Surgical Applications of Compliant Mechanisms:A Review

Current surgical devices are mostly rigid and are made of stiff materials, even though their predominant use is on soft and wet tissues. With the emergence of compliant mechanisms (CMs), surgical tools can be designed to be flexible and made using soft materials. CMs offer many advantages such as monolithic fabrication, high precision, no wear, no friction, and no need for lubrication. It is therefore beneficial to consolidate the developments in this field and point to challenges ahead. With this objective, in this article, we review the application of CMs to surgical interventions. The scope of the review covers five aspects that are important in the development of surgical devices: (i) conceptual design and synthesis, (ii) analysis, (iii) materials, (iv) maim facturing, and (v) actuation. Furthermore, the surgical applications of CMs are assessed by classification into five major groups, namely, (i) grasping and cutting, (ii) reachability and steerability, (iii) transmission, (iv) sensing, and (v) implants and deployable devices. The scope and prospects of surgical devices using CMs are also discussed

Dual-Continuum Design Approach for Intuitive and Low-Cost Upper Gastrointestinal Endoscopy

Objective: This paper introduces a methodology to design intuitive, low-cost, and portable devices for visual inspection of the upper gastrointestinal tract. Methods: The proposed approach mechanically couples a multi-backbone continuum structure, as the user interface, and a parallel bellows actuator, as the endoscopic tip. Analytical modeling techniques derived from continuum robotics were adopted to describe the endoscopic tip motion from user input, accounting for variations in component size and pneumatic compressibility. The modeling framework was used to improve intuitiveness of user-to-task mapping. This was assessed against a 1:1 target, while ease-of-use was validated using landmark identification tasks performed in a stomach simulator by one expert and ten non-expert users; benchmarked against conventional flexible endoscopy. Pre-clinical validation consisted of comparative trials in in-vivo porcine and human cadaver models. Results: Target mapping was achieved with an average error of $5^\circ$ in bending angle. Simulated endoscopies were performed by an expert user successfully, within a time comparable to conventional endoscopy ( $<$ 1 min difference). Non-experts using the proposed device achieved visualization of the stomach in a shorter time (9 s faster on average) than with a conventional endoscope. The estimated cost is $<$ 10 USD and $<$ 30 USD for disposable and reusable parts, respectively. Significance and Conclusions: Flexible endoscopes are complex and expensive devices, actuated via non-intuitive cable-driven mechanisms. They frequently break, requiring costly repair, and necessitate a dedicated reprocessing facility to prevent cross contamination. The proposed solution is portable, inexpensive, and easy to use, thus lending itself to disposable use by personnel without formal training in flexible endoscopy

Design of Novel Sensors and Instruments for Minimally Invasive Lung Tumour Localization via Palpation

Minimally Invasive Thoracoscopic Surgery (MITS) has become the treatment of choice for lung cancer. However, MITS prevents the surgeons from using manual palpation, thereby often making it challenging to reliably locate the tumours for resection. This thesis presents the design, analysis and validation of novel tactile sensors, a novel miniature force sensor, a robotic instrument, and a wireless hand-held instrument to address this limitation. The low-cost, disposable tactile sensors have been shown to easily detect a 5 mm tumour located 10 mm deep in soft tissue. The force sensor can measure six degrees of freedom forces and torques with temperature compensation using a single optical fiber. The robotic instrument is compatible with the da Vinci surgical robot and allows the use of tactile sensing, force sensing and ultrasound to localize the tumours. The wireless hand-held instrument allows the use of tactile sensing in procedures where a robot is not available

Smart actuation and sensing for meso-scale surgical robotic systems

This dissertation presents the development of meso-scale surgical robotics based on smart actuation and sensing for minimally invasive surgery (MIS). By replacing conventional straight tools by steerable surgical robots, surgical outcomes can potentially be improved due to more precise, stable, and flexible manipulation. Since bending and torsion are the two fundamental motion forms required by surgical tools to complete general surgical procedures, compact torsion and bending modules, both integrated with intrinsic sensors for motion feedback, have been developed based on shape memory alloy (SMA). The developed actuation and sensing techniques have been applied on a robot for neurosurgical intracerebral hemorrhage evacuation (NICHE) and a steerable catheter for atrial fibrillation (AFib) treatment. The NICHE robot consists of a straight stem, an SMA torsion module, and an SMA bending module as a distal bending tip. By synchronizing the motion of the stem, the bending module, and the torsion module, the robot is capable of tip articulation within the brain to remove hemorrhage effectively through suction and electrocauterization. In addition, a skull-mounted robotic headframe has been developed based on a Stewart platform to manipulate the NICHE robot. The robotic catheter is developed by integrating multiple SMA bending modules with flexible braid reinforced tubing. Polymer 3D-printing is used to fabricate all the structural components due to its relatively low cost, short fabrication period, and capability of fabricating complicated structures with high accuracy. The developed surgical robotic systems have been thoroughly evaluated using phantom or cadaver models under computed tomography (CT) and/or magnetic resonance imaging (MRI) guidance. The imaging-guided experimental studies showed that the developed robotic systems consisting of smart actuation and sensing were compatible with CT and MR imaging.Ph.D