The majority of functional deficiencies that still exist in NOTES platforms could be overcome by a broad range of already existing or emerging enabling technologies. To combine them in an optimal manner, a permanent dialogue between researchers and clinicians is mandatory.
Although the use of minimally invasive surgery techniques has steadily increased, the development of new tools for these procedures has stagnated. Indeed a new generation of surgical instruments, with tips that have multiple degrees of freedom, has been developed. However, they are facing so many technical problems that none have been able to establish themselves in the medical market. To overcome the problems these instruments are facing, a micro hydraulic power transmission system has been developed and been presented in [1]. With these driving units it was possible to design an instrument for minimally invasive surgery with a tip which is movable in 3 degrees of freedom (DOF) and that is light in weight, small in size and powerful in movements and gripping. This paper presents the mechanical setup (including dimensions and materials), describes the theoretical basis for the control with the inverse kinematic model, discusses the external drives setup and gives first performance data of this novel hydraulically actuated laparoscopic instrument with 3 degrees of freedom.
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