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Jenny Dankelman

‘We’re going to cut, but just a bit…’

Bio

Bio

Jenny Dankelman studied Mathematics in Groningen. She obtained her doctorate in June 1989 from TU Delft with research on the dynamics of coronary artery circulation After 2 years as a postdoc at the AMC in Amsterdam she took the post of researcher at the TU Delft Department of Measurement and Control. In 2001 she was appointed Antoni van Leeuwenhoek Professor. At the present time she is head of the Department of Biomechanical Engineering at TU Delft and Professor of Minimally Invasive Techniques. Additionally, Dankelman is Medical Delta Professor at the Leiden University Medical Center.

POSITION AT:

TU Delft: Head of the department of Biomechanical Engineering
LUMC: Gynaecology

ROLE WITHIN MEDICAL DELTA:

Technical Scientific Leader NIMIT (IMDI)

‘A robotic needle, equipped with a sensor on the tip that allows the doctor to ‘feel’ tissue mechanically? Yes, we can do that!’

Smallest incision possible

‘What we want to achieve here is to allow doctors in the future to reach every part of the body in a minimally invasive manner, that is, by means of the smallest in - cision possible. Once there they will not only be able to observe but also to examine the tissue and, if there is an acute problem, to treat it. But we are not quite there yet. One remaining major challenge is directing the needle. You are also dependant on the skills of the surgeon.’

Sensation of the resistance of the tissue essential

‘Humans are not designed to perform actions remotely, these are skills that we have to learn. This is why we are developing training systems in tandem with the new instruments, to give the surgeon the feeling that he is working ‘hands on’, as far as is possible. That’s not very easy! Force-measurement is an important aspect. Many of the doctors who have followed a course have said afterwards that the training was not ‘true to life’, because they felt or had to apply different forces later in real situ - ations. It is very hard to simulate these forces. You can leave them out and concentrate on other skills in your training systems, but sometimes, such as when administering an epidural, the sensation of the resistance of the tissue is essential to learning the procedure properly.’

Robotic needles in the Medical Delta region

‘We have various projects run - ning in the Medical Delta region. We are working on instruments for treating damaged cartilage in joints; a robotic needle with a tip equipped with a sensor that allows the doctor to ‘feel’ the tissue mechanically. Needles with sensors that can report changes in the shape of the needle; instruments with multiple steering, or articulated ‘joints’ that can turn corners... and at the same time we are developing the corresponding training systems.’ ‘The road from idea to prototype and the first preclinical tests is a long one. We need to shorten it. Sometimes it can take 15 years, and then it’s difficult to keep up the motivation of all the parties involved. We should be able to get it down to a couple of years: that would already be a great improvement. We are trying to achieve this by working together with doctors and other hospital personnel, such as those who are responsible for sterilising equipment or for maintenance, in as early a stage as possible. Also by keeping in contact with the companies who will be manufac - turing the instruments – after all, it all has to be affordable. These are all facets that you have to take into account.’

Using sensor techniques to assess the problem

‘What does the future hold? Well, really we’d prefer not to have to enter the body of the patient at all. But if you have to, you want to damage as little healthy tissue as possible, and to be done in a single session. This means that in the future, doctors will use sensor techniques to assess the problem, they will decide on a course of action, they will choose their instruments and then determine the least harmful route through the patient’s body.’

Possibility of storing medicines in optical fibres

‘We are also working on optical fibres here in Delft. When you bundle a number of fibres, the bundle might prove to be suitable for directing the needle. And fibres can also transmit information, as well as providing the tip with energy that can then be converted into a different, functional form, such as a laser that can be used to burn some - thing off. No, you can’t transport medicines through an optical fibre – but you could perhaps store them in the tip, and regu - late their release optically.’

‘I think that a great deal of the operations which now involve incisions will eventually be able to be performed in a minimally invasive manner. Perhaps even all the operations that can be planned in advance. What will remain are the acute emergencies and haemorrhages, in other words, trauma care. In these cases, you have to work as fast as possible. There’s no time to plan, so you have to cut.’