TEAK Traveling Engineering Activity Kits

TEAK Bioengineering Laparoscopic Lesson Plan Page 1 TEAK Traveling Engineering Activity Kits Biomedical Engineering Kit: Laparoscopic Surgery Laparoscopic Surgery Activity

TEAK Bioengineering Laparoscopic Lesson Plan Page 2 Instructor Preparation Guide: Laparoscopic Surgery Activity Bioengineering Overview Bioengineering is the application of engineering principles to address challenges in the fields of biology and medicine. Bioengineering is the application of the principles of engineering design to the full spectrum of living systems. Biomaterials Overview Biomaterials are any material that may be used within a living system or for a medical device which performs, augments, or takes the place of a natural function. Biomaterials are utilized in such fields as medicine, biology, surgery, and material sciences. The most important property of a biomaterial is that it must be compatible with the human body without causing inflation, infection, or the spread of disease. Biomaterials are typically used in such applications as hip replacements, bone plates, artificial ligaments, artificial organs, dental implants, skin repair devices, and contact lenses. Typical metals that may be used as biomaterials are 316 and 316 L stainless steels, cobalt-chromium based alloys, gold, mercury alloys, titanium, and titanium based alloys. Ceramic materials that are often used for bioengineering applications are alumina and zirconia. Aside from ceramics and metals, polymers represent a large class of biomaterials. Typical polymers used in bio related applications range from high-density polyethylene to softer elastomers such as silicones. Figure 1.0: 316 Stainless Steel

TEAK Bioengineering Laparoscopic Lesson Plan Page 3 Figure 1.1: Titanium Defibrillator Laparoscopic Surgery Overview Laparoscopic surgery is a minimally invasive surgery that is performed through small incisions rather than large incisions as needed in traditional surgeries. Laparoscopic surgery belongs to the larger field of endoscopy. They key element in laparoscopic surgery is the use of a laparoscope. There are two types of laparoscopes. The first type of laparoscope includes a telescopic rod lens systems that is connected to a video camera. The second type is a digital laparoscope where a charge-coupled device is placed at the end of the scope eliminating the need for the rod lens system. Some of the advantages of laparoscopic surgery are reduced blood loss, smaller incisions, less recovery time from surgery, and a shortened hospital stay. Disadvantages to this form of surgery are injuries to blood vessels or the large bowel, electrical burns, and CO2 gas in the abdominal cavity. Figure 2.0: Laparoscopic Instruments

TEAK Bioengineering Laparoscopic Lesson Plan Page 4 Figure 2.1: Laparoscope Resources www.wikipedia.com Encyclopedia of Super Molecular Chemistry: http://books.google.com/books?id=6q479mq8pfoc&pg=pa111&lpg=pa111&dq =typical+biomaterials&source=web&ots=77jf2p7zsc&sig=swkncmlbqhnrgz qo9aobz0flwo0&hl=en&sa=&oi=book_result&resnum=1&ct=result#ppa115,m1 Image Resources Figure 1.0: http://ecx.images-amazon.com/images/i/41rw9olwdl._aa280_.jpg Date: February 1, 2009 Time: 12:39 pm Figure 1.1: http://www.medtronic.com/wcm/groups/mdtcom_sg/@mdt/@crdm/documents/im ages/crdm_virtuoso_d154awg_lres.jpg Date: February 1, 2009 Time: 12:45 pm

TEAK Bioengineering Laparoscopic Lesson Plan Page 5 Figure 2.0: http://www.stryker.com/enus/products/instruments/endoscopicinstruments/laparoscopyinstruments/groups/ public/documents/web_prod/da_026674.jpg Date: February 1, 2009 Time: 1:15pm Figure 2.1: http://www.medifixinc.com/op-laparoscopemf45deg.jpg Date: February 1, 2009 Time: 1:17 pm

TEAK Bioengineering Laparoscopic Lesson Plan Page 6 Activity Preparation Guide Laparoscopic Surgery Activity Overview This kit contains activities for students to gain a better understanding of how engineers must design instrumentation and tools so that form fits function. The activities in this kit will teach students how engineers must design to fit their intended environment and what type of materials and design considerations must be taken into account during the design process. It further explains how engineers design and develop surgical instrumentation to reduce and limit the number of invasive surgical procedures currently practiced in order to improve the quality of human life. The main focus of this kit is biocompatible materials, laparoscopic surgery, laparoscopic devices, engineering team work, and practical applications. Learning Objectives By the end of this lesson, students should be able to Describe biocompatibility and give an example of a biocompatible material. Explain why a particular material was chosen for its application. Explain what laparoscopic surgery is. Explain what a laparoscopic device is. Engineering Connection Engineers must be fully aware of the environment for which they are designing. The overall design of surgical and biomedical instrumentation is focused on the form fitting the function of the device, as well as the appropriate biocompatible materials being chosen for the intended usable environment. New biomedical technologies developed by engineers are changing how modern surgeries are performed and are drastically reducing patient recovery time by limiting the number of invasive procedures required. This advancement in surgical technology through innovative engineering designs is dramatically improving the quality of life for surgical patients. Activity Descriptions A.) Class Discussion and Biomaterials Activity: 15 Minutes This class discussion will focus around numerous concepts that biomedical engineers must take into account when designing instrumentation for surgical and medical applications. The main concepts discussed will focus on biomaterials, biocompatibility, design considerations, and engineering team

TEAK Bioengineering Laparoscopic Lesson Plan Page 7 work. The class discussion will also include how the form of engineering designs must fit their intended application, laparoscopy, and laparoscopic devices. At the conclusion of the class discussion, students will participate in a biomaterials activity were the students must attempt to identify what they believe to be acceptable materials suitable for medical and surgical applications. This activity will be a design activity leading into the surgical activity, were the students must identify and chose the most appropriate biomaterial that is suitable for biomedical and surgical applications. From this preliminary activity, the student will learn how to choose the correct material for the intended design environment and how selecting the appropriate design can optimize its intended function. B.) Laparoscopic Surgery Activity: 35 Minutes This activity allows the students to be laparoscopic surgeons for the day. During this activity students will work together in their groups as surgical teams to maneuver and manipulate items within a shoebox. During this activity, students will assume one of four roles and then rotate to the next role after the completion of the task within the box. Allowing the students to rotate and perform each of the different roles within the team setting will allow them to learn about affective communication skills within a team environment and how to work together effectively as a team. The four roles that the students will assume during this activity are surgeon, webcam operator, timer, and lighting specialist. The students participating in this activity may view this as a challenge between the other groups within the class to see which group can perform the given task the fastest. The focus of this activity is how engineers must design instrumentation based on environmental considerations and how team work is an intricate part of the both the surgical and engineering working environment. C.) Student Engineering Team Roles: Surgeon Performs the given task within the surgical black box. Webcam/Mirror Operator Operates the webcam or mirror throughout the surgery by working with the surgeon to properly position the camera or mirror as directed by the surgeon. Timer Records the amount of time it takes for the surgeon to complete the given task. Lighting Specialist Provides a light source in the black box for the webcam operator to see the materials that the surgeon must manipulate.

TEAK Bioengineering Laparoscopic Lesson Plan Page 8 New York State Learning Standards MST 1 E Engineering Design Discuss how best to test the solution; perform the test under teacher supervision; record and portray results through numerical and graphic means; discuss orally why things worked or did not work; and summarize results in writing, suggesting ways to make the solution better MST 1 E Engineering Design Plan and build, under supervision, a model of the solution using familiar materials, processes, and hand tools New York State Technology Learning Standards a.) Standard 1: Engineering Design 1. Under supervision, manipulate components of a simple, malfunctioning device to improve its performance. b.) Standard 2: Information Systems 2. Use a variety of equipment and software packages to process, display, and communicate information in different forms using text, pictures, and sound. c.) Standard 5: Tools, Resources, and Technological Processes 3. Use a variety of tools and energy sources to construct things. 4. Develop basic skills in the use of hand tools. 5. Understand the importance of safety and ease of use in selecting tools and resources for a specific purpose. d.) Standard 5: Computer Technology 6. Use the computer as a tool.

TEAK Bioengineering Laparoscopic Lesson Plan Page 9 e.) Standard 5: Impact of Technology 7. Demonstrate that certain technologies have safety issues. f.) Standard 5: Management of Technology 8. Work cooperatively with others on a joint task. New York State Science Learning Standards a.) Intermediate Standard 1: Analysis, Inquiry, and Design. 9. T1.1: Identify needs and opportunities for technical solutions to from an investigation of situations of general or social interest. 10. T1.1a: Identify a scientific or human need that is subject to a technological solution which applies scientific principles. 11. T1.3a: Identify alternative solutions base on the constraints of the design. 12. MST1: Students represent, present, and defend their proposed explanations of everyday observations so that they can be understood and assessed by others. b.) Intermediate Standard 6: Interconnectedness 13. 1.2: Describe the differences and similarities between among engineering systems, natural systems, and social systems. 14. 1.4: Describe how the output of one part of a system can become the input to other parts. New York State Math Learning Standards a.) 6 th Grade Standards 15. Students will solve problems that arise in mathematics and in other contexts. 16. Students will apply and adopt a variety of appropriate strategies to solve problems. 17. Students will organize and consolidate their mathematical thinking through communication. 18. Students will collect, organize, display, and analyze data.

TEAK Bioengineering Laparoscopic Lesson Plan Page 10 Resources A.) www.wikipedia.com B.) http://www.laparoscopy.com/ C.) http://www.webmd.com/infertility-and-reproduction/guide/laparoscopic-surgeryfor-endometriosis D.) http://www.mediflex.com/laparoscopic-surgery.asp E.) http://www.stryker.com/enus/products/endoscopy/laparoscopy/laparoscopicinstruments/index.htm F.) http://www.nylearns.org/standards/browsestandards.asp

TEAK Bioengineering Laparoscopic Lesson Plan Page 11 Laparoscopic Surgery DURATION 45-50 Minutes CONCEPTS Bioengineering Circulatory System Blood Flow Characteristics Biomedical Applications

TEAK Bioengineering Laparoscopic Lesson Plan Page 12 Bioengineering Discussion: (2 Minutes) Background Information: Bioengineering is the application of engineering principles to address challenges in the fields of biology and medicine. Bioengineering is the application of the principles of engineering design to the full spectrum of living systems. Group Discussion: Bioengineering Background (Pose the following questions to the group and let the discussion flow naturally try to give positive feedback to each child that contributes to the conversation) What do you think bio (biology) means? The study of life and a branch of the natural sciences that studies living organisms and how they interact with each other and their environment. The study of the environment. The study of living organisms and living systems. What do you think engineering is? What do you think it means to be an engineer? A technical profession that applies skills in: o Math o Science o Technology o Materials o Structures Discuss with the students what bioengineering is and the broad scope of areas that bioengineering includes. For this discussion, provide students with examples of bioengineered products and applications. Bioengineering is the application of engineering principles in the fields of medicine, biology, robotics, and any other living system. Examples of products that have been bioengineered for Laparoscopic Surgery are: o Laparoscopic Tools o Laparoscope

TEAK Bioengineering Laparoscopic Lesson Plan Page 13 Biomaterials and Biocompatibility Discussion: (5 Minutes) Background Information: Biomaterials are any material that may be used within a living system or for a medical device which performs, augments, or takes the place of a natural function. Biomaterials are utilized in such fields as medicine, biology, surgery, and material sciences. The most important property of a biomaterial is that it must be compatible with the human body without causing inflation, infection, or the spread of disease. The focus of biocompatible materials is that these materials will not corrode over time due to an exposure to body fluids. Biomaterials are typically used in such applications as hip replacements, bone plates, artificial ligaments, artificial organs, dental implants, skin repair devices, and contact lenses. Simplified Definitions: A.) Biocompatible Material - Biocompatible Materials are any material that does not cause any adverse or biological reaction. If the Material is not biocompatible, the body will reject them, causing inflammation and infection. B.) Corrosion The breakdown of material properties due to chemical reactions with its surrounding environment. C.) Rust Chemical reaction of iron and oxygen which form iron oxide. Group Discussion: Biomaterials and Biocompatibility (Pose the following questions to the group and let the discussion flow naturally try to give positive feedback to each child that contributes to the conversation) What are some different types of materials? Wood Metal (Steels, Aluminum, etc.) Ceramics Plastics Composites How do materials rust or corrode? They are exposed to moisture for long periods of time They are exposed to salt mixtures (Salt trucks during winter time, etc.) Rust is the chemical reaction of iron and oxygen

TEAK Bioengineering Laparoscopic Lesson Plan Page 14 Explain to the students the concept of biocompatibility and what makes a material biocompatible with a living system. Give examples during this part of the discussion of biomaterial applications. A biocompatible material and typical examples are: Biocompatible Material - Biocompatible Materials are any material that does not cause any adverse or biological reaction. If the Material is not biocompatible, the body will reject them, causing inflammation and infection. Metals such as stainless steel, titanium, and gold. Plastics Ceramics What do you think are some biomaterials that you see or use everyday? Plastics Ceramics Stainless Steels - There are numerous examples of these materials used in everyday life that may also be biocompatible materials. Why do you think it is important to use a biomaterial for medical applications or instruments? To prevent infection, inflammation, and the rejection by the body of the material.

TEAK Bioengineering Laparoscopic Lesson Plan Page 15 Learning Objectives Biomaterials Brainstorming Activity 8 Minutes By the end of this exercise, students should be able to 1. Describe biocompatibility and give an example of a biocompatible material. 2. Explain why a particular material was chosen for its intended application. 3. Explain simple material properties that must be considered when designing instruments for the human body. Materials 1. 1 Biomaterials Brainstorming Worksheet per student. Procedure 1. Get the students into 5 groups. 2. Have the students read the list of biomaterials. 3. The students should then mark the materials that are biocompatible and not biocompatible and explain why. 4. Review the results with the class and discuss. Expected Results 1. See Brainstorming Answer Guide. End Biomaterials Brainstorming Activity

TEAK Bioengineering Laparoscopic Lesson Plan Page 16 Biomaterials Brainstorming Activity Handout Name Material Biomaterial Not a Biomaterial Wood Titanium Stainless Steel Iron Bronze Nickel Aluminum Composites Glass Ceramics Gold Plastics

TEAK Bioengineering Laparoscopic Lesson Plan Page 17 Biomaterials Brainstorming Activity Answer Key Material Biomaterial Not a Biomaterial Wood Titanium Stainless Steel Iron Bronze Nickel Aluminum Composites Glass Ceramics Gold Plastics

TEAK Bioengineering Laparoscopic Lesson Plan Page 18 Laparoscopic Surgery Discussion: (5 Minutes) Background Information: Laparoscopic surgery is a minimally invasive surgery that is performed through small incisions rather than large incisions as needed in traditional surgeries. Laparoscopic surgery belongs to the larger field of endoscopy. They key element in laparoscopic surgery is the use of a laparoscope. Simplified Definitions: A.) Laparoscopic Surgery A minimally invasive surgery that is performed by utilizing small incisions. B.) Laparoscope An instrument through which structures within the abdomen and pelvis can be seen. Group Discussion: Laparoscopic Surgery (Pose the following questions to the group and let the discussion flow naturally try to give positive feedback to each child that contributes to the conversation) For this section of the discussion, present to the students the topic of Laparoscopic Surgery. During the discussion, describe to the students the advantages and disadvantages of this form of minimally invasive surgery. Also, be sure to tie in the topic of biocompatible materials when using surgical equipment. Laparoscopic Surgery - A minimally invasive surgery that is performed by utilizing small incisions. Laparoscope An instrument through which structures within the abdomen and pelvis can be seen. o The first type of laparoscope includes a telescopic rod lens systems that is connected to a video camera. o The second type is a digital laparoscope where a charge-coupled device is placed at the end of the scope eliminating the need for the rod lens system Advantages of Laparoscopic Surgery: o Reduced blood loss o Smaller incisions o Shorter recovery time o Shortened hospital stay

TEAK Bioengineering Laparoscopic Lesson Plan Page 19 Disadvantages of Laparoscopic Surgery: o Injury to blood vessels or the large bowel o Surgical burns o Excess CO2 gas in the abdomen o Longer surgeries Why do you think it is important for engineers to use biomaterials when designing laparoscopic tools for surgeries? To prevent infections To prevent inflammation To prevent corrosion

TEAK Bioengineering Laparoscopic Lesson Plan Page 20 Learning Objectives Laparoscopic Surgery Activity 30 Minutes By the end of this exercise, students should be able to Materials 1. Explain what a laparoscopic device is. 2. Explain what laparoscopic surgery is. 1. 1 Surgical Box with Lid. 2. 1 Laparoscopic Device. 3. 1 Stopwatch. 4. 1 Webcam. 5. 1 Mirror. 6. 1 Activity worksheet per engineering team. 7. 1 Surgical Activity Package. Procedure 1. Have the students get into 5 groups and assume one of the engineering team roles. 2. Set up the surgical activity package within the surgical box. 3. Once the surgical activity has been set up within the surgical box, place the lid back over the surgical box and press fit. (If computers are available, one of the TEAK instructors should set up the webcams during the biomaterials activity to save set up time.) 4. Once all of the webcams are set up and the team roles have been determined, the students may begin the activity. The goal of each surgical activity within the surgical box is to perform the given task, through group communication, in under or around two minutes. 5. After the team has finished the activity within the surgical box, the time keeper should record the time on the activity worksheet. The students may now rotate roles, giving their previous role to the student on their right hand side.

TEAK Bioengineering Laparoscopic Lesson Plan Page 21 6. Steps 3 5 should be repeated until all of the students have had the opportunity to participate in the activity as each of the different team roles. Expected Results 1. The goal of each activity is to complete the task in less than two minutes. For an adult, it takes approximately 1 min 45 sec to 2 minutes to complete the task. 2. At the completion of the activity, students within their engineering teams should decide which arrangement of roles allowed them to complete the activity in the least amount of time. This will be their optimal team. End Laparoscopic Surger Activity

TEAK Bioengineering Laparoscopic Lesson Plan Page 22 Laparoscopic Surgery Activity Worksheet Team Name Team Member Roles Trial A Trial B Team Member Role Team Member Team Member Surgeon Time Keeper Lighting Specialist Camera Operator Trial C Trial D Team Member Role Team Member Team Member Surgeon Time Keeper Lighting Specialist Camera Operator Trial Times Time (s) Trial A Trial B Trial C Trial D

TEAK Bioengineering Laparoscopic Lesson Plan Page 23 Concluding Discussion (Pick and choose depending on student questions/responses to the activity worksheets) What are some biomaterials that would be good to use when designing medical tools? Titanium. Stainless Steel. Aluminum. Plastics. Why are biocompatible materials a must to use when designing medical tools? They don t have adverse reactions with the body. Do not cause infections within the body. They do not rust or corrode. What was hard about performing the laparoscopic surgery? Working with a multi-member team. Manipulating the objects. (This is a very open ended answer. What ever they found to be difficult will be correct.) Based on the surgery you performed, do you think engineers and surgeons must train a lot at performing such a surgery and designing such laparoscopic instruments? Yes, lots of practice and lots evaluations and assessments of functional form fitting instruments by engineers.