Towards an anthropomorphic design of minimally invasive instrumentation for soft tissue robotic surgery

Minimally invasive procedures, such as laparoscopy, have significantly decreased blood loss, postoperative morbidity and length of hospital stay. Robot-assisted Minimally Invasive Surgery (MIS) has offered refined accuracy and more ergonomic instruments for surgeons, further minimizing trauma to the patient [1]. On the other hand, training surgeons in minimally invasive surgical procedures is becoming increasingly long and arduous [2]. In this paper, we outline the rationale of a novel design of instruments for robotic surgery with increased dexterity that will provide more natural manipulation of soft tissues. The proposed system will not only reduce the training time for surgeons but also improve the ergonomics of the procedure. © 2012 Springer-Verlag

Design, simulation and evaluation of kinematic alternatives for Insertable Robotic Effectors Platforms in Single Port Access Surgery

This paper presents the task specifications for designing a novel Insertable Robotic Effectors Platform (IREP) with integrated stereo vision and surgical intervention tools for Single Port Access Surgery (SPAS). This design provides a compact deployable mechanical architecture that may be inserted through a single Ø15 mm access port. Dexterous surgical intervention and stereo vision are achieved via the use of two snake-like continuum robots and two controllable CCD cameras. Simulations and dexterity evaluation of our proposed design are compared to several design alternatives with different kinematic arrangements. Results of these simulations show that dexterity is improved by using an independent revolute joint at the tip of a continuum robot instead of achieving distal rotation by transmission of rotation about the backbone of the continuum robot. Further, it is shown that designs with two robotic continuum robots as surgical arms have diminished dexterity if the bases of these arms are close to each other. This result justifies our design and points to ways of improving the performance of existing designs that use continuum robots as surgical arms

Continuum Robots for Space Applications Based on Layer-Jamming Scales with Stiffness Capability

Continuum robots, which have continuous mechanical structures comparable to the flexibility in elephant trunks and octopus arms, have been primarily geared toward the medical and defense communities. In space, however, NASA projects these robots to have a place in irregular inspection routines. The inherent compliance and bending of these continuum arms are especially suitable for inspection in obstructed spaces to ensure proper equipment functionality. In this paper, we propose a new solution that improves on the functionality of previous continuum robots, via a novel mechanical scaly layer-jamming design. Layer-jamming assisted continuum arms have previously required pneumatic sources for actuation, which limit their portability and usage in aerospace applications. This paper combines the compliance of continuum arms and stiffness modulation of the layer jamming mechanism to design new hybrid layer jamming continuum arms. The novel designs use an electromechanical actuation which eliminates the previous need for pneumatic actuation therefore making the hardware compact and portable

A CONSIDERATION BASED ON PASSIVITY FOR VIBRATION SUPPRESSION VIA ADDITION OF IMPEDANCE COMPONENTS IN FORCE REFLECTING TYPE BILATERAL CONTROL SYSTEM

In the previous study, Grasp force observer (GFO) was proposed to estimate reacting force of the object gripped by the forceps manipulator used in the robotic surgical system for single port surgery (SPS). However, when the estimated force by the GFO was fed back to master\u27s gripper directly, it was difficult to distinguish the hardness of the gripped object because the vibration of the gripper occurred. In this paper, a vibration suppression method via addition of impedance components into input torque in the force reflecting type bilateral control system was proposed. Using the MATLAB software, on the basis of mathematical model of the system, passivity of the control system was numerically verified in certain frequency bands. In addition, distinction experiment for hardness of the gripped object was conducted, and the results showed the effectiveness of the proposed control system

Development of a New Single Port Surgery Robot with Increased Torque and Workspace

This paper presents the development of a new single port surgery robot, Plat spring driven mech-anism equipped robot for single port LAparoscopic Surgery (PLAS), with plate spring driven mechanism. Recently, the number of single port laparoscopic surgery (SILS) that can easily conceal postoperative scars is increasing, and robotic SILS platforms are being developed for solving inconvenient maneuverability of manual SILS. However, the drive mechanism of most robotic SILS platforms existing consists of wire, therefore cannot afford to deliver sufficient force, and the wire is mechanically deformed, thus causing negative effects on movement accuracy. Due to this limitation, a precious operation cannot be conducted by using conventional robotic SILS platforms. Accuracy and force are reduced as the workspace is ex-panding. The purpose of proposed robot is to increase tissue handling force of forceps by using plate spring driven mechanism, and to conduct more stable and precious operations in an expanded area. Eval-uations of PLAS were performed and its feasibility as a new effective robotic SILS platform was proved ⓒ 2013 DGISTI. INTRODUCTION 1 -- 1.1 Introduction to Single Incision Laparoscopic Surgery (SILS) 1 -- 1.2 Previous researches of robotic SILS 5 -- 1.3 Advantages and disadvantages of current SILS robots 7 -- 1.4 Plate spring driven mechanism 10 -- 1.5 Research contents and goals 13 -- II. DESIGN 15 -- 2.1 Ideal robotic SILS platform 15 -- 2.2 New robotic SILS platform 17 -- 2.1.1 Force requirement 18 -- 2.1.2 Considerations on work Space and degree of freedom 19 -- 2.3 Mechanical implementation of joints 23 -- III. DIRECT AND INVERSE POSITION ANALYSIS 36 -- 3.1 Direct Kinematics 40 -- 3.2 Inverse Kinematics 41 -- IV. VELOCITY AND JACOBIAN ANALYSIS 45 -- 4.1 Direct and Inverse Velocity Problem 47 -- 4.2 Singularity Analysis 48 -- V. EXPERIMENTAL METHODS AND RESULTS 49 -- 5.1 Measuring forces and results 49 -- 5.2 Assessment for reliability of movements and its results 57 -- VI. CONCLUSION AND FURTHER WORKS 61본 연구에서는 판 스프링을 구동 메커니즘으로 하는 새로운 형태의 단일공복강경 수술 로봇을 개발하였다. 최근, 복부에 3~5개의 상처를 남기는 기존의 복강경 수술의 대안으로 수술 후 상처를 쉽게 숨길 수 있는 배꼽을 통한 단일 공 복강경 수술(single port laparoscopic surgery)의 수요가 증가하는 추세이다. 하지만 단일 공 복강경 수술은 내시경과 두 개의 겸자(forceps)가 단 하나의 침습 구로 삽입되어 시술 중 도구간의 충돌을 피하기 어려우며, 작업 공간을 확보하기도 힘들다. 이러한 문제를 해결하기 위해 여러 가지 단일 공 복강경 수술 로봇이 개발 되고 있지만 수술을 하기에 충분한 힘을 전달하지 못하는 문제가 있다. 이 논문에서는 위와 같은 문제를 해결하고, 수술에 필요한 충분한 힘과 넓은 작업영역을 확보하기 위해 판 스프링으로 구동되는 단일 공 수술로봇을 설계, 제작한 후 성능평가를 실시했다. 국내에서는 처음 개발되는 Y 타입 단일 공 수술로봇을 개발하기 위해 매뉴얼 단일 공 복강경 수술의 임상적인 제한 사항과 기존에 개발된 단일 공 복강경 수술로봇의 장단점을 심도 있게 분석하여 기구 설계에 적용시켰다. 특히 의사들의 현장 경험과 의견을 수용하여 기구설계에 적극 반영하였으며, 기존 단일 공 수술 로봇들보다 넓은 작업공간을 갖는 단일 공 수술 로봇을 개발할 수 있었다. ⓒ 2013 DGISTMasterdCollectio

Laparoscopic robotic surgery : current perspective and future directions

Just as laparoscopic surgery provided a giant leap in safety and recovery for patients over open surgery methods, robotic-assisted surgery (RAS) is doing the same to laparoscopic surgery. The first laparoscopic-RAS systems to be commercialized were the Intuitive Surgical, Inc. da Vinci and the Computer Motion Zeus. These systems were similar in many aspects, which led to a patent dispute between the two companies. Before the dispute was settled in court, Intuitive Surgical bought Computer Motion, and thus owned critical patents for laparoscopic-RAS. Recently, the patents held by Intuitive Surgical have begun to expire, leading to many new laparoscopic-RAS systems being developed and entering the market. In this study, we review the newly commercialized and prototype laparoscopic-RAS systems. We compare the features of the imaging and display technology, surgeons console and patient cart of the reviewed RAS systems. We also briefly discuss the future directions of laparoscopic-RAS surgery. With new laparoscopic-RAS systems now commercially available we should see RAS being adopted more widely in surgical interventions and costs of procedures using RAS to decrease in the near future

Study and development of stretchable sensors for flexible surgical instrumentation.

Recently, attention has been focused to minimize the invasiveness of existing minimally invasive surgery (MIS) approaches: one example is the development of continuum-like and soft robots that can bend, extend, contract at any point along their length. This provides them with capabilities well beyond those of their rigid-link counterparts, thus allowing to perform whole arm manipulation. One recent approach to soft and modular systems is represented by the on-going EU project STIFF-FLOP (www.stiff-flop.eu). The STIFF-FLOP arm is not fabricated by rigid structures, but soft ones showing advanced manipulation capabilities for surgical applications, with multiple degrees of freedom (DOFs), and ability of multi-bending. Ideally, the entire robotic structure should safely move with contact and bend detection and the embedded sensors should not interfere with the movements: the use of small sensors, both soft and stretchable, which remain functional when deformed, becomes necessary. For the aforementioned reasons, we introduce a small, low-cost, soft and stretchable sensor composed of a silicone rubber (EcoFlex0030, SmoothOn), integrating a conductive liquid channel filled with biocompatible Sodium Chloride (NaCl) solution. By stretching the sensor the cross-section of the channel deforms, thus leading to a change in electrical resistance. The functionality of the sensor has been proved through testing: changes in electrical resistance are measured as a function of the applied strain. The advantage of using silicone rubber is its mechanical durability and high flexibility, non-toxicity, chemical stability and low cost. Furthermore, liquid conductors eliminate the need for rigid electronics and preserve the natural elasticity of the sensor, and the NaCl solution fulfills the need for a biocompatible liquid. Differently from existing solutions that are not truly stretchable and biocompatible, the contribution of this work is an effort for improving the current soft sensors technologies through the demonstration that NaCl filled channel rubbers represent a valid solution for measuring deformations in flexible surgical instrumentation

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