Natural orifice surgery with an endoluminal mobile robot

Abstract

Natural orifice transgastric endoscopic surgery promises to eliminate skin incisions and reduce postoperative pain and discomfort. Such an approach provides a distinct benefit as compared with conventional laparoscopy, in which multiple entry incisions are required for tools and camera. Endoscopy currently is the only method for performing procedures through the gastrointestinal tract. However, this approach is limited by instrumentation and the need to pass the entire scope into the patient. In contrast, an untethered miniature robot inserted through the mouth would be able to enter the abdominal cavity through a gastrotomy for exploration of the entire peritoneal cavity. In this study, the authors developed an endoluminal robot capable of transgastric abdominal exploration under esophagogastroduodenoscopic (EGD) control. Under EGD control, a gastrotomy was created, and the miniature robot was deployed into the abdominal cavity under remote control. Ultimately, future procedures will include a family of robots working together inside the gastric and abdominal cavities after their insertion through the esophagus. Such technology will help to reduce patient trauma while providing surgical flexibility.

Cholecystectomy: evolution of laparoscopic approach

“…работа успешно продемонстрирована при выполне-нии TGC у свиней [132,186]. В литературе описан «ловкий» многофункциональный мини-робот, при помощи которого была произведена эксперимен-тальная TGC на животных (рис.…”

New trends in minimally invasive urological surgery

“…Recently, NOTES has been performed in a porcine model by an endoluminal robot capable of transgastric abdominal e�ploration (39). Under endoscopic control, a gastrotomy was created, and the robot was deployed into the peritoneal cavity.…”

Cirugía endoscópica trans orificios naturales (NOTES)

“…En muchos casos, la localización del sitio de la incisión (viscerotomía) fue elegida cuidadosamente para minimizar las complicaciones y optimizar el acceso a la cavidad peritoneal de acuerdo al procedimiento a realizar 28,[43][44][45][46][47][48][49][50][51][52][53][54][55][56] , o para identificar el sitio de la colotomía.…”

“…En otros, se utilizó un nuevo instrumento para tomar una porción del órgano y pasarla dentro de la pared gás-trica 18,29,[30][31][32][33]37,40,44,45 . Parker et al (2005) 38 , afirman que el método utilizando el esfinterótomo para realizar la gastrostomía, es más rápido que la dilatación con balón y que no existe la posibilidad que se cierre espontáneamente porque se ha seccionado la capa mus-cular 30,33,34,36,39,44,45 . En los estudios donde se empleó el mini robot para la exploración, no se requirió la dilatación de la incisión ya que el robot fue capaz de fijarla 31,34,35,37,39,41,43,44 .…”