Scientific Poster Session (Wednesday)

Skin cancer is the most prevalent form of cancer, with melanoma being the most deadly form. Early detection is crucial for effective treatment, yet it remains challenging, as accurate diagnosis often requires expert medical knowledge. This study presents a novel, portable, and non-invasive optical imaging device designed for early detection of melanoma in clinical and non-clinical settings. By leveraging diffuse reflectance spectroscopy and incorporating a new 'Z criterion' into the established ABCD rule (Asymmetry, Border, Color, Diameter), the device offers an enhanced assessment. The preliminary study on a cohort of elderly patients demonstrated the device's feasibility in detecting melanoma, showing significant promise for application in portable diagnostics and at-home care.

For stabilization of scoliotic curves the Thoracic Lumbar Sacral Orthosis (TLSO) has become very popular. This device applies flexion, extension and lateral bending forces to the torso to decrease the curvature of the scoliotic spine. The brace is typically worn 23 hours per day. 3D printing is being applied to the manufacture of these braces as it offers the ability to manufacture the brace quickly, accurately and with much lower labor costs. However, adolescent braces (typically 12” x 8” x 22”) are much larger than infantile braces. This requires the use of larger capacity printers which are inherently much more expensive to purchase as well as operate. So for adolescent braces, in comparison to traditional manufacturing methods, 3D printing of adolescent braces is commercially unviable. A solution to this issue is to print the brace in multiple pieces and then assemble the pieces to form a complete brace. Thus, an adolescent brace may be printed on smaller 3D printers, thereby exploiting the advantages of the 3D printing process, and produce a commercially viable product.

This study explores the design and development of a laparoscopic surgery Pediatric Box trainer used with augmented reality (AR) training. A cohort of 11 medical residents from Hershey Medical Center, with varied experience in laparoscopic surgery, participated in a peg transfer task to assess hand-eye coordination, dexterity, and ambidexterity while interacting with the Pediatric Box trainer. Results showed the average force exerting on the needle holder averaged 0.43 N and 0.33 N for the dominant and non-dominate hands, respectively. Individual laparoscopic grasping profiles were shown to uniquely vary among users.  Future work will further develop the system to provide more effective AR training feedback based on the grasping force sensed.

Workflows for MRI-guided minimally-invasive neurosurgeries are often time-consuming and complex. Many minimally-invasive interventions utilize magnetic resonance imaging (MRI) to noninvasively visualize internal anatomy and pathologies. This, in conjunction with external trajectory guides, can be used to internally position devices to perform complex surgeries with minimal disruption to the patients’ healthy anatomy.

These trajectory guides are typically rigidly attached to the skull and feature adjustable channels through which drills, needles, and /or catheters may be introduced.  Trajectories are oriented by iterating between imaging and manipulation of device settings. MRI scans, while offering a great deal of valuable anatomic information, are slow to acquire. Scans of a sufficient resolution for neurosurgery can take on the order of 10 minutes to acquire, depending on field of view. Noniterative approaches could reduce complexity and anesthesia time.

This work describes efforts to create and validate a new trajectory guide that enables faster, accurate trajectory guidance in minimally-invasive neurosurgeries. Using new hardware and software, a single scan approach was used to perform drill guidance and device insertion on phantoms and cadaver heads.

The proposed methodology accurately guided needles to targets within phantoms and human cadaver brains using a single targeting scan. The initial design produced a radial error of 1.4±0.8mm in phantoms and 1.5±0.8mm in cadaver brains.

The proposed device and software accelerate trajectory guidance in minimally-invasive neurosurgeries by reducing the number of acquired scans and procedural steps. This in turn minimizes time under anesthesia.

Introduction: Nasal obstruction significantly impacts the quality of life, with dynamic collapse during inspiration being a primary cause. Current treatments lack precise quantification of nasal cartilage strength, relying on subjective quality of life assessments. This study introduces a novel device, the nasal cartilage caliper, designed to accurately measure nasal cartilage strength, addressing the need for objective quantification in treatment evaluation.

Methods: The nasal cartilage caliper, incorporating off-the-shelf electronics, was custom-designed to provide lightweight, accurate measurements of stress-strain relationships in nasal cartilage. The device's efficacy was evaluated through a series of tests measuring force and distance to calculate stress-strain curves. These tests aimed to demonstrate the device's potential in clinical settings for assessing nasal cartilage strength.

Results: Preliminary testing showed the nasal cartilage caliper could effectively quantify the stress-strain relationship of nasal cartilage, offering a more specific assessment compared to traditional methods like rhinomanometry. The device demonstrated a linear relationship between force applied and distance, indicating its potential for reliable, accurate measurements in a clinical setting.

Conclusion: The nasal cartilage caliper represents a significant advancement in the quantification of nasal cartilage strength, providing a novel tool for physicians to evaluate and monitor treatment outcomes objectively. This device addresses a critical gap in current medical practices, potentially enhancing decision-making in treatments and advancing research in nasal cartilage dynamics.

This study introduces a novel synthetic cecal content (SCC) formulation for in vitro medical device testing, addressing a gap in simulated biological fluids. By modifying a synthetic feces recipe, the research successfully replicates the mechanical properties of actual cecal contents, particularly in terms of viscosity and shear response. Rheometric testing confirms the SCC's consistency with actual cecal contents, providing an efficient, cost-effective solution for preliminary medical device evaluations. This advancement offers significant implications for medical device research, particularly in digestive health, by enabling more accurate benchtop testing without the ethical and logistical challenges of using real biological samples.

Finger actuation mechanisms are being investigated to aid the development of a low-cost prosthetic hand. Fingers were tested independently of the thumb to make the results applicable to multiple designs. Each finger actuation mechanism consists of a finger design and a driver. The three finger designs considered are the Tact finger, a derivative of the OpenBionics hand denoted the Channel finger, and a 4-Bar Linkage finger. The two actuation drivers tested for each finger are a solid-bar linkage system and a pulley system, both of which are motor-driven. The finger actuation mechanisms are assessed based on the force produced, movement precision, degrees of movement, power consumption, contraction and extension times, and finally weight. The motor-driven linkage systems outperform the motor-driven pulley systems with the 4-Bar linkage finger being the best-performing finger actuation mechanism overall. It is recommended that the number of actuation mechanisms be expanded to provide a more comprehensive set of results. Different motors should be tested to improve the force produced to bring it in line with an average human finger.

Frequent prenatal visits allow for early detection of fetal abnormalities and prevention of fetal mortality. While research has shown that the use of the fetal heart rate Doppler is superior compared to the Pinard stethoscope for detecting abnormal fetal heart rate, the usability of the device is limited in areas that lack consistent electricity sources or battery access. Our proposed device is a low-cost, self-powered method to monitor the fetal heart rate for pregnant women in low resource, rural areas in order to reduce fetal mortality and bridge key gaps in care. Using solar power and supplemental mechanical energy (via motor crank), this device is able to run without the need of replaceable batteries or an external power supply. Through multiple iterations and testing, our team was able to create a working prototype that incorporates key design input from stakeholders while also remaining compact and low cost. Future considerations include increasing the length of the battery life in order to assist in continuous monitoring for deliveries and further exploration on the adaptability of the device in developing countries.

Simulation-based training is a primary method for ensuring skill acquisition and retention, particularly within medicine. The use of simulated training in combat medicine is one of the only methods for soldiers to practice lifesaving skills prior to the battlefield, thus it is imperative that soldiers have ample opportunity to experience high quality training scenarios. The current study assesses the relationship between errors made in a tactical field care simulation and the participants previous simulated training experience. Twenty-eight soldiers and ROTC cadets with CLS or equivalent training completed two tactical field care simulations providing treatment to a male and female simulator, in random order, both experiencing a GSW to the chest and trauma amputation to the leg. Errors in treating patient injuries were coded for analysis. The results indicate that participants committed more errors when treating the female simulator. Errors during tourniquet application, GSW treatment, and undressing were most common when the female was presented first. Previous simulation training experience was correlated with error rates, particularly in regard to undressing, indicating that a lack of undressing training correlated to increased undressing errors. Findings suggest a pronounced gap in simulation-based training using female simulators within the CLS training curriculum.

Microperfusion provides the ability to sample compounds diffusing through the brain parenchyma but lacks the ability to pinpoint the origin of the collected biomarker. Therefore, we pursued the time-distance relationship of diffusing biomarkers in the brain parenchyma. Computational simulations predict the diffusion gradient of 3 kDa dextran injected into both agar and brain tissue. Experimental results show that dextran can be detected from several millimeters away during a 6-hour sampling window. This suggests that microperfusion can successfully capture large biological compounds diffusing from distant origins in vivo.

This poster explores the need for individualized feedback in medical simulation training for procedures such as endotracheal intubations and colonoscopies. This experiment investigates the application of visual hand tracking technology, specifically Google's MediaPipe, to offer quantitative feedback. Using a wooden hand model on a linear motor with a depth camera, this experiment explores tracking hand movements in real time. Results demonstrated consistent patterns in knuckle movements corresponding to linear motor actions. Total distance traveled by each knuckle and error analysis, averaging 3.1 mm, provided insights into the accuracy of visually measured hand movements. The experiment explores the technology's accuracy and underscores its potential application in medical training, addressing a gap in current practices and emphasizing the importance of tailored feedback for improved patient outcomes.

Articulation can play a role in laparoscopic surgical instruments to increase access to surgical sites and avoid unwanted interference between instruments or between instruments and other tissues. The effect of articulation on instrument shape can also be influential in the feasibility of specialized surgical approaches such as single-incision laparoscopic surgery.  In this paper, we present a modular instrument with an articulated shaft.  The unique design allows preoperative configuration of the instrument’s shape to best suit the minimally invasive access path to the surgical site. The details of the design, prototyping efforts, and validation in simulation are presented.

In the context of design, an experiential gap occurs when a disparity exists between the experiences of the target user and that of the designer. When designing for persons with disabilities, an experiential gap presents a challenge in addressing usability during the conceptual design process. In other words, the designer cannot grasp the differences in functional ability or the complexities of disability. This can hinder the design process as conceptual designs are developed and evaluated. This project used a priming package to better orient student designers to their project and unfamiliar target users. Using interviews with the design teams, guidelines for developing priming packages are proposed. The priming package should include a project brief and objective, desirable features list, background information, predicate technology, and stakeholder contact information. The purpose of the priming package was to allow the design team to kickstart design activities and to better prepare students to engage users and stakeholders. Student interviews confirmed that a benefit of the priming package was to improve early communication.

Surgeries of the ear and lateral skull base frequently require the use of bone wax to seal off small vessels and to repair or prevent leakage of cerebrospinal fluid. Application of bone wax to the hard, wet, and irregular surface of the bone is challenging with conventional instruments due to the tendency of the wax to slip off the bone and the narrow surgical corridors of the lateral skull base. Here we present a novel surgical tool for bone wax application, comprised of a rigid core with a coating of softer material over the ends. We tested several combinations of 3D printed materials in cadaveric temporal bones simulating surgical conditions. The tool was superior to conventional methods of bone wax application for all material combinations tested. Further studies into optimal materials and additional applications are planned.

Pleural biopsies are challenging procedures that rely heavily on the skill of the performing clinician as there is little to guide them other than the feel of the needle within the patient. This is especially true in resource-poor settings as the cost and availability of external imaging equipment (such as computed tomography, ultrasound scanners, or thoracoscopes), and the increased skill needed to use the equipment prohibits their regular usage during these procedures. As a result, basic cutting needle biopsies have high risks of causing damage to the lung when the needle is inserted past the pleural space, or low diagnostic rates as pleural tissue is often not included in the biopsies. However, despite these drawbacks, pleural biopsies are performed regularly, most notably for the diagnosis of tuberculous pleurisy, in low- or middle-income countries. This paper proposes an updated cutting needle design to firstly improve the yield of pleural tissue in the biopsies, secondly, allow for multiple biopsies to be collected with a single insertion, and lastly, minimise the risks of pneumothoraces during the procedure by the addition of low-cost sensors to guide the clinician during insertion. 

Ingestible medical capsules are used for non-invasive diagnosis and treatment of gastrointestinal (GI) tract diseases. For any task performed by a medical capsule (delivering drugs, collecting images, implanting a sensor, collecting bio samples, etc.), localization of the device is critical for proper functionality. Current methods enable approximate localization (a general location in 3D space), so physicians are aware if the capsule is in the stomach, small intestine, or colon. However, precise auto-localization (e.g. knowing the precise distance from the stomach) has been elusive as there is currently no way for an ingested capsule to know its exact location with precision. In this paper we discuss our development of a new medical capsule technology that uses odometry to measure the linear distance traveled by the capsule and transmits that data wirelessly to an external device. A small spool is wound with dissolvable suture thread and rotates as the capsule traverses the gastrointestinal tract, leaving behind a trail of suture. These spool rotations are tracked and mapped into a linear distance traveled by the capsule. Initial analysis showed that our technology is able to accurately track distance to within an average error of 7.33 ± 5.34 mm.

Telesurgery applications in laparoscopic surgeries are limited by the need for a surgeon to manually insert the trocar for access to the abdominal cavity. This feasibility study aims to solve this by capitalizing on the biomechanical properties of the abdominal wall to introduce the Robotic Automated Peritoneal Insertion Device (RAPID), a novel mechanism employing a purely mechanical indication system for accessing the abdominal cavity. The RAPID leverages pressure differences between layers in the abdominal wall and the abdominal cavity to indicate entry.

In a previous study, optimal pressure parameters for the RAPID were determined through experiments conducted on cadaver and porcine models. In the present work, the RAPID utilizes this optimal pressure in an entry indication system that is validated in live porcine models. The system operated correctly in 19 out of 21 placements, affirming the feasibility of the entry indication system. This shows that the RAPID can accurately indicate entry of the trocar into the abdominal cavity. This groundbreaking advancement has the potential to automate initial and subsequent trocar insertions, thus removing one more constraint on laparoscopic telesurgery.

Impaired hand function, commonly presenting as impaired finger extension, is one of the most common motor deficits after stroke, and an affordable, accessible device for hand rehabilitation is needed. Our team presents a soft robotic extensor designed to address finger extension deficits in stroke survivors while emphasizing patient accessibility. Performance evaluation of the device through preliminary testing in healthy adults is also discussed. Results highlight the soft robot extensor’s potential as an accessible device for improving hand function in stroke survivors.

Premature births, a significant global health challenge, often result in various health complexities that require specialized neonatal intensive care. Traditional monitoring methods designed for term infants pose risks to the delicate skin and the overall health of premature infants. Continuous Positive Airway Pressure is commonly used for respiratory support in Neonatal Intensive Care Units but has notable drawbacks, including the risk of skin damage and gastrointestinal issues. High-flow Nasal Cannula offers a less invasive alternative but lacks crucial airway pressure feedback. To overcome these challenges, we developed a multifunctional catheter that integrates feeding and vital sign monitoring into a single, less invasive device capable of providing nutrition and measuring airway pressure, electrocardiogram, and core body temperature. This study focuses on testing multiple pressure sensors to select the most suitable type and their placement on the catheter. Functionality, effectiveness, reliability, and safety are important selection criteria for future use in neonatal care. Our experiments replicate a simplified neonatal respiratory condition, employing a systematic process where sensors are subjected to drift tests and noise level analysis under varying air pressure conditions. Signal analysis and filtering was performed to enhance data clarity and to find sources of potential noise sources. Results indicate significant variations in sensor performance, with certain sensors demonstrating superior stability, minimal drift, and reduced noise levels, making them more suitable for integration into the catheter. The findings of this study underscore the feasibility of offering evidence-based, non-invasive monitoring solutions that lead to more comfortable and accurate monitoring of this vulnerable population.

A survey of the competencies needed for biomedical engineers working in medical product development (MPD) was sent to medtech professionals in industry. The MPD survey received 120 responses from participants in small, medium, and large organizations. Almost half the respondents reported >10 years of experience in medtech. Respondents numerically scored 41 competencies related to medical product development based on their importance to engineers. In addition, respondents provided open-ended input on expected changes in the industry, as well as key drivers and trends in the next 5-10 years. Professional skills such as communication, teamwork, creativity, and self-awareness were highly ranked, as was practical experience. Fundamental medical product development competencies such as quality, risk, and regulatory were also considered important, as were training in statistics and design for manufacturing. Respondents noted the recent emphasis on remote monitoring and telehealth necessitated by the COVID-19 pandemic in 2020-23. Big data, artificial intelligence, machine learning, robotics, and automation were identified as expanding areas that will influence the evolution of the field. The survey data provide direct insight into the needs of the medical technology workforce, which can be used to inform the education and training of biomedical engineers.

RealCooL is a device that can rapidly modify the temperature of many liquids to a desired target value. Extensive interviews revealed that there is a need for a device that can rapidly cool or heat liquids, specifically for the use of rewarming or chilling human milk for babies. Commercially available devices such as freezers or baby bottle warmers are slow and lack the ability for temperature control of the milk. The heating and cooling rates of RealCooL were compared to two commercially available devices: a standard LG freezer for cooling and a Thermo Fisher water bath for heating. Bovine milk was used to simulate human milk in these experiments. Results indicate that RealCooL results in a 6-fold higher cooling rate and a 45-fold higher warming rate compared to commercial devices. Next steps include examination of whether RealCooL affects nutritive and biologically active components in human milk and determination of optimal cooling and heating rates for HM.

Even a small to moderate degree of global cardiac ischemia during heart surgery can significantly contribute to a patient’s postoperative morbidity and mortality. While various ischemic damage mitigation strategies have been implemented, the efficacy of the intravenous administration of polyunsaturated fatty acids has not been extensively studied. This research evaluates the impact of myocardial pharmacological postconditioning via intravenous infusion of lipid emulsions on the hemodynamic performance during global cardiac ischemia using Visible Heart® Methodologies: swine hearts were reanimated with an acellular perfusate saturated with oxygen.

Intravascular postconditioning with omega 3/omega 6 fatty acid emulsions led to improved cardiac performance metrics during global ischemia occurring in reanimated swine hearts. These findings suggest that further investigation into the protective effects of PUFAs is warranted. Due to the use of a Krebs-Henseleit physiological buffer solution for the isolated heart models, any effect seen in these experiments would be independent of blood components (e.g. lymphocyte mediated effects) and most likely a direct effect on the cardiac myocytes.

Keywords: Heart failure, ischemia reperfusion injury, swine, heart transplant

Surgeons in training have a limited opportunity to practice their skills in a realistic surgical environment. Surgical training models are expensive and are often single-use exercises involving consumable supplies. The goal of the work presented in this paper is to increase surgeon training time by developing a surgical training simulator that is portable, inexpensive, and offers a realistic surgical environment. To achieve this goal, the device must be easily assembled, compact, durable, resistant to loads experienced during transport, and can be integrated with virtual reality training modules. This device must also work with a variety of surgical instruments, since the surgeons will be supplying their own instruments for training. The simulation environment for this project is developed with the focus of simulating laparoscopic gallbladder surgery, with the potential of extending the simulation environment for other surgeries. This paper will outline the current state of the prototype and the design process for creating the prototype.

Fractures of the patella can be challenging to treat surgically. The current standard of tension band wiring is susceptible to wire loosening and fracture displacement. In this study we introduce a novel concept involving a flexible patella fixation device which leverages pre-strain to deliver interfragmentary compression concentrated anteriorly. Finite element analysis provides a preliminary exploration of the concept, demonstrating that two different flexible patella plates can provide increased anterior compression both alone and when paired with lag screws.

In the realm of robot-assisted surgery, maneuverability in confined spaces remains a critical challenge. This paper presents the development of a snake-like robotic arm designed specifically for large organ and tissue retraction during minimally invasive surgeries. Emulating the flexible movements of a snake, the robotic arm aims to push the boundaries of current surgical robots. Key objectives include compatibility with existing minimally invasive ports, capacity to hold up to 2 pounds of tissue without deformation, axial stability under 10N force at full extension, compatibility with articulate-by-wire robotic systems, and a minimum of 4 degrees of freedom.

The design and construction involve three segments: the base attachment, middle links, and the end manipulator. Finite Element Analysis (FEA) validates the design and demonstrates the device’s ability to handle up to 10N before the onset of deformation. The arm, manufactured using stereolithography printing, handled 2 lbs (~10N) of distal-segment load thus providing real-world evidence to reinforce the FEA data. The actuation base, powered by high-torque servo motors controlled by a separate control module, provides precise and responsive movement. Extensive testing, both in simulated computational environments and physical stress tests, demonstrates the arm's proficiency in handling surgical tasks within minimally invasive procedures.

Keywords: Snake-like robotic arm, Minimally invasive surgery, Tissue retraction, Organ retraction, Maneuverability, Finite Element Analysis, Stereolithography printing, High-torque servo motors.

The results of this study prove that the CETCS cannula and microneedles are visible with CT imaging. CETCS and the predicate device material for the tissue insertion tests behave similarly, with an average tissue accumulation mass of 16.4 ± 3.6 mg and 21.4 ± 4.0 mg, respectively. The microneedles did not experience function-limiting damage with any of the attached syringes in the syringe drop test. The passing of all tests suggests that the CETCS satisfactorily met regulatory testing milestones required for clinical use.

Laparoscopy is a surgical method that involves the use of several tools inserted into the body through small incisions, and a small camera to provide visualization of the surgical field. This method allows for decreased risk of infection, rapid healing time, and reduced scarring of the incision sites. Currently, the most advanced form of this technique is robotic laparoscopic surgery, where a robot controlled by a surgeon. While very precise, this system is very expensive and requires special facilities, therefore, undesirable for smaller hospitals to implement. Thus, an intermediary device that bridges the gap between traditional laparoscopic surgery and robotic laparoscopic surgery, while remaining cost effective and practical, could be a solution.

Keywords: Laparoscopic surgery, robotic surgery, robotics

The current breast pump equipment sanitization method is cumbersome. Multiple pump parts require cleaning between each use and daily steam sanitization with a plastic bag. This study aims to improve the current sanitation method, that may improve maternal satisfaction, making breastfeeding more successful. The study involves Neonatal Intensive Care (NICU) mothers using and evaluating the Q. Basin, a novel multifunctional device to clean, dry, and sanitize breast pump parts in a streamlined and hygienic process. This study describes the device design and satisfaction testing with 20 mothers in a NICU at our full-service pediatric hospital. The design was developed to create a 3 in 1 system encompassing a basin for washing equipment and a lid doubling as an equipment drying rack. The Q. Basin size was dictated by standard hospital and at-home microwave compatibility and has multiple vents for water drainage during steam sanitization. Ten Q. Basin prototypes were 3D printed in M30i food-compatible material on Stratasys Fortus 400 printer. The Q. Basin method was preferred over the existing sanitization method by 20%. It demonstrated a quicker, faster, and more environmentally friendly breast pump part sanitation method.