Surgery with cooperative robots

Abstract

Advances in endoscopic techniques for abdominal procedures continue to reduce the invasiveness of surgery. Gaining access to the peritoneal cavity through small incisions prompted the first significant shift in general surgery. The complete elimination of external incisions through natural orifice access is potentially the next step in reducing patient trauma. While minimally invasive techniques offer significant patient advantages, the procedures are surgically challenging. Robotic surgical systems are being developed that address the visualization and manipulation limitations, but many of these systems remain constrained by the entry incisions. Alternatively, miniature in vivo robots are being developed that are completely inserted into the peritoneal cavity for laparoscopic and natural orifice procedures. These robots can provide vision and task assistance without the constraints of the entry incision, and can reduce the number of incisions required for laparoscopic procedures. In this study, a series of minimally invasive animal-model surgeries were performed using multiple miniature in vivo robots in cooperation with existing laparoscopy and endoscopy tools as well as the da Vinci Surgical System. These procedures demonstrate that miniature in vivo robots can address the visualization constraints of minimally invasive surgery by providing video feedback and task assistance from arbitrary orientations within the peritoneal cavity.

Natural orifice cholecystectomy using a miniature robot

“…Similarly, a preliminary procedure using three miniature in vivo robots including a peritoneum-mounted imaging robot, a lighting robot, and a retraction robot has demonstrated the feasibility of developing a robotic platform using cooperative robots with sufficient functionality for performing NOTES procedures [25].…”

Dexterous miniature robot for advanced minimally invasive surgery

“…This device has been used to track surgical tools in real-time and has also been used in multiple animal model surgical procedures. Previous work within our research group has also focused on the development of fully insertable robots with applications for NOTES and SILS, including mobile camera and biopsy robots [25,26], magnetically mounted imaging robots [27], and dexterous robots [28].…”

A statically balanced and bi-stable compliant end effector combined with a laparoscopic 2DoF robotic arm

“…In current robotic platforms the tools, are not manipulated directly by the surgeon anymore, but are held by specialized robot arms and remotely commanded by the surgeon who comfortably sits at an input console, such as in the Intuitive Surgical's da Vinci system (Alterovitz, 2009) and in the RAVEN robotic platform for telesurgery (Lum et al, 2009). An alternative approach is to introduce small robots with embedded actuators inside the body, as demonstrated by several researchers (Rentschler et al, 2006;Hu et al, 2009;Fowler et al, 2010;Lehman et al, 2008;Oleynikov et al, 2005).…”