Natural Orifice Transluminal Endoscopic Surgery (NOTES)-an Emerging Technique in Surgery

Bm, Shrestha

doi:10.31729/jnma.35

Cited by 4 publications

(4 citation statements)

References 21 publications

(22 reference statements)

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“…surgery Natural orifice transluminal endoscopic surgery (NOTES) is a recent advancement in MIS [34]. This procedure takes advantage of natural orifices such as the mouth stomach, esophagus, vagina, bladder, and rectum to treat abdominal pathologies [35].…”

Section: Natural Orifice Transluminal Endoscopic (Notes)mentioning

confidence: 99%

“…Nevertheless, the conventional surgical instrumentation that is used in NOTES was not designed exclusively for this kind of procedure; thus, this presents several limitations related to manipulation, range of motion, and size. For this reason, many researchers are developing novel articulated grasping systems to pass through the large channels of endoscopes [37] in order to contribute more every day to NOTES advancements [38,37,34].…”

Section: Natural Orifice Transluminal Endoscopic (Notes)mentioning

confidence: 99%

See 1 more Smart Citation

Surgical Microgrippers: A Survey and Analysis

Pasaguayo

Masry

Lescano³

et al. 2023

Journal of Medical Devices

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This review article provides an overview of some challenges that arise when developing new medical robotic microgrippers. The main challenges are due to miniaturization and are present in the manufacturing and assembly processes, the types of mechanisms, the biomaterials used, the actuation principles, and the compliance with some standards and regulations. The main medical fields where these microgrippers are used are in MIS and biomedical applications. Therefore, taking these two large groups into account, this review presents a microgrippers classification according to the type of mechanism used (traditional rigid-body mechanisms and complaint mechanisms). Moreover, parameters such as applications, functionalities, DOF, sizes, range of motion, biomaterial used, and proposed methods are highlighted. In total, the analysis of 21 microgrippers among commercial and developed by research institutes is presented.

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Section: Natural Orifice Transluminal Endoscopic (Notes)mentioning

confidence: 99%

Section: Natural Orifice Transluminal Endoscopic (Notes)mentioning

confidence: 99%

Surgical Microgrippers: A Survey and Analysis

Pasaguayo

Masry

Lescano³

et al. 2023

Journal of Medical Devices

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“…1–3 The field of natural orifices transluminal endoscopic surgery (NOTES) strives to further reduce the negative effects of surgery using natural orifices such as the mouth, nose, and anus as the surgical entry point. 4,5 This approach does introduce technical challenges as the currently used rigid Ø5-mm instruments designed for MIS are not able to confine to the curved nature of the human anatomy but dictate a straight path from entry point to lesion. Making the Ø5-mm instruments flexible, as for example the MultiFlex of Figure 1(a), could therefore extend the reach of NOTES procedures in compact anatomical areas.…”

Section: Introductionmentioning

confidence: 99%

The MemoSlide: An explorative study into a novel mechanical follow-the-leader mechanism

Henselmans

Gottenbos

Smit

et al. 2017

Proc Inst Mech Eng H

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Follow-the-leader propagation allows for the insertion of flexible surgical instruments along curved paths, reducing the access required for natural orifice transluminal endoscopic surgery. Currently, the most promising follow-the-leader instruments use the alternating memory method containing two mechanical memory-banks for controlling the motion of the flexible shaft, which reduces the number of actuators to a minimum. These instruments do, however, require concentric structures inside the shaft, limiting its miniaturization. The goal of this research was, therefore, to develop a mechanism conforming the principles of the alternating memory method that could be located at the controller-side instead of inside the shaft of the instrument, which is positioned outside the patient and is therefore less restricted in size. First, the three-dimensional motion of the shaft was decoupled into movement in a horizontal and vertical plane, which allowed for a relatively simple planar alternating memory mechanism design for controlling planar follow-the-leader motion. Next, the planar movement of the alternating memory mechanism was discretized, increasing its resilience to errors. The resulting alternating memory mechanism was incorporated and tested in a proof-of-concept prototype called the MemoSlide. This prototype does not include a flexible shaft, but was fully focused on proving the function of the alternating memory mechanism. Evaluation of the MemoSlide shows the mechanism to work very well, being able to transfer any planar path that lays within its physical boundaries along the body of the mechanism without accumulating errors.

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“…The management of significant complications (such as bleeding, bowel perforation and splenic injury) solely with current transgastric devices could also be a quite complicated task. Main benefits and risks of NOTES procedure are summarised in Figure 3 (Noguera et al, 2010;Shrestha, 2011).…”

Section: Introductionmentioning

confidence: 99%

State of the art in robots used in minimally invasive surgeries. Natural Orifice Transluminal Surgery (NOTES) as a particular case

Díaz

Fernández

Armada

et al. 2015

Industrial Robot: An International Journal

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Purpose – This paper aims to provide an insight into recent advancements and developments of robotics for Natural Orifice Transluminal Surgery (NOTES) procedures. Design/methodology/approach – Following an introduction that highlights the evolution from Minimally Invasive Surgery (MIS) to NOTES in the medical field, this paper reviews the main robotics systems that have been designed and implemented for MIS and NOTES, summarising their advantages and limitations and remarking the technological challenges and the requirements that still should be addressed and fulfilled. Findings – The state-of-the-art presented in this paper shows that the majority of the platforms created for NOTES are laboratory prototypes, and their performances are still far from being optimal. New solutions are required to solve the problems confronted by the proposed systems such as the limited number of DOFs, the limited resolution, the optimal fixation and stiffening of the instruments for enabling stable and precise operation, the effective transmission of forces to the tip tools, the improvement of the force feedback feeling and the proper visualization and spatial orientation of the surgical field. Advances in robotics can contribute significantly to the development and future implementation of the NOTES procedure. Originality/value – This paper highlights the current trends and challenges ahead in robotics applied to NOTES procedure.

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Natural Orifice Transluminal Endoscopic Surgery (NOTES)-an Emerging Technique in Surgery

Cited by 4 publications

References 21 publications

Surgical Microgrippers: A Survey and Analysis

Surgical Microgrippers: A Survey and Analysis

The MemoSlide: An explorative study into a novel mechanical follow-the-leader mechanism

State of the art in robots used in minimally invasive surgeries. Natural Orifice Transluminal Surgery (NOTES) as a particular case

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