Each year, MIT’s Lemelson program awards an outstanding student inventor for his or her contribution to innovative technology. This year, Nikolai Begg was awarded the $30,000 prize for his portfolio of cutting-edge medical devices. The main inspiration behind his work was a quest to create less invasive surgical tools, and by all means, he is succeeding.

Begg’s philosophy towards engineering medical devices is refreshing and poignant. Like many passionate engineers, he is fearlessly imaginative and committed to the inventive process. What makes his approach notable, and in this case highly effective, is his compassion and dedication towards solving a problem.

A Portfolio of Innovative Devices

There is a persistent challenge in the medical industry for making more non-invasive surgical devices. This is a particular challenge for such procedures as laparoscopies, epidurals, and bone marrow biopsies, which are all characterized as puncture-access procedures—that is, they all require an initial puncture step in what is considered to a be minimally-invasive procedure. However, what makes these initial punctures troublesome is that they continue to tear forward upon breaking the necessary tissue. The surgeon must respond by knowing when to retract force, while risking a potential danger to the patient’s underlying organs. This was one of the many issues Begg set out to combat. As a result, he has invented a puncturing device that retracts its blade at the exact moment necessary. The highly sensitive tip is said to be capable of withdrawing within 1/100 of a second.
The major innovation Begg has made with this particular device is the flexural linkage, which reduces a 12-part hinged linkage to one part with flexural elements. The linkage amplifies and converts the axial force into a radial friction-locking force, which holds the tip in an extended position until the tissue is punctured.
Another surgical device in Begg’s award winning portfolio is a tissue retractor that holds organs away during laparoscopic surgery, without the traditional requirement of a dedicated incision. Its flexibility configures to an expanded position once it is inside the abdomen, where it fixes itself onto the abdomen wall in order to be accurately positioned throughout the procedure. Rather than clamping or piercing the organ, it holds an organ out of the area through its tensioned, retraction mechanism.
Plenty of other innovations reside in Nikolai Begg’s bag of tricks, including a device he developed with a team of colleagues that cleans fog or debris from the lens of a laparoscopic camera during surgical procedures. The device efficiently restores the surgeon’s view, without having to remove the camera from the body. What makes the device so novel is the fact that it isolates the lens from debris using a continuous barrier that is replaced and recirculated when needed, unlike standard devices, which need to be removed and cleaned.

Begg’s Design Process

The key behind Begg’s approach to an engineering challenge is the extent to which he immerses himself in a particular problem. He works closely with surgeons and other medical professionals in their environment, so that he is able to witness how a device is used. “Firsthand experience is key at this step – you want to live the problem to best understand it. Hold it in your hands and try to take it apart. Speak to people affected by the problem face to face, and then watch them at work. Work with them, if you can,” says Begg. He continues this relationship throughout the design process and development stages to ensure the highest level of success.
Begg’s proactive approach is evident in the entire engineering process, from conception to completion. After preliminary studies and ideating, the prototyping and construction phases are just as involved. “Throughout the process, I stay as hands-on as possible, and build something whenever I have the chance. The value of proof-of-concept prototypes and bench-level experiments cannot be underestimated.”

Practice Makes Perfect

Through Begg’s initial testing, it was important to demonstrate the basic functionality behind his concept. The demonstration showed that a biased linkage is capable of amplifying the force applied to the device tip and creates enough of a frictional lock to oppose a retraction spring until the tip force is released.
The next step was to conduct analysis of the mechanism and create a set of theoretical models to facilitate design. The models were then used to design an alpha prototype that demonstrated the mechanism for use in a laparoscopic trocar.
The alpha prototype was designed with CAD software and constructed using manual machining techniques, as well as SLA rapid prototyping for the outer casing, which featured complex curvature.  Once constructed, the prototype was tested for functionality on tissue simulators. Issues were identified and incorporated into a second iteration, which was again designed and fabricated with the same methods.
“When examining the motion of the mechanism, I realized that the pinned joints in the linkage rotated through an extremely small angle, therefore a flexural linkage would easily offer the same functionality at a highly reduced part count,” says Begg. This meant that a flexure could then be incorporated directly into the alpha prototype. The flexure itself was designed and fabricated using a new kind of micro-abrasive water-jetting technology. The flexure’s theoretical behavior was then analyzed using computation software.
At that point, several new prototypes were designed with a focus on flexure design and iteration. Those prototypes featured a layered, modular construction of acrylic using a laser-cutter, which allowed for rapid part switching. Through that method Begg was able to produce and demonstrate multiple flexure designs. This concept of checks and balances in the initial stages was very important to Begg’s approach, as it allowed him to work out any possible kinks in advance. “My favorite part of the engineering design process is going from the initial problem to a robust and well-designed prototype that demonstrates a solution to that problem,” he says.

Words of Wisdom

When asked to summarize his design and engineering philosophy, Begg offers three bits of wisdom: practice, “live” the problem, and stay fascinated. His engineering success is an example of the importance of being truly invested in an engineering issue. In most cases, it is not possible to arrive at a successful device solution if one does not become involved in the ultimate application of the end product.

“Nothing compares to standing in the operating room and feeling the tension as a surgeon curses at an instrument while performing a life-saving procedure, or navigating the awkward silence as you watch the patient you are interviewing struggle to take a blood-glucose measurement with his one functioning hand,” he says. By really getting to know the challenge, including the environment and its users, he is able to succeed with better results. Apart from Begg’s work with MIT, he is also an avid teacher, mentor, and ambassador for engineering. Begg's award winning portfolio and promising talent make him a true inspiration to the industry.