972 research outputs found
Snake-Like Robots for Minimally Invasive, Single Port, and Intraluminal Surgeries
The surgical paradigm of Minimally Invasive Surgery (MIS) has been a key
driver to the adoption of robotic surgical assistance. Progress in the last
three decades has led to a gradual transition from manual laparoscopic surgery
with rigid instruments to robot-assisted surgery. In the last decade, the
increasing demand for new surgical paradigms to enable access into the anatomy
without skin incision (intraluminal surgery) or with a single skin incision
(Single Port Access surgery - SPA) has led researchers to investigate
snake-like flexible surgical devices. In this chapter, we first present an
overview of the background, motivation, and taxonomy of MIS and its newer
derivatives. Challenges of MIS and its newer derivatives (SPA and intraluminal
surgery) are outlined along with the architectures of new snake-like robots
meeting these challenges. We also examine the commercial and research surgical
platforms developed over the years, to address the specific functional
requirements and constraints imposed by operations in confined spaces. The
chapter concludes with an evaluation of open problems in surgical robotics for
intraluminal and SPA, and a look at future trends in surgical robot design that
could potentially address these unmet needs.Comment: 41 pages, 18 figures. Preprint of article published in the
Encyclopedia of Medical Robotics 2018, World Scientific Publishing Company
www.worldscientific.com/doi/abs/10.1142/9789813232266_000
Multi-View Vision System for Laparoscopy Surgery.
International audienceThis paper deals with the development of a new generation of augmented laparoscopy system. We propose to equip a traditional endoscope, or a robotic endoscope holder, with a miniature stereovision device. The system includes two miniature high resolution CMOS cameras mounted around the endoscope as a pair of glasses that provides a global view of the abdominal cavity completing the traditional view. Each camera can reach a frame rate of 30 images/second with a resolution of 1600 _ 1200 pixels. A deployment, fixation and rapid extraction system of the proposed device through the trocar was designed and validated through preclinical experiments (testbench and human cadaver). The main benefit of the proposed system in the minimally invasive surgery domain is to provide simultaneously local/global views, and with perspectives in 3D reconstruction of the organ being treated
Intelligent Information-Guided Robotic Surgery
Laparoscopic surgery is minimally invasive, providing various benefits for patients. On the other hand, it is technically demanding for physicians due to limited dexterity of tools, limited vision. In order to cope with those limitations, recent various engineering technologies are trying to help surgeon. Robotics is one of the major technologies in this field. Until today, da Vinci has been only one such robot. But recently, many other robotic systems are under development. Those new robots are introduced in this chapter first. Other than robotics, or in conjunction with robotics, navigation technologies are getting popularity in clinical use. Navigation is a technology that provides useful information such as preoperative images or distance between tool and lesion, etc. to surgeon. Our experience in clinical use of navigation system in robotic surgery is introduced. Finally, technologies applied for the training of surgeon are introduced and described
Development of An In Vivo Robotic Camera for Dexterous Manipulation and Clear Imaging
Minimally invasive surgeriy (MIS) techniques are becoming more popular as replacements for traditional open surgeries. These methods benefit patients with lowering blood loss and post-operative pain, reducing recovery period and hospital stay time, decreasing surgical area scarring and cosmetic issues, and lessening the treatment costs, hence greater patient satisfaction would be earned. Manipulating surgical instruments from outside of abdomen and performing surgery needs precise hand-eye coordination which is provided by insertable cameras. The traditional MIS insertable cameras suffer from port complexity and reduced manipulation dexterity, which leads to defection in Hand-eye coordination and surgical flow. Fully insertable robotic camera systems emerged as a promising solution in MIS. Implementing robotic camera systems faces multiple challenges in fixation, manipulation, orientation control, tool-tissue interaction, in vivo illumination and clear imaging.In this dissertation a novel actuation and control mechanism is developed and validated for an insertable laparoscopic camera. This design uses permanent magnets and coils as force/torque generators in an external control unit to manipulate an in vivo camera capsule. The motorless design of this capsule reduces the, wight, size and power consumption of the driven unit. In order to guarantee the smooth motion of the camera inside the abdominal cavity, an interaction force control method was proposed and validated.Optimizing the system\u27s design, through minimizing the control unit size and power consumption and extending maneuverability of insertable camera, was achieved by a novel transformable design, which uses a single permanent magnet in the control unit. The camera robot uses a permanent magnet as fixation and translation unit, and two embedded motor for tilt motion actuation, as well as illumination actuation. Transformable design provides superior imaging quality through an optimized illumination unit and a cleaning module. The illumination module uses freeform optical lenses to control light beams from the LEDs to achieve optimized illumination over surgical zone. The cleaning module prevents lens contamination through a pump actuated debris prevention system, while mechanically wipes the lens in case of contamination. The performance of transformable design and its modules have been assessed experimentally
Optical techniques for 3D surface reconstruction in computer-assisted laparoscopic surgery
One of the main challenges for computer-assisted surgery (CAS) is to determine the intra-opera- tive morphology and motion of soft-tissues. This information is prerequisite to the registration of multi-modal patient-specific data for enhancing the surgeon’s navigation capabilites by observ- ing beyond exposed tissue surfaces and for providing intelligent control of robotic-assisted in- struments. In minimally invasive surgery (MIS), optical techniques are an increasingly attractive approach for in vivo 3D reconstruction of the soft-tissue surface geometry. This paper reviews the state-of-the-art methods for optical intra-operative 3D reconstruction in laparoscopic surgery and discusses the technical challenges and future perspectives towards clinical translation. With the recent paradigm shift of surgical practice towards MIS and new developments in 3D opti- cal imaging, this is a timely discussion about technologies that could facilitate complex CAS procedures in dynamic and deformable anatomical regions
Cable-driven parallel robot for transoral laser phonosurgery
Transoral laser phonosurgery (TLP) is a common surgical procedure in otolaryngology.
Currently, two techniques are commonly used: free beam and fibre delivery. For free beam
delivery, in combination with laser scanning techniques, accurate laser pattern scanning can
be achieved. However, a line-of-sight to the target is required. A suspension laryngoscope is
adopted to create a straight working channel for the scanning laser beam, which could
introduce lesions to the patient, and the manipulability and ergonomics are poor. For the fibre
delivery approach, a flexible fibre is used to transmit the laser beam, and the distal tip of the
laser fibre can be manipulated by a flexible robotic tool. The issues related to the limitation
of the line-of-sight can be avoided. However, the laser scanning function is currently lost in
this approach, and the performance is inferior to that of the laser scanning technique in the
free beam approach.
A novel cable-driven parallel robot (CDPR), LaryngoTORS, has been developed for TLP.
By using a curved laryngeal blade, a straight suspension laryngoscope will not be necessary
to use, which is expected to be less traumatic to the patient. Semi-autonomous free path
scanning can be executed, and high precision and high repeatability of the free path can be
achieved. The performance has been verified in various bench and ex vivo tests. The technical
feasibility of the LaryngoTORS robot for TLP was considered and evaluated in this thesis.
The LaryngoTORS robot has demonstrated the potential to offer an acceptable and feasible
solution to be used in real-world clinical applications of TLP.
Furthermore, the LaryngoTORS robot can combine with fibre-based optical biopsy
techniques. Experiments of probe-based confocal laser endomicroscopy (pCLE) and
hyperspectral fibre-optic sensing were performed. The LaryngoTORS robot demonstrates the
potential to be utilised to apply the fibre-based optical biopsy of the larynx.Open Acces
Autofluorescence lifetime augmented reality as a means for real-time robotic surgery guidance in human patients.
Due to loss of tactile feedback the assessment of tumor margins during robotic surgery is based only on visual inspection, which is neither significantly sensitive nor specific. Here we demonstrate time-resolved fluorescence spectroscopy (TRFS) as a novel technique to complement the visual inspection of oral cancers during transoral robotic surgery (TORS) in real-time and without the need for exogenous contrast agents. TRFS enables identification of cancerous tissue by its distinct autofluorescence signature that is associated with the alteration of tissue structure and biochemical profile. A prototype TRFS instrument was integrated synergistically with the da Vinci Surgical robot and the combined system was validated in swine and human patients. Label-free and real-time assessment and visualization of tissue biochemical features during robotic surgery procedure, as demonstrated here, not only has the potential to improve the intraoperative decision making during TORS but also other robotic procedures without modification of conventional clinical protocols
Magnetic Surgical Instruments for Robotic Abdominal Surgery.
This review looks at the implementation of magnetic-based approaches in surgical instruments for abdominal surgeries. As abdominal surgical techniques advance toward minimizing surgical trauma, surgical instruments are enhanced to support such an objective through the exploration of magnetic-based systems. With this design approach, surgical devices are given the capabilities to be fully inserted intraabdominally to achieve access to all abdominal quadrants, without the conventional rigid link connection with the external unit. The variety of intraabdominal surgical devices are anchored, guided, and actuated by external units, with power and torque transmitted across the abdominal wall through magnetic linkage. This addresses many constraints encountered by conventional laparoscopic tools, such as loss of triangulation, fulcrum effect, and loss/lack of dexterity for surgical tasks. Design requirements of clinical considerations to aid the successful development of magnetic surgical instruments, are also discussed
Automated pick-up of suturing needles for robotic surgical assistance
Robot-assisted laparoscopic prostatectomy (RALP) is a treatment for prostate
cancer that involves complete or nerve sparing removal prostate tissue that
contains cancer. After removal the bladder neck is successively sutured
directly with the urethra. The procedure is called urethrovesical anastomosis
and is one of the most dexterity demanding tasks during RALP. Two suturing
instruments and a pair of needles are used in combination to perform a running
stitch during urethrovesical anastomosis. While robotic instruments provide
enhanced dexterity to perform the anastomosis, it is still highly challenging
and difficult to learn. In this paper, we presents a vision-guided needle
grasping method for automatically grasping the needle that has been inserted
into the patient prior to anastomosis. We aim to automatically grasp the
suturing needle in a position that avoids hand-offs and immediately enables the
start of suturing. The full grasping process can be broken down into: a needle
detection algorithm; an approach phase where the surgical tool moves closer to
the needle based on visual feedback; and a grasping phase through path planning
based on observed surgical practice. Our experimental results show examples of
successful autonomous grasping that has the potential to simplify and decrease
the operational time in RALP by assisting a small component of urethrovesical
anastomosis
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