Computer guidance system for single-incision bimanual robotic surgery

Abstract

The evolution of surgical robotics is following the progress of developments in Minimally Invasive Surgery (MIS), which is moving towards Single-Incision Laparoscopic Surgery (SILS) procedures. The complexity of these techniques has favored the introduction of robotic surgical systems. New bimanual robots, which are completely inserted into the patient's body, have been proposed in order to enhance the surgical gesture in SILS procedures. However, the limited laparoscopic view and the focus on the end-effectors, together with the use of complex robotic devices inside the patient's abdomen, may lead to unexpected collisions, e.g., between the surrounding anatomical organs not involved in the intervention and the surgical robot.This paper describes a computer guidance system, based on patient-specific data, designed to provide intraoperative navigation and assistance in SILS robotic interventions. The navigator has been tested in simulations of some of the surgical tasks involved in a cholecystectomy, using a synthetic anthropomorphic mannequin. The results demonstrate the usability and efficacy of the navigation system, underlining the importance of avoiding unwanted collisions between the robot arms and critical organs. The proposed computer guidance software is able to integrate any bimanual surgical robot design.

Future of Minimally Invasive Colorectal Surgery

“…Two different miniaturized robotic platforms specifically dedicated for single-incision surgery have been developed so far, SPRINT (single port laparoscopy bimanual robot) and ARAKNES. [108][109][110][111] The SPRINT is composed of two remotely controlled robotic arms with six degrees-of-freedom and a stereoscopic camera, which are inserted into the abdominal cavity through a 3-cm introducer. The full intra-abdominal position of robotic units allows for optimal triangulation.…”

Technical review of the da Vinci surgical telemanipulator

“…From a mechanical viewpoint, ongoing research and development should focus on the development of robotics for single‐port surgery and the use of teleoperated fully implantable mini‐robots to reduce the invasiveness and size of existing robots. The SPRINT robot (Araknes EU F7, European Consortium) is an example of a novel robotic platform for single‐port laparoscopic surgery (SPLS) and has a master–slave configuration not dissimilar to that of the da Vinci robot, with a bimanual solution . Other groups have demonstrated the feasibility of small fully implantable robots, asserting that implantable robots can be manipulated from the outside with much less force and trauma to the tissues, allowing for better precision and delicate tissue handling.The feasibility of implantable robots has been demonstrated; however, these devices are still developmental and are tested only in animal models.…”

Cholecystectomy by using a surgical robotic system

“…This technology has been incorporated into the robotic platform for Single-Site cholecystectomy demonstrating, in prospective trials, to be safe and effective [31]. Other interesting innovations that may improve the R-LESS experience include computer guidance systems to improve intraoperative orientation [32] and patient-specific simulators for preoperative planning [33]. Apart from the extensively discussed adapted R-LESS platform, other promising devices are starting to emerge and are currently being tested in experimental trials.…”