Health Care Engineering
For Every Body
The Jump ARCHES center received a $50 million boost in 2019 and is now backed by a total of $112.5 million in endowment support. Research by the collaboration will have impact throughout the body and the hospital for decades to come.
The Jump Applied Research for Community Health through Engineering and Simulation Center launched in 2013 thanks to gifts from OSF HealthCare Foundation and the DiSomma Family Foundation. The partnership between The Grainger College of Engineering and OSF HealthCare supports joint research in clinical simulation, health care systems, and the social and behavioral determinants of health.
“The Jump ARCHES partnership is already unique because of its size and impact. We believe this endowment is the largest in the world dedicated to health care engineering,” said Kesh Kesavadas, director of The Grainger College of Engineering’s Health Care Engineering Systems Center and the Engineer-in-Chief of Jump ARCHES. “With this expansion of the endowment, we are now able to combine the strengths of Grainger Engineering with the University of Illinois’ Center for Social and Behavioral Sciences and Illinois Innovation Network to engineer the next generation of solutions to improve health care.”
have been funded in recent years by Jump ARCHES and earned millions of dollars in support from external funding agencies and foundations.
These 5 examples cover the entire human body:
Liz Hsiao-Wecksler of Grainger Engineering’s Department of Mechanical Science and Engineering leads a team that includes the University of Illinois’ College of Medicine in Peoria, OSF HealthCare, the Illinois Neurological Institute, and Bradley University. The team is building a simulator that mimics the spasticity and rigidity in upper arm muscles that will help doctors diagnose the brain lesions that can cause these conditions.
Manuel Hernandez from the University of Illinois’ Department of Kinesiology and Community Health is developing virtual reality simulations of posture problems in people with Parkinson’s disease. He works with researchers at OSF HealthCare and Grainger Engineering’s Department of Industrial and Enterprise Systems Engineering.
A team led by OSF HealthCare’s Vahid Tohidi is creating an educational platform that mixes visualization and simulation to teach health care providers how to perform nerve conduction studies and electromyography studies. These tests are crucial to diagnosing and managing disorders of the peripheral nervous system.
Heart-patch surgeries require doctors to fix a 3D problem with the heart by cutting, shaping, and placing a 2D sheet of material. Visualizing how the complex 3D structure is built from that oddly shaped 2D piece of material is challenging—meaning that the surgeon often has to modify the patch on the fly during surgery. Arif Masud of Grainger Engineering’s Department of Civil and Environmental Engineering and Matthew Bramlet of OSF HealthCare are developing a virtual reality heart patching simulator to help doctors get it right the first time.
Twenty years ago, heart and vascular surgeons probably wouldn’t have been very interested in collaborating with Hyunjoon Kong. He was a graduate student at the University of Michigan researching concrete, how to tweak its chemistry to make it easier to pour, and how it fractures under stress.
But post-docs at Michigan and Harvard took Kong’s work in a different direction. Now the Robert W. Schaefer Professor in the University of Illinois at Urbana-Champaign’s Department of Chemical and Biomolecular Engineering, Kong and his team study hydrogels. These polymers are frequently used in tissue engineering, drug-delivery systems, bio-bots, and biosensors. Kong’s team explores all of these applications, as well as new applications for training surgeons in microvascular surgery.
Kong knows that’s quite a jump. Ask him about how he got from the construction site to the operating room, and he tells the whole story with a laugh and a smile. But that jump—and the willingness to take it—means bigger impact on the world. “We find areas that are not as well trodden, things that are more interesting to customers and collaborators than what everyone else is doing.”
That interest in always branching out onto a fresh path led Kong’s team to a pair of new collaborations in 2019, developing models of the human heart and blood vessels. Both require finely tuned hydrogels, and both represent the future of medical training and surgical planning.
‘A Revelation’
Doctors and medical students visit Dr. Heidi Phillips’ Microsurgery Research and Training Laboratory at the University of Illinois for a five-day course in which students learn to use a microscope to perform surgical procedures involving blood vessels two millimeters in diameter and smaller. These procedures are crucial in human ear, nose, and throat operations, organ transplants, reproductive surgery, hand surgery, and reconstructive surgery. They are also used more and more frequently in small animal veterinary surgery and may someday allow veterinarians to perform trauma and cancer surgery for conditions that are currently considered terminal for household pets.
Fewer than 10 institutions in the world offer these formal training laboratories, according to Phillips, a professor in Illinois’ College of Veterinary Medicine. In her laboratory, students practice working in a very confined space under the light of an operating microscope—first by using a needle to scratch letters off a magazine’s page to develop fine hand skills, then moving on to stitching an “incision” in a rubber glove. From there, they work on a simulated blood vessel made of latex, and, after a day and a half, they begin to perform microsurgeries on the blood vessels in the legs of anesthetized rats.
“There’s growing concern globally about the use of animals in training surgeons,” Phillips said. “If we can mimic the blood vessel accurately, we may not be able to completely eliminate the use of animals in training and education. But we could require use of fewer animals to accomplish the same level of training.”
The latex models that are currently used to model microvascular surgery are very rudimentary. “Real vessels are covered in a gossamer web of connective tissue termed adventitia. If you handle a blood vessel roughly, you cause a clot and destroy the vessel.” Using the web of adventitia as a grasp allows gentle handling of blood vessels during surgical manipulation. Current models in no way model connective tissue adventitia, and, generally, don’t much feel like a real vessel.
“Ultimately, doctors need a hydrogel that is easy to print, doesn’t fracture when punctured, is very life-like, and keeps its pliancy under non-lab conditions.”
Phillips is working with the Kong team on a simulated blood vessel that better replicates the experience of microsurgery. She’d been looking for a partner on this work for some time and said, “we always ran into roadblocks. But this team is super-excited to solve our real-world problem. Working with Dr. Kong was a revelation.”
The team presented an initial hydrogel-based vessel model at an international conference in May 2019. It was one millimeter in diameter and had an authentic outer texture to simulate the crucial connective tissue. It accurately holds a suture when stitched. Phillips plans to continue the work, improve the model vessel with the Kong team, and validate it with expert surgeons and novices.
“Dr. Phillips is really focused on authenticity,” said Will Ballance, a PhD student in Kong’s lab. “She even says ‘Make it red,’ when we show her simulated blood.”
Visual fidelity means more skill and a higher rate of success, Phillips said. When surgeons start working on patients, “we want them to see something they’ve seen before. If they are seeing something new in surgery, it increases the learning curve and increases stress.”
‘Bad Training Means Bad Habits’
As part of the Jump ARCHES health care engineering collaboration with Peoria’s OSF HealthCare, Kong’s team along with Dean Rashid Bashir and Professor Brad Sutton, is developing new hydrogels that can be used as models of human heart muscle.
They aren’t the only team working on these materials. Many of them—a team at Tel Aviv University and one at MIT and Harvard, for example—work on materials that might be used to patch or repair the heart. The team from The Grainger College of Engineering also researches those applications, especially those needed for vascular surgery. Their work with OSF HealthCare, however, focuses on materials that will be vital to the future of surgical planning and medical training.
“Heart models for surgical planning that are based on MRI or CT imaging have been around for 30 years, and there have been gradual improvements,” Dr. John Vozenilek explained. Vozenilek has been an emergency room physician for more than 20 years and has been part of the Jump ARCHES collaboration from its very beginning.
“But those models have been mostly proof-of-concept. They aren’t realistic. They are very stiff. They crack and fracture when you puncture them with a suture, which, unsurprisingly, isn’t how heart muscle typically responds.”
Silicon-based products currently on the market for training surgeons are much stiffer than real heart tissue, Kong said. The more closely those products mimic heart tissue, the better the training experience for doctors.
“A bad training experience means bad habits in the operating room,” according to Vozenilek.
There are more authentic models today, but they often require a multistep 3D printing process that takes a long time and involves curing the model in a liquid bath. “They’re beautiful, but they’re art,” Kong said.
“When surgeons start working on patients, we want them to see something they’ve seen before. If they are seeing something new in surgery, it increases the learning curve and increases stress.”
The team from Grainger Engineering and OSF HealthCare want that beauty—they want the material to be authentic and respond like real heart tissue—but they also want something that can be printed and used quickly.
Speed is absolutely crucial for surgical planning. If someone requires immediate treatment, doctors in the future will need to be able to image the patient’s heart, create a replica of the heart on-site, study the individual features and problems of that heart, and then get to work. A hydrogel that requires a complicated, slow printing process is a non-starter in such a situation.
Ultimately, doctors need a hydrogel that is easy to print, doesn’t fracture when punctured, is very life-like, and keeps its pliancy under non-lab conditions. It’s a tall order, but Will Ballance, the PhD student in Kong’s lab, is making further improvements to the team’s hydrogel. He says the team’s formulation allows for large-scale 3D printing, which is “necessary for getting it into the emergency room.” But it still tends to dry out, so Ballance is exploring ways to allow the hydrogel to absorb humidity in the air and keep medical simulations built with hydrogels viable longer.
And that goal isn’t so far from where Kong started. “Concrete and hydrogels are pretty similar. They’re both complex structures, and you want to control their characteristics” by adjusting their chemistry and microstructure, Kong said. “We change materials. We try to use them in different ways.”
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