Description
Addressing the exploding interest in bioengineering for healthcare applications, this book provides readers with detailed yet easy-to-understand guidance on biomedical device engineering. Written by prominent physicians and engineers, Medical Devices: Surgical and Image-Guided Technologies is organized into stand-alone chapters covering devices and systems in diagnostic, surgical, and implant procedures. Assuming only basic background in math and science, the authors clearly explain the fundamentals for different systems along with such topics as engineering considerations, therapeutic techniques and applications, future trends, and more. After describing how to manage a design project for medical devices, the book examines the following: * Instruments for laparoscopic and ophthalmic surgery, plus surgical robotics * Catheters in vascular therapy and energy-based hemostatic surgical devices * Tissue ablation systems and the varied uses of lasers in medicine * Vascular and cardiovascular devices, plus circulatory support devices * Ultrasound transducers, X-ray imaging, and neuronavigation An absolute must for biomedical engineers, Medical Devices: Surgical and Image-Guided Technologies is also an invaluable guide for students in all engineering majors and pre-med programs interested in exploring this fascinating field. MARTIN CULJAT, PhD, is Adjunct Assistant Professor in the UCLA Departments of Bioengineering and Surgery and the Engineering Research Director of the UCLA Center for Advanced Surgical and Interventional Technology (CASIT), a research center that promotes collaboration between medicine and engineering. RAHUL SINGH, PhD, is Adjunct Assistant Professor in the UCLA Departments of Bioengineering and Surgery. He leads several collaborative research projects at the UCLA Center for Advanced Surgical and Interventional Technology (CASIT). HUA LEE, PhD, is Professor in the Department of Electrical and Computer Engineering at UC Santa Barbara. Well known for his pioneering research laboratory, Dr. Lee is also the author of three other books on imaging technology and engineering. PREFACE xvii CONTRIBUTORS xix PART I INTRODUCTION TO MEDICAL DEVICES 1 1. Introduction 3 Martin Culjat 1.1 History of Medical Devices 3 1.2 Medical Device Terminology 6 1.3 Purpose of the Book 10 2. Design of Medical Devices 11 Gregory Nighswonger 2.1 Introduction 11 2.2 The Medical Device Design Environment 11 2.3 Basic Design Phases 15 2.4 Postmarket Activities 25 2.5 Final Note 25 PART II MINIMALLY INVASIVE DEVICES AND TECHNIQUES 27 3. Instrumentation for Laparoscopic Surgery 29 Camellia Racu-Keefer, Scott Um, Martin Culjat, and Erik Dutson 3.1 Introduction 29 3.2 Basic Principles 31 3.3 Laparoscopic Instrumentation 34 3.4 Innovative Applications 45 3.5 Summary and Future Applications 46 4. Surgical Instruments in Ophthalmology 49 Allen Y. Hu, Robert M. Beardsley, and Jean-Pierre Hubschman 4.1 Introduction 49 4.2 Cataract Surgery 51 4.3 Vitreoretinal Surgery 56 4.4 Other Ophthalmic Surgical Procedures 61 4.5 Conclusion 62 5. Surgical Robotics 63 Jacob Rosen 5.1 Introduction 63 5.2 Background and Leading Concepts 63 5.3 Commercial Systems 80 5.4 Trends and Future Directions 93 6. Catheters in Vascular Therapy 99 Axel Boese 6.1 Introduction 99 6.2 Historic Overview 100 6.3 Catheter Interventions 102 6.4 Catheter and Guide Wire Shapes and Configurations 105 6.5 Conclusion 116 PART III ENERGY DELIVERY DEVICES AND SYSTEMS 119 7. Energy-Based Hemostatic Surgical Devices 121 Amit P. Mulgaonkar, Warren Grundfest, and Rahul Singh 7.1 Introduction 121 7.2 History of Energy-Based Hemostasis 122 7.3 Energy-Based Surgical Methods and Their Effects on Tissues 125 7.4 Electrosurgery 128 7.5 Future Of Electrosurgery 134 7.6 Conclusion 135 8. Tissue Ablation Systems 137 Michael Douek, Justin McWilliams, and David Lu 8.1 Introduction 137 8.2 Evolving Paradigms in Cancer Therapy 138 8.3 Basic Ablation Categories and Nomenclature 140 8.4 Hyperthermic Ablation 140 8.5 Fundamentals of In Vivo Energy Deposition 141 8.6 Hyperthermic Ablation: Optimizing Tissue Ablation 143 8.7 Radiofrequency Ablation 144 8.8 RFA: Basic Principles 145 8.9 RFA: In Vivo Energy Deposition 145 8.10 Optimizing RFA 147 8.11 Other Hyperthermic Ablation Techniques 149 8.12 Laser Ablation 153 8.13 Hypothermic Ablation 154 8.14 Chemical Ablation 157 8.15 Novel Techniques 158 8.16 Tumor Ablation and Beyond 160 9. Lasers in Medicine 163 Zachary Taylor, Asael Papour, Oscar Stafsudd, and Warren Grundfest 9.1 Introduction 163 9.2 Laser Fundamentals 167 9.3 Laser Light Compared to Other Sources of Light 174 9.4 Laser-Tissue Interactions 178 9.5 Lasers in Diagnostics 181 9.6 Laser Treatments and Therapy 186 9.7 Conclusions 196 PART IV IMPLANTABLE DEVICES AND SYSTEMS 197 10. Vascular and Cardiovascular Devices 199 Dan Levi, Allan Tulloch, John Ho, Colin Kealey, and David Rigberg 10.1 Introduction 199 10.2 Biocompatibility Considerations 200 10.3 Materials 202 10.4 Stents 204 10.5 Closure Devices 206 10.6 Transcatheter Heart Valves 208 10.7 Inferior Vena Cava Filters 212 10.8 Future Directions-Thin Film Nitinol 214 10.9 Conclusion 216 11. Mechanical Circulatory Support Devices 219 Colin Kealey, Paymon Rahgozar, and Murray Kwon 11.1 Introduction 219 11.2 History 220 11.3 Basic Principles 221 11.4 Engineering Considerations in Mechanical Circulatory Support 223 11.5 Devices 228 11.6 The Future of MCS Devices 239 11.7 Summary 240 12. Orthopedic Implants 241 Sophia N. Sangiorgio, Todd S. Johnson, Jon Moseley, G. Bryan Cornwall, and Edward Ebramzadeh 12.1 Introduction 241 12.2 Basic Principles 244 12.3 Implant Technologies 253 12.4 Summary 272 PART V IMAGING AND IMAGE-GUIDED TECHNIQUES 275 13. Endoscopy 277 Gregory Nighswonger 13.1 Introduction 277 13.2 Ancient Origins 278 13.3 Modern Endoscopy 280 13.4 Principles of Modern Endoscopy 283 13.5 The Imaging Chain 285 13.6 Endoscopes for Today 288 13.7 Endoscopy’s Future 301 14. Medical Ultrasound Devices 303 Rahul Singh and Martin Culjat 14.1 Introduction 303 14.2 Basic Principles of Ultrasound 304 14.3 Ultrasound Transducer Design 316 14.4 Applications of Medical Ultrasound 329 14.5 The Future of Medical Ultrasound 338 15. Medical X-ray Imaging 341 Mark Roden 15.1 Introduction 341 15.2 X-ray Physics 342 15.3 Two-Dimensional Image Acquisition 348 15.4 Image Acquisition Technologies and Techniques 351 15.5 Basic 2D Processing Techniques 361 15.6 Real-Time X-ray Imaging 367 15.7 Three-Dimensional X-ray Imaging 372 15.8 Conclusion 373 16. Navigation in Neurosurgery 375 Jean-Jacques Lemaire, Eric J. Behnke, Andrew J. Frew, and Antonio A. F. DeSalles 16.1 Basics of Neurosurgery 375 16.2 Introduction to Neuronavigation 381 16.3 Neuronavigation Systems 381 16.4 Implementation of Neuronavigation 386 16.5 Augmented Reality and Virtual Reality 390 16.6 Summary/Future 391 REFERENCES 395 INDEX 425
