This paper presents an articulated manipulator with multiple instruments for natural orifice endoscopic transluminal endoscopic surgery (NOTES). This robotic system is made up of four major components, namely a multifunctional manipulator, a robot-connecting arm, an articulated drive mechanism, and a surgeon control console. The manipulator, capable of changing instruments in situ at the surgical site, was developed to reduce infection risk, improve surgical workflow, and encourage solo surgery by providing surgeons with all the required instruments. The robot-connecting arm serves as an experimental platform for future bimanual robot configurations. To facilitate stable positioning and optimal orientation of the robot, the articulated drive mechanism was also created. The surgeon control console provides a user-friendly platform to receive system input from surgeons. Benchtop testing showed adequate articulation and tool-tip forces for accomplishment of typical tasks in abdominal surgery. This system leverages the benefits both of cable-wire actuation systems and of direct motor embedding on different components to achieve better tool triangulation, higher instrument grasping force, and improved positioning at the surgical site.
This paper presents kinematic aspects of a multifunctional robotic manipulator for use in natural orifice surgery. A literature review of some existing surgical robots is presented. The robot folding configurations for insertion/removal are described. The kinematics and workspace of the robotic manipulator and their application in a space-constrained environment are explored as well. The main goal is to find out the best way to fully utilize limited degrees of freedom in the robot arms local to the surgical site as well as additional motions provided by the hyper-redundant, underactuated articulated drive mechanism, in order to provide the dexterity and workspace required for typical surgical interventions.
Natural orifice translumenal endoscopic surgery (NOTES) has reduced the invasiveness of surgery by eliminating external incisions on the patient. With this type of procedure, recovery time is drastically shortened, cosmetics are improved, and infections and pain are greatly reduced. For NOTES procedures to be successfully performed, a flexible endoscope or similar instrument is important for passing orifice flexures. However, technological deficiencies like poor angulations of surgical instruments introduced through working channels in flexible endoscopes, the lack of scope fixation, and lack of scope stiffening are technological barriers which prevent NOTES from being widely accepted in human surgeries. A novel multifunctional robot with an articulated drive mechanism for NOTES has been developed. The steerable articulating drive mechanism is connected to the robotic end effector to guide the robot and navigate through a natural orifice. The design process for the articulating drive mechanism and engineering analysis are discussed in this paper. Workspace of the drive mechanism with and without a translational insertion degree of freedom is presented in detail. The kinematics of the drive mechanism is also discussed. Additionally, friction in the spherical joints of the drive mechanism is explored to characterize its influence on the overall shape achieved by the articulation, including the effects of varying the total length in the steering mechanism. The surgeon control console for the drive mechanism is briefly discussed as well. Bench-top testing results are presented as proof of feasibility of the design.
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