This child-sized device assists children with thumb movements while giving them sensory and visual feedback. (Image: Wyss Institute, Harvard University)
Our ability to use the thumb as an opposable digit is a critical part of what sets us apart as a species. “That’s how you’re holding a pen,” Leia Stirling, PhD, a senior staff engineer at the Wyss Institute for Biologically Inspired Engineering told me recently as we talked about the Wyss’ latest collaboration with Boston Children’s Hospital. “That’s how you hold your phone; that’s how you open a door; that’s what makes us unique.”
It’s also an ability that children who have suffered a stroke or have cerebral palsy or hemiplegia (paralysis on one side of the body) can lose or fail to develop in the first place.
Stirling, along with Hani Sallum, MS, and Annette Correia, OT, in Boston Children’s departments of Physical and Occupational Therapy, are the architects of a robotic device that may improve functional hand use. The device assists children with muscle movements, using small motors called “actuators” placed over the hand joints, while giving them sensory and visual feedback. It’s called the Isolated Orthosis for Thumb Actuation, or IOTA. Full story »
A lab at Boston Children's Hospital hopes to make neurosurgery as minimally invasive as possible. (Photo: Katherine Cohen)
When Patrick Codd, MD, removed a toddler’s deep brain tumor not long ago at Massachusetts General Hospital, he first put a catheter inside the boy’s head to drain the excess fluid that had built up. He and the neurosurgery team then removed a large portion of the child’s skull, exposed the brain and dissected through the brain tissue, using a microscope, until he could reach the tumor, which the team then removed.
The boy is doing fine, but Codd and his mentors at Boston Children’s Hospital—Joseph Madsen, MD, and Pierre Dupont, PhD, chief of Pediatric Cardiac Bioengineering—had a vision: Could the tumor have been removed via the same catheter that he used to drain the fluid, leaving the rest of the brain intact?
Standard surgical techniques—and even newer ones that use lasers or go into the brain through the nose—require surgeons to bore through brain tissue to get to their destination. This carries a risk of injuring sensitive areas as they pass through, like the structures involved in language, as well as a risk for wound infections and complications from extended anesthesia times. Full story »
Children and parents connect with home robots that "embody" their health care provider. (Image submitted by a patient at Children's Hospital Boston)
Robotic technology can take many forms. In the Department of Urology at Children’s Hospital Boston, we are evaluating a remotely controlled, videoconferencing robot on wheels to help transition our patients’ care to the home after surgery. This transition is a time of significant anxiety for all. In the hospital, children have around-the-clock care and monitoring; after discharge, families tend to lose contact with their physicians and nurses unless there is a problem or complication.
The robot we’re testing, the VGo, allows us to make virtual house calls. As children recover in familiar and comfortable surroundings, with their families around them, we can talk to them, monitor them, view their home environment, help parents assess their child’s status and answer their questions and concerns. We can sometimes identify errors and avoid complications before they require emergent and costly medical attention.
We’re often asked why we use this mobile robotic system, a relatively new and costly technology, rather than established, less expensive alternatives such as cell phones or computer-based videoconferencing programs like Skype or Facetime. Full story »
The most expensive way to deliver care is in a hospital – but discharging patients too soon can lead to complications and rehospitalizations. That’s where robots can help – and sometimes a robot can be as simple as a video/audio system that can roll around under remote control, transmitting communications over a Verizon 4G cellular network.
Instead of having to drag kids back to the hospital for frequent office checks after surgery, Hiep Nguyen, a urologist/surgeon at Children’s Hospital Boston, can call the family at home and do the check remotely. You’d think it might feel impersonal and alienating, but the opposite seems to be true. “Families love the robot,” says Nguyen. “They feel secure that they have a lifeline to their doctor.”
Hospital innovators are beginning to turn to robotic systems – some as simple as a cell phone that enables video conferencing between doctor and patient – to enhance patient care and lower costs (see yesterday’s post). The Child Life department at Children’s Hospital Boston asked kids staying at the hospital to share their ideas for robots that could help them and assist their doctors and nurses. A few hospital staff got in the spirit, too. At left and below are a few of their submissions. Click to enlarge them.
>>>Designed first with legos, “Harold” has two antennae that function both as hands and an FM radio, so it can help carry things around the hospital while rockin’ to some tunes. Full story »
This robot, proposed by a patient at Children's Hospital Boston, would check vitals and tell stories.
It can’t be ignored that dramatic transformation in our healthcare system is imminent. The economy, market forces and increasing political demands will soon force physicians and healthcare professionals to change how we take care of our patients. Just as the days of housecalls are gone, so is our current system of delivering care.
The rising cost of healthcare now has the government and insurance companies placing more emphasis on controlling costs, sometimes at the expense of quality. They demand that we become more efficient and manage an even greater number of patients. Advancements in medical technology are believed to be a principal cause of the rising cost of healthcare: While they have improved patient care, they often come with a high price tag.
Does that mean we should abandon them? My answer is to play with robots. Full story »
A sequence of motion frames of a normally kicking baby's legs (shown in blue and green), illustrating changing joint angles at the hip and knee.
Countless scientific epiphanies never leave the bench – unless there’s the kind of serendipitous encounter that set Children’s Hospital Boston psychologist Gene Goldfield on a path he never expected to follow.
One in eight babies are born prematurely, putting them at greater risk for cerebral palsy, an inability to fully control their muscles. Goldfield saw these children being wheeled around the hospital, and was convinced that they did not have to be wheelchair-bound.
During early infancy, he knew, the developing brain naturally undergoes a rewiring of its circuits, including those that control the muscles. Could some type of early intervention encourage more typical motor development by replacing damaged circuits with more functional connections?
It began as a proof-of-principle demonstrated with LEGOs – a surgical biopsy needle whose motor is driven solely by a clinical MRI scanner:
The above demo shows that an MRI machine’s magnetic field can be programmed to produce enough force to control a robotic instrument — an accomplishment with broad potential in medicine. In the demo, the scanner’s magnetic field swings a rotating arm, and a set of gears convert that motion into the motion of a biopsy needle, strong enough to puncture the tough outer tissue of an animal heart and then withdraw. All parts exposed to the magnetic field are metal-free and MRI-compatible.
While MRI-compatible robots have been built before, this was the first demo of a motor powered by MRI, says Pierre Dupont, chief of Pediatric Cardiac Bioengineering at Children’s Hospital Boston. His engineering team was one of five finalists for Best Paper Award — out of 790 papers presented — at last week’s International Conference on Intelligent Robots and Systems (IROS 2011). Full story »
During breaks at TEDMED, Children’s Hospital Boston is demonstrating a sampling of its technologies. Medgadget, the Internet Journal of Emerging Medical Technologies, came by to watch and posted these videos.
Above, Children’s engineer Pierre Dupont describes a new way of fixing children’s hearts — with enhanced, robot-guided catheters and tiny surgical tools that he’s developing with Pedro del Nido, chief of Cardiac Surgery. We hope these tools (shown at their true miniscule size and in large models) and the robotic system driving them will allow children, especially babies, avoid the rigors of open-heart surgery. Instead, a short-stay catheterization procedure could be performed while their hearts are still beating.
Here, Children’s epidemiologist-informatician John Brownstein explains some of the new features of HealthMap, an Internet-based infectious-disease tracking system. He zeroes in on Haiti’s emerging cholera outbreak, in which a “crisis mappers” community on the ground is sending real-time data to HealthMap via iPhone and iPad.
Read more about innovations at Children’s on our website, and stay with Vectorblog and our Twitter feed (@science4care) for continuing TEDMED coverage.