Physician-Inspired Medical Device Solutions

With the goal of engaging graduate students and accelerating ideas into prototypes, teams of MIT graduate students in Electrical Engineering and Mechanical Engineering spend a semester collaborating with clinicians in CIMIT-affiliated hospitals to develop innovative medical devices. Clinicians (physicians, nurses, and scientists) present clinical problems and initial ideas on how they might be solved. Students form teams to work with the clinicians to turn these ideas into reality. The goal is for the students to deliver a working prototype and a journal-quality article in one semester. The course has been a great opportunity for clinicians to test out new ideas and to stimulate new collaborations. For example, Robopsy, a robotic device to assist radiologists performing tumor biopsies was invented by an MIT team led by Rajiv Gupta, MD, in 2004. The team has been awarded the 2007 MIT $100K prize, the world's leading entrepreneurship competition.

Moderator: Rajiv Gupta, MD, Resident, Radiology, Massachusetts General Hospital, rgupta1@partners.org

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Physician/Student Teams:

Accurate Non-Invasive Electronic Monitor for Human Body Hydration
Physician: Lynne Levitsky, MD, Associate Professor of Pediatrics, Harvard Medical School, Massachusetts General Hospital, llevitsky@partners.org
Team: Al-Thaddeus Avestruz, Michael Rinehart, Anthony Sagneri and Alexander Hayman

There is a continued need for a non-invasive method to accurately measure the level of hydration in human beings. Monitoring hydration is important to the titration of hormones, diuretics and fluids for individuals with water regulation disorders, such as diabetes insipidus, SIADH, or hypodipsia. In addition, it reduces the risk to individuals with no control over their fluid intake, such as those under intravenous feeding (G- or J-tube) or infants. Everyone involved in continued physical exertion such as athletes and military personnel, among others, are at risk of hypo- and hyperanatremia (over- and dehydration). At best, physical and possibly mental performance is below optimal.

The team's method uses low power RF energy from 100 kHz to 10 MHz to measure the loss tangent of the frontalis muscle (in the forehead). The team chose this site because of its large surface area, relatively consistent tissue profile among individuals, and copious vascularization. The loss tangent is a function of electrical conductivity and permittivity and is a material property and therefore independent of sensor electrode geometry. Studies show that the loss tangent is strongly a function of tissue osmolality and hematocrit, which are strong indicators of hydration. The group pays particular attention to the skin-electrode interface and employs a four-electrode geometry to accurately and robustly measure the localized complex impedance, from which they can derive the loss tangent, which is potentially a large improvement over other techniques which use full body impedance.

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Catheter-based Device for Intra-Cardiac Mitral Valve Chord Manipulation
Physician: Robert Levine, MD, Professor of Medicine, Harvard Medical School, Massachusetts General Hospital, rlevine@partners.org
Team: Will Boswort, Ani Mazumdar, Miguel Saez and Alex Slocum, Jr.

This project focuses on the design and implementation of a catheter-guided, intra-cardiac device that has the potential potential to help physicians mitigate the effects of mitral valve regurgitation. Mitral valve regurgitation occurs when the mitral valve becomes deformed as a result of disease or damage to the surrounding cardiac anatomy. The purpose of this device is to provide physicians with a tool that may be controlled externally and is capable of manipulating the chordae tendinae within the heart. The device is important because many patients do not have the stamina, or the required level of health necessary to survive open-heart surgery. A percutaneous procedure would be beneficial to these patients. This device could have a significant impact on the quality and length of patient’s lives, and change how physicians perform this procedure.

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Transfascial Hernia Fixation Device
Physician: Ali Tavakkoli-zadeh, MD, Instructor in Surgery, Harvard Medical School, Brigham and Women's Hospital, tavakkolizadeh@partners.org
Team: Megan Roberts, Michael Eilenberg, Jessica Galie, Rajiv Gupta, Martin Culpepper

Hernias are common surgical problems. Although hernias have been traditionally repaired by open surgery, laparoscopic repair is becoming increasingly more common. In this approach, small incisions are made in the abdominal wall, laparoscopic ports are placed, and the hernia defect repaired using a piece of prosthetic mesh. One of the most common laparoscopic hernia surgeries is laparoscopic ventral hernia repair. An important step in this operation is fixation of the mesh to the abdominal wall to prevent hernia recurrence. This fixation is usually achieved by tacking the mesh to the abdominal wall.  Several companies (e.g. Ethicon, US Surgical, Bard) produce such tacking devices, with various configurations of tacks and of differing biomaterial. Often the tacks do not provide adequate fixation, resulting in mesh migration and hernia recurrence. Many surgeons who perform this surgery reinforce the mesh by placing additional sutures. These sutures, referred to as ‘transfascial sutures’, are placed to provide long term secure fixation of the mesh to the abdominal wall. Placement of these sutures is often difficult, and results in significant pain and discomfort to the patient. This team will propose a novel way to fix a mesh to the abdominal wall during laparoscopic hernia surgery. This new device is easier to use, thus reducing operating room time and costs. It is also anticipated that this approach will result in less post-operative pain, benefiting the patient.

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