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

Task and Configuration Space Compliance of Continuum Robots via Lie Group and Modal Shape Formulations

Continuum robots suffer large deflections due to internal and external forces. Accurate modeling of their passive compliance is necessary for accurate environmental interaction, especially in scenarios where direct force sensing is not practical. This paper focuses on deriving analytic formulations for the compliance of continuum robots that can be modeled as Kirchhoff rods. Compared to prior works, the approach presented herein is not subject to the constant-curvature assumptions to derive the configuration space compliance, and we do not rely on computationally-expensive finite difference approximations to obtain the task space compliance. Using modal approximations over curvature space and Lie group integration, we obtain closed-form expressions for the task and configuration space compliance matrices of continuum robots, thereby bridging the gap between constant-curvature analytic formulations of configuration space compliance and variable curvature task space compliance. We first present an analytic expression for the compliance of a single Kirchhoff rod. We then extend this formulation for computing both the task space and configuration space compliance of a tendon-actuated continuum robot. We then use our formulation to study the tradeoffs between computation cost and modeling accuracy as well as the loss in accuracy from neglecting the Jacobian derivative term in the compliance model. Finally, we experimentally validate the model on a tendon-actuated continuum segment, demonstrating the model's ability to predict passive deflections with error below 11.5\% percent of total arc length

Design Considerations and Robustness to Parameter Uncertainty in Wire-Wrapped Cam Mechanisms

Collaborative robots must simultaneously be safe enough to operate in close proximity to human operators and powerful enough to assist users in industrial tasks such as lifting heavy equipment. The requirement for safety necessitates that collaborative robots are designed with low-powered actuators. However, some industrial tasks may require the robot to have high payload capacity and/or long reach. For collaborative robot designs to be successful, they must find ways of addressing these conflicting design requirements. One promising strategy for navigating this tradeoff is through the use of static balancing mechanisms to offset the robot's self weight, thus enabling the selection of lower-powered actuators. In this paper, we introduce a novel, 2 degree of freedom static balancing mechanism based on spring-loaded, wire-wrapped cams. We also present an optimization-based cam design method that guarantees the cams stay convex, ensures the springs stay below their extensions limits, and minimizes sensitivity to unmodeled deviations from the nominal spring constant. Additionally, we present a model of the effect of friction between the wire and the cam. Lastly, we show experimentally that the torque generated by the cam mechanism matches the torque predicted in our modeling approach. Our results also suggest that the effects of wire-cam friction are significant for non-circular cams

A learning algorithm for visual pose estimation of continuum robots

Continuum robots offer significant advantages for surgical intervention due to their down-scalability, dexterity, and structural flexibility. While structural compliance offers a passive way to guard against trauma, it necessitates robust methods for online estimation of the robot configuration in order to enable precise position and manipulation control. In this paper, we address the pose estimation problem by applying a novel mapping of the robot configuration to a feature descriptor space using stereo vision. We generate a mapping of known features through a supervised learning algorithm that relates the feature descriptor to known ground truth. Features are represented in a reduced sub-space, which we call eigen-features. The descriptor provides some robustness to occlusions, which are inherent to surgical environments, and the methodology that we describe can be applied to multi-segment continuum robots for closed-loop control. Experimental validation on a single-segment continuum robot demonstrates the robustness and efficacy of the algorithm for configuration estimation. Results show that the errors are in the range of 1°

Forces and trauma associated with minimally invasive image-guided cochlear implantation

Objective. Minimally invasive image-guided cochlear implantation (CI) utilizes a patient-customized microstereotactic frame to access the cochlea via a single drill-pass. We investigate the average force and trauma associated with the insertion of lateral wall CI electrodes using this technique. Study Design. Assessment using cadaveric temporal bones. Setting. Laboratory setup. Subjects and Methods. Microstereotactic frames for 6 fresh cadaveric temporal bones were built using CT scans to determine an optimal drill path following which drilling was performed. CI electrodes were inserted using surgical forceps to manually advance the CI electrode array, via the drilled tunnel, into the cochlea. Forces were recorded using a 6-axis load sensor placed under the temporal bone during the insertion of lateral wall electrode arrays (2 each of Nucleus CI422, MED-EL standard, and modified MED-EL electrodes with stiffeners). Tissue histology was performed by microdissection of the otic capsule and apical photo documentation of electrode position and intracochlear tissue. Results. After drilling, CT scanning demonstrated successful access to cochlea in all 6 bones. Average insertion forces ranged from 0.009 to 0.078 N. Peak forces were in the range of 0.056 to 0.469 N. Tissue histology showed complete scala tympani insertion in 5 specimens and scala vestibuli insertion in the remaining specimen with depth of insertion ranging from 360° to 600°. No intracochlear trauma was identified. Conclusion. The use of lateral wall electrodes with the minimally invasive image-guided CI approach was associated with insertion forces comparable to traditional CI surgery. Deep insertions were obtained without identifiable trauma. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2014