Array of Robots Augmenting the Kinematics of Endocavitary Surgery

Abstract

Minimally invasive surgery (MIS) has been introduced\ud in the last decades with the goal of making scarless surgery\ud feasible. In general, an MIS approach allows concrete benefits in\ud terms of reduced trauma, quicker recovery times, and improved\ud cosmetics. On the other hand, in its current state, MIS introduces\ud more difficulties for surgeons, due to its intrinsic complexity. This\ud issue has inspired the major technological challenge of designing\ud miniaturized robots able to completely enter the body and to perform\ud surgical procedures under intuitive teleoperation. The dream\ud of achieving a completely minimally invasive therapeutic procedure,\ud while offering the typical advantages of traditional open\ud surgery, has brought to the complete elimination of external incisions\ud by gaining access to the peritoneal cavity through a natural\ud orifice. These scarless procedures are known as Natural Orifice\ud Transluminal Endoscopic Surgery (NOTES) interventions. In this\ud paper, novel approaches to NOTES instruments and platforms are\ud presented, in which modular robots measuring 12 mm in diameter\ud with basic functionalities (manipulation, cutting, vision, and\ud retraction) and multiple degrees of freedom are deployed inside a\ud human phantom and anchored on a supporting frame for the stable\ud execution of tasks. This paper illustrates the general concept, novel design guidelines for the modular robots, and two robotic units successfully assembled and tested with ten users, in order to assess the capabilities of the system in pick and place experiments and cutting tasks. Experiments for the assessing force and accuracy are described as well

Medical Technologies and Challenges of Robot-Assisted Minimally Invasive Intervention and Diagnostics

“…There is an array of different tool types that can operate anchored to the abdomen with a magnet. Systems include: a 3 DOF pneumatically actuated cauterizer [93]; a magnetically anchored pan tilt and translation camera system [91,94]; various retractors [95], and a number of multi-degree of freedom arms [88,26,96]. Some of [88,87,89] these works have incorporated the use of reconfigurable frames that insert with the tool and keep the tools mounted together in order to localize the arms with respect to one another and to provide better dexterity.…”

Snake-Like Robots for Minimally Invasive, Single-Port, and Intraluminal Surgeries

“…Several works have explored the design space for reconfigurable robotic systems that are assembled after being deployed into the surgical workspace. 26,64,151 The system shown in Figure 17 has 12 mm diameter robotic modules, each of which may have either manipulation, cutting, vision, or retraction functions, deployed through the esophagus and mounted on a frame that is anchored to the abdominal wall with external permanent magnets. After insertion, the modules are assembled to the anchoring frame using an assistive endoscope.…”

Closed-Loop Control of Local Magnetic Actuation for Robotic Surgical Instruments

“…Actuation for the several DoF may be external, by means of cables or rigid connection [5], [6]; internal, using on-board motors [7]- [9]; or hybrid [10]. In any case, the mechanical continuity of the kinematic chain constrains the workspace proximally at the insertion point.…”

“…The main drawback of this approach is in the low dexterity and poor motion accuracy due to manual operation of the external magnets [13]. To overcome this limitation, magnetic coupling can be used mainly for gross positioning, while on-board EM motors can be adopted for providing fine motion of the surgical end effector [9], [13], [14]. As previously mentioned, however, the on-board actuators that can fit through a single tiny incision are very limited in power and do not allow the performance of surgical tasks such as lifting an organ or following in real-time the surgeon's movements at the master interface.…”