement of Bypass surgery by NanorobotsCONCLUSION:It is a proposed idea that can be made practical by the existing engineering technology.a) The Nanorobot to be designed must be biocompatible.b) The size of the Nanorobot should not be more than 3 micron so as, not to block anycapillary.c) The Nanorobot should resist the corrosive environment of the blood vessels.d) The nano particles that are attached to this Nanorobot should be held tightly and mustbe durable.With the application to healthcare, nanotechnology is indeed quite the exciting andrevolutionary technique in the pursuit of quality healthcare. Nanomedicine endeavors toimprove human health utilizing molecular tools and nano particles. The technology andthe applicability of it to the human body is still at preliminary stagesDepartment of Biomedical engineeringKLE Dr.M.S.Sheshgiri College of Engineering and Technology Page 17
  18. 18. Replacement of Bypass surgery by Nanorobots BIBLIOGRAPHY  Replacement Of Heart Bypass Surgery By Nanorobots, International Journal Of Advanced Research And technology, ,Shinob M.C, Department of ECE,Roever Engineering College,Perambalur Jidhin G, Department of ECE,Roever Engineering College,Perambalur ,  Possibilitieswithnanorobotics, rt-assignment-1.pdf  123seminarsonly, Robots.pdf  Discoveryhealth, 120.  wiseGEEK,  John Hopkins medicine, cialty_areas/coronary_artery_surgery.htmlDepartment of Biomedical engineeringKLE Dr.M.S.Sheshgiri College of Engineering and Technology Page 18
  19. 19. Replacement of Bypass surgery by NanorobotsDepartment of Biomedical engineeringKLE Dr.M.S.Sheshgiri College of Engineering and Technology Page 19