Page 160 - Flexible Robotics in Medicine

146 Chapter 5

guide at the center of the device. Insert the fiber-optic bronchoscope into the wire
guide above the drilling wire.
11. Activate the drill wire (9) and stop after it drills through the subject’s skin, creating
a stoma.
12. Activate the drill wire (9) in the opposite direction so that it is removed from the
stoma. An indication of when to stop the drill is by using the bronchoscope to ensure
that the tip of the wire is inside the trachea. If it is still in the trachea, activate the drill
wire again.
13. Deactivate the mechanical force so that the device is now slack.
14. Remove the device from the subject.

5.6 Conclusion remarks and future work

In conclusion, the tendon-based approach can be considered to produce more reliable
results, being able to satisfy the criteria for the deflection angle and also being more
stable in comparison with the pneumatics-based approach. However, further experiments
need to be done to accurately determine the stability of the prototype due to the limitations
of Tracker software. We have come up with some potential ways to improve MOJO, but
due to the time constraints of this project, these ideas are proposed in this section for
future study.
First, we have experimented with an automatic mechanism that involves pneumatics. Using
pneumatics will allow for more stability. When negative pressure is applied to the device
concealed in an airtight bag, the device becomes rigid. The use of an airtight bag will also
conceal the modules, and in the case of a broken hinge, the modules will not be stuck in the
upper airways of the subject. Since there is no tendon, there are fewer risks involved in this
concept.

Second, to make MOJO customizable, we propose to make disposable hinges detachable so
that the modules can be switched. The modules can be reused after sterilizing, as they are
stable and rigid. The hinges, drilling wires, and tendons can be disposable and attached to
MOJO before the procedure. This would allow for more subjects to be able to receive a
minimally invasive tracheostomy procedure.
Third, we suggest changing the manual mechanism to a semimanual mechanism. This
would allow more flexible bending angles rather than fixed angles. A control lever that can
control bending and activate the drill wire will be ideal because it will be able to stabilize
the device and prevent it from moving. Manpower will also be more efficiently allocated as
only one operator will be needed to control the device and activate the drill wire. A
controlled bending angle will benefit subjects who do not share the average anatomical
angles. To ensure the compatibility of MOJO in serving the purpose of performing a