Articulated Manipulator With Multiple Instruments for Natural Orifice Transluminal Endoscopic Surgery

Abstract

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.

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

“…A prototype design of a NOTES surgery system were presented by Min Seow et al 132 and Shen et al 133 A similar friction shape-lock principle to the concept presented by Sturges 96 has been proposed for deploying miniature robotic modules with embedded actuation through the esophagus. 132 A passively bending articulated snake-like arm having a diameter of 13 mm is used to support a multi-functional manipulator capable of introducing several tools when the snake-like arm is locked. This design concept was later generalized by Shen et al 133 who replaced the passive bending articulated arm with a 16 mm wire-actuated articulated snake-like arm.…”

Hydraulic Robotic Surgical Tool Changing Manipulator

“…In a separate work, two generations of a snake robot for NOTES have been designed and built [8,9]. Several versions of a multiple-instrument manipulator have been developed to attach to these robots [2,9,10]. These designs use miniature DC motors for tool exchange and actuation.…”

“…To augment the output torque and deliver adequate forces for tissue manipulation, previous designs have used relatively big gearheads and spur and/or bevel gears. Accordingly, these electric-motor driven manipulators are still bulky (outer diameter ¼ 28 mm, length ¼ 104 mm [10])-not suitable for NOTES applications with tight spaces for insertion and operation of the tools. With the use of miniature electric motors and large gearing, there comes slow tool exchange and actuation and high cost as seen in previous designs.…”

Design and Analysis of a Novel Articulated Drive Mechanism for Multifunctional NOTES Robot

“…In Refs. [15] and [16], a NOTES robot with an end effector carrying multiple tools tips guided by a steerable and shape lockable drive mechanism was presented.…”

“…Based on our previous work [15,16], this paper presents a novel ADM containing two independent curvature sections for a bimanual, multifunctional NOTES manipulator. The ADM consists of an articulated snakelike linkage, motor housing, and an arm connector.…”