3-D modelling of heart enables robotic surgery on beating heart
15 December 2009
A team at the Montpellier Laboratory of Informatics in France
has developed a computerized 3D model that allows surgeons to use
robotics to operate on a beating heart, according to a paper published
in The International Journal of Robotics Research, published by
The robotic technology predicts the movement of the heart as it
beats, enabling the surgical tools to move in concert with each beat. It
means that the surgeon can perform a procedure as if the heart was
stationary. This development could be very important for millions of
patients who require less invasive surgical heart procedures, where
stopping the heart from beating would cause unnecessary risk.
Rogério Richa, Philippe Poignet and Chao Liu from France’s
Montpellier Laboratory of Informatics, Robotics, and Microelectronics
developed a three-dimensional computerized model that tracks the motion
of the heart’s surface as it beats.
In addition to the heart, this model also accounts for the movement
of a patient’s chest wall during breathing. Known as the “thin-plate
spline deformable model”, this new computerized approach allows the
robotic arm to continually adjust to heart and chest movements during
The new approach relies on a mathematical representation of the
heart’s surface as it moves in three dimensions during pumping.
Researchers have made many attempts to use computer modelling to account
for heart and breathing motion.
However, previous efforts have relied on 2D imaging combined with
other steps, making them to slow to provide instantaneous feedback
during an operation. This new 3D imaging predicts the heart movements in
a single step, making it faster in real-life surgical environments.
Over the last 10 years, robotic arms have become essential in many
kinds of surgical procedures, including microsurgery and operations that
require extremely delicate movements. However, these machines also
prevent the surgeons from using their sense of touch and coordination to
adjust for rapidly changing environments.
This new computer-generated model makes it possible for the surgeon
to focus on suturing or cutting without having to adjust for the moving
surface. Ultimately, this breakthrough will have many potential
applications including heart surgery, coronary bypasses, and many kinds
of brain surgery.
This is the first successful attempt to effectively isolate the
physical movements of the heart and lungs during surgery. This has been
particularly difficult given the heart’s irregular shape, as well as its
tendency to expand outward in all directions during beating. The heart’s
irregular surface also makes it more difficult to use visual tracking to
accurately pinpoint movement.
This important development will allow surgeons to perform less
invasive procedures that are not “life-or-death”, but that do require a
high level of precision and can have life-altering consequences for
patients worldwide. To date, patients have gone without many of these
procedures because the risk of complications during surgery outweighed
1. Rogério Richa, Philippe Poignet and Chao Liu. Three-dimensional
Motion Tracking for Beating Heart Surgery Using a Thin-plate Spline
Deformable Model. International Journal of Robotics Research,
11 Dec 2009.