97 research outputs found

    Medical Robotics

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    The first generation of surgical robots are already being installed in a number of operating rooms around the world. Robotics is being introduced to medicine because it allows for unprecedented control and precision of surgical instruments in minimally invasive procedures. So far, robots have been used to position an endoscope, perform gallbladder surgery and correct gastroesophogeal reflux and heartburn. The ultimate goal of the robotic surgery field is to design a robot that can be used to perform closed-chest, beating-heart surgery. The use of robotics in surgery will expand over the next decades without any doubt. Minimally Invasive Surgery (MIS) is a revolutionary approach in surgery. In MIS, the operation is performed with instruments and viewing equipment inserted into the body through small incisions created by the surgeon, in contrast to open surgery with large incisions. This minimizes surgical trauma and damage to healthy tissue, resulting in shorter patient recovery time. The aim of this book is to provide an overview of the state-of-art, to present new ideas, original results and practical experiences in this expanding area. Nevertheless, many chapters in the book concern advanced research on this growing area. The book provides critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies. This book is certainly a small sample of the research activity on Medical Robotics going on around the globe as you read it, but it surely covers a good deal of what has been done in the field recently, and as such it works as a valuable source for researchers interested in the involved subjects, whether they are currently โ€œmedical roboticistsโ€ or not

    Surgical Applications of Compliant Mechanisms:A Review

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    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

    Design, Modelling and Fabrication of a Robotic Retractor for Colorectal Surgery

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    PhDThis research presents the design, fabrication and controller development of a robotic retractor which driven by a robotic manipulator for laparoscopic colorectal surgery. The system consists of a dual-head fan retractor and a manipulator. The dual-head fan retractor comprises two fan devices, retractor wrist, tubular element and handle. The fan device is facilitated with a fan end-effector, an expansion mechanism and a clutchspring mechanism. Two fan devices have been used in the system to provide an anthropoid hand-holding shape which is specifically advanced for surgical purpose because intestine tends to slip when subject to disturbance and the anthropoid handholding shape can effectively halt that. One of the two fan devices is rotatable which makes the anthropoid hand-holding shape achievable. The retractor wrist possesses a triggering device, based on clutch-spring mechanism, for rotating the rotatable fan device. The clutch-spring mechanism has an impact on rotating the palms of the fan devices. In front of the handle, it is the so called front body which includes two fan devices, retractor wrist and tubular element. The front body can be controlled and is motorised using two motors fixed to the tubular element. The dual-head fan retractor is modelled in SolidWorks, and stress analysis of the retractor has been carried out by SolidWorks Simulation. Then, the mathematical model of the fan blades is developed. A 3-joint manipulator is modelled and controlled by a computed torque PD control approach as part of an investigative study to fit such a system to the retractor for robotic manipulation. Based on this investigation, the retractor is attached to a 2-joint robotic manipulator which has one rotational joint and a prismatic joint. This manipulator is mathematically modelled, and the dynamic equations are obtained. Control methods from Azenha and Khatib are simulated and compared. Azenha & Machadoโ€™s method has fewer input parameters and less oscillation when utilising the same control gains. Timeoptimal control is then successfully developed for the above 2-joint manipulator. This study clearly indicates that a retractor to be used for laparoscopic surgery can be effectively controlled using a multi-joints and multi degrees of freedom robotic manipulator

    Force measurement capability for robotic assisted minimally invasive surgery systems

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    An automated laparoscopic instrument capable of non-invasive measurement of tip/tissue interaction forces for direct application in robotic assisted minimally invasive surgery systems_ is introduced in this paper. It has the capability to measure normal grasping forces as well as lateral interaction forces without any sensor mounted on the tip jaws. Further to non-invasive actuation of the tip, the proposed instrument is also able to change the grasping direction during surgical operation. Modular design of the instrument allows conversion between surgical modalities (e.g., grasping, cutting, and dissecting). The main focus of this paper is on evaluation of the grasping force capability of the proposed instrument. The mathematical formulation of fenestrated insert is presented and its non-linear behaviour is studied. In order to measure the stiffness of soft tissues, a device was developed that is also described in this paper. Tissue characterisation experiments were conducted and results are presented and analysed here. The experimental results verify the capability of the proposed instrument in accurately measuring grasping forces and in characterising artificial tissue samples of varying stiffness.<br /

    Design of a Robotic Instrument Manipulator for Endoscopic Deployment

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    This thesis describes the initial design process for an application of continuum robotics to endoscopic surgical procedures, specifically dissection of the colon. We first introduce the long-term vision for a benchtop dual-instrument endoscopic system with intuitive haptic controllers and then narrow our focus to the design and testing of the instrument manipulator itself, which must be actuated through the long, winding channel of a standard colonoscope. Based on design requirements for a target procedure, we analyze simulations of two types of continuum robots using recently established kinematic and mechanic modeling approaches: the concentric-tube robot (CTR) and the concentric agonist-antagonist robot (CAAR). In addition, we investigate solutions to the primary engineering challenge to this system, which is accurately transmitting joint motion through exible, hollow shafts. Based on our study of the manipulator simulations and transmission shafts, we select instrument designs for prototyping and testing. We present approaches for controlling the position of the robotic instrument in real-time using an input device, and demonstrate the degree of control we can achieve in various configurations by performing time trial experiments with our prototype robotic instruments. Our observations of the manipulator during testing inform us of sources of error, and we conclude this report with suggestions for future work, including shaft design and alternative continuum manipulator approaches

    From passive tool holders to microsurgeons: safer, smaller, smarter surgical robots

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    Modeling, Analysis, Force Sensing and Control of Continuum Robots for Minimally Invasive Surgery

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    This dissertation describes design, modeling and application of continuum robotics for surgical applications, specifically parallel continuum robots (PCRs) and concentric tube manipulators (CTMs). The introduction of robotics into surgical applications has allowed for a greater degree of precision, less invasive access to more remote surgical sites, and user-intuitive interfaces with enhanced vision systems. The most recent developments have been in the space of continuum robots, whose exible structure create an inherent safety factor when in contact with fragile tissues. The design challenges that exist involve balancing size and strength of the manipulators, controlling the manipulators over long transmission pathways, and incorporating force sensing and feedback from the manipulators to the user. Contributions presented in this work include: (1) prototyping, design, force sensing, and force control investigations of PCRs, and (2) prototyping of a concentric tube manipulator for use in a standard colonoscope. A general kinetostatic model is presented for PCRs along with identification of multiple physical constraints encountered in design and construction. Design considerations and manipulator capabilities are examined in the form of matrix metrics and ellipsoid representations. Finally, force sensing and control are explored and experimental results are provided showing the accuracy of force estimates based on actuation force measurements and control capabilities. An overview of the design requirements, manipulator construction, analysis and experimental results are provided for a CTM used as a tool manipulator in a traditional colonoscope. Currently, tools used in colonoscopic procedures are straight and exit the front of the scope with 1 DOF of operation (jaws of a grasper, tightening of a loop, etc.). This research shows that with a CTM deployed, the dexterity of these tools can be increased dramatically, increasing accuracy of tool operation, ease of use and safety of the overall procedure. The prototype investigated in this work allows for multiple tools to be used during a single procedure. Experimental results show the feasibility and advantages of the newly-designed manipulators

    Cable-driven parallel mechanisms for minimally invasive robotic surgery

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    Minimally invasive surgery (MIS) has revolutionised surgery by providing faster recovery times, less post-operative complications, improved cosmesis and reduced pain for the patient. Surgical robotics are used to further decrease the invasiveness of procedures, by using yet smaller and fewer incisions or using natural orifices as entry point. However, many robotic systems still suffer from technical challenges such as sufficient instrument dexterity and payloads, leading to limited adoption in clinical practice. Cable-driven parallel mechanisms (CDPMs) have unique properties, which can be used to overcome existing challenges in surgical robotics. These beneficial properties include high end-effector payloads, efficient force transmission and a large configurable instrument workspace. However, the use of CDPMs in MIS is largely unexplored. This research presents the first structured exploration of CDPMs for MIS and demonstrates the potential of this type of mechanism through the development of multiple prototypes: the ESD CYCLOPS, CDAQS, SIMPLE, neuroCYCLOPS and microCYCLOPS. One key challenge for MIS is the access method used to introduce CDPMs into the body. Three different access methods are presented by the prototypes. By focusing on the minimally invasive access method in which CDPMs are introduced into the body, the thesis provides a framework, which can be used by researchers, engineers and clinicians to identify future opportunities of CDPMs in MIS. Additionally, through user studies and pre-clinical studies, these prototypes demonstrate that this type of mechanism has several key advantages for surgical applications in which haptic feedback, safe automation or a high payload are required. These advantages, combined with the different access methods, demonstrate that CDPMs can have a key role in the advancement of MIS technology.Open Acces

    ๋ณต๊ฐ•๊ฒฝ ์ˆ˜์ˆ  ๋กœ๋ด‡ ์‹œ์Šคํ…œ์˜ ํ™œ์šฉ๋„ ํ–ฅ์ƒ์„ ์œ„ํ•œ ์ถ”๊ฐ€์ ์ธ ๋งˆ์Šคํ„ฐ ์ธํ„ฐํŽ˜์ด์Šค ๊ฐœ๋ฐœ๊ณผ ์ด๋ฅผ ์ด์šฉํ•œ ์‘์šฉ ์‹œ์Šคํ…œ ๊ฐœ๋ฐœ ์—ฐ๊ตฌ

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    ํ•™์œ„๋…ผ๋ฌธ (๋ฐ•์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› ๊ณต๊ณผ๋Œ€ํ•™ ํ˜‘๋™๊ณผ์ • ๋ฐ”์ด์˜ค์—”์ง€๋‹ˆ์–ด๋ง์ „๊ณต, 2017. 8. Sungwan Kim.Robot-assisted laparoscopic surgery offers several advantages compared to open surgery and conventional minimally invasive surgery. However, important issues which need to be resolved are the complexity of current operation room environment for laparoscopic robotic surgery and demand for a larger operation room. To overcome these issues, additional interfaces based on Hands-On-Throttle-And-Stick (HOTAS) concept which can be simply attached and integrated with master interface of da Vinci surgical robot system were proposed. HOTAS controller is widely used for flight control in the aerospace field which can manipulate hundreds of functions and provide feedback to the pilot on flight conditions. The implementation of HOTAS controller significantly reduced the complexity of flights and reduced the number of pilots required in a cockpit from two to one. In this study, to provide above benefits to the operation room for robotic laparoscopic surgery, two types of additional interfaces are proposed. Proposed additional interfaces can be easily manipulated by the surgeons index finger, which is currently operated only by finger clutch buttons, and therefore enable the surgeon to use multiple functions. Initially, a novel master interface (NMI) was developed. The NMI mainly consists of a 9-way switch and a microprocessor with a wireless communication module. Thus, the NMI can be also regarded as a 9-way compact HOTAS. The performance test, latency, and power consumption of the developed NMI were verified by repeated experiments. Then, an improved novel master interface (iNMI) was developed to provide more intuitive and convenient manipulation. The iNMI was developed based on a capacitive touch sensor array and a wireless microprocessor to intuitively reflect the surgeons decision. Multiple experiments were performed to evaluate the iNMI performance in terms of performance test, latency, and power consumption. In addition, two application systems based on Surgical-Operation-By-Wire (SOBW) concept are proposed in this research to enhance the function of laparoscopic surgical robot system based on clinical needs that are stated below. The size of the additional interface is small enough to be easily installed to the master tool manipulators (MTMs) of da Vinci research kit (dVRK), which was used as an operation robot arm system, to maximize convenience to the surgeon when using the additional interfaces to simultaneously manipulate the application systems with the MTMs. Firstly, a robotic assistant that can be simultaneously manipulated via a wireless controller is proposed to allow the surgeon to control the assistant instrument. This approach not only decreases surgeon fatigue by eliminating communication process with assistants, but also resolves collision between the operation robot arms and the assistant instruments that can be caused by an inexperienced assistant or miscommunication and misaligned intent between the surgeon and the assistant. The system comprises two additional interfaces, a surgical instrument with a gripper actuated by a micromotor and a 6-axis robot arm. The gripping force of the surgical instrument was comparable to that of conventional systems and was consistent even after 1,000 times of gripping motion. The workspace was calculated to be 8,397.4 cm3. Recruited volunteers were able to execute the simple peg task within the cut-off time and successfully performed the in vitro test. Secondly, a wirelessly controllable stereo endoscope system which enables simultaneous control with the operating robot arm system is proposed. This is able to remove any discontinuous surgical flow that occurs when the control is swapped between the endoscope system and the operating robot arm system, and therefore prevent problems such as increased operation time, collision among surgical instruments, and injury to patients. The proposed system consists of two additional interfaces, a four-degrees of freedom (4-DOFs) endoscope control system (ECS) and a simple three-dimensional (3D) endoscope. The 4-DOFs ECS consists of four servo motors and employs a two-parallel link structure to provide translational and fulcrum point motions to the simple 3D endoscope. The workspace was calculated to be 20,378.3 cm3, which exceeds the reference workspace. The novice volunteers were able to successfully execute the modified peg transfer task. Throughout the various verifications, it has been confirmed that the proposed interfaces could make the surgical robot system more efficiently by overcoming its several limitations.1. Introduction 1 1.1. Robotic Laparoscopic Surgery 1 1.2. Objectives and Scope 8 1.2.1. Additional Master Interfaces 14 1.2.2. Application Systems 15 2. Materials and Methods 20 2.1. Additional Master Interfaces 20 2.1.1. Novel Master Interface: 9-way Compact Hands-On-Throttle-And-Stick 20 2.1.2. improved Novel Master Interface: Capacitive Touch Type Compact Hands-On-Throttle-And-Stick 26 2.2. Application Systems 34 2.2.1. Robotic Assistant 34 2.2.2. Stereo Endoscope System 49 3. Results 57 3.1. Novel Master Interface with Application Systems 57 3.1.1. Novel Master Interface 57 3.1.2. Robotic Assistant 59 3.1.3. Novel Master Interface with Robotic Assistant 67 3.1.4. Stereo Endoscope System 76 3.1.5. Novel Master Interface with Stereo Endoscope System 82 3.2. improved Novel Master Interface with Application Systems 87 3.2.1. improved Novel Master Interface 87 3.2.2. improved Novel Master Interface with Stereo Endoscope System 90 4. Discussion 91 5. Conclusion 102 References 105 Abstract in Korean 117Docto
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