Evolution of a micro manipulator for minimally invasive neurosurgery

M. Harada , ... K. Takakura , in Homo Friendly Mechatronics, 2001

Surgical robots are useful for minimally invasive surgery, since it enables precise manipulation of surgical instruments beyond human power in a minor operation space. In this approach, we are developing a micro manipulator for minimally invasive neurosurgery. The micro manipulator consists of two micro grasping manipulators, a rigid neuroendoscope, a suction tube, and a perfusion tube. This paper reports on the micro grasping manipulator. It has two D.O.F for angle and one D.O.F for grasping. This epitome is three.1  mm in diameter and can bend thirty degrees in whatever direction. Stainless steel wire was used to actuate the manipulator.

Read full chapter

URL:

https://www.sciencedirect.com/science/article/pii/B9780444506498500140

Robotic Surgery

Pinar Boyraz , ... Marko B. Popovic , in Biomechatronics, 2019

15.1.ane Introduction: Traditional Robotic Surgery

Surgical robots assist during surgical procedures. They take been used since the mid-1980s. Today, the majority of prostatectomies in the United States are robot-aided procedures as chances for successful functioning are higher with robotic aid than without.

Robotic surgeries are typically minimally invasive. This feature has been around long before the introduction of robots. Information technology is a broad concept that encompasses many common procedures, such as a laparoscopic cholecystectomy, or gall float excisions. The procedure refers to a method that avoids long cuts past operating on the body through small (usually 1 cm) entry incisions. Surgeons use long-handled instruments to operate on tissue inside the torso. Such operations are guided by viewing equipment called endoscopes. These are thin tubes with a camera fastened to the stop of it that allows the surgeon to view highly magnified real-fourth dimension three-dimensional images of the functioning site on a monitor.

The current benefits of robotic surgery include better accurateness, precision, dexterity, tremor corrections, scaled motion, and more recently haptic cosmetic feedback. These benefits upshot in more successful surgeries and smaller necessary incision cuts. Overall, the robotic systems take better accuracy and precision than unaided surgeons. Surgical robots are able to position the surgical tools closer to the "correct spot" and deviate less from the "right trajectory." The robot'southward stop-effectors tin can be much smaller and more than dexterous than a human hand. They can record and filter out a surgeon's natural hand tremor and rescale movement to increase precision and reduce the chance for error. Lastly, the robot could restrain the surgeon'due south movement into undesired directions through haptic feedback.

Researchers are formulating new ways to address move and tissue resistance. For example, the surgical robot could synchronically move with a beating heart such that their relative speed is close to zero. Another possible improvement is the power for the robot to automatically accommodate to the dynamical tissue resistance over time as the sensitivity calibration of these processes goes beyond man capabilities.

Typically, robotic surgery can be classified every bit either (i) supervisory-controlled, (2) tele-surgical, or (three) shared-controlled.

The supervisory-controlled arroyo is the virtually automatic of the three methods. The RoboDoc from Integrated Surgical Systems Inc. is an example of a supervisory-controlled organization used in orthopedic surgeries. After the surgeon positions the RoboDoc's bone-milling tool at the correct position inside the patient, the robot automatically cuts the bone to but the right size for the orthopedic implant.

Prior to the surgical procedure, the surgeon needs to prepare the functioning through the planning and registration phase. In the planning phase, images of the patient's body are used to make up one's mind the right surgical approach. Common imaging methods include computer tomography (CT) scans, magnetic resonance imaging (MRI) scans, ultrasonography, fluoroscopy, and X-ray scans. Adjacent, in the registration phase, the surgeon must locate the points on the patient's body that correspond to the images created during the planning phase. These points are matched to a 3D model, which can be updated by images seen through cameras or other existent-time imaging techniques during surgery. After the robot finds the best fit betwixt the model and reality, the surgical procedure is performed.

The tele-surgical arroyo allows the surgical robot to be tele-operated, that is, operated from a distance by a human surgeon. In practice, the robot and the surgeon are only a couple of meters apart. Tele-functioning is too possible beyond larger distances. Nevertheless, bug such as time delays (i.e., tele-surgical latencies) and the available bandwidth (i.e., the corporeality of data that can be transferred per unit of measurement time) demand to be considered.

The tele-surgical approach is used past the da Vinci Surgical System, which was invented past Philip S. Greenish and developed by Intuitive Surgical Inc. This system currently dominates the surgical robot market. Initially dubbed Mona (after Leonardo's Mona Lisa), the organization was rechristened the da Vinci Surgical Robot in 1999; according to Mr. Green "…in laurels of the homo who had invented the starting time robot." Although da Vinci never invented or built a real robot (credit for that goes to Tesla), he made many drawings of various mechanisms.

The da Vinci Organization consists of three primary components: (1) a viewing and control console that is used by surgeon, (2) a vision cart that holds the endoscopes and provides visual feedback and (iii) a surgical robot's manipulator arm unit that includes 3 or four arms, depending on the model. The instruments that are fastened to the artillery are highly specialized. Functions for them include clamping, cutting, suturing, tissue manipulation, cauterizing, etc.

It takes some time for surgeons to get accustomed to the da Vinci System. According to a study, even with initial training programme, provided past the Intuitive Surgical, it takes nigh 12–18 operations before surgeons feel comfortable performing the procedure. Ofttimes, during this period, surgeons complain on lack of tactile force feedback or ability to "feel" the tissue.

The shared-controlled approach refers to the method past which the robot is non simply motion tele-operated as it can decide to resist the surgeons' intended motility if it deems that it would non exist beneficial. Typically, the piece of work infinite is split into several segments and the system behaves differently based on different localization according to safe, close, boundary, or forbidden classification. For example, if surgeon moves a cutting tool in the management of tissue that should not be damaged, the robot volition apply the force haptic feedback that will grow stronger equally the cutting tool comes closer to the fragile tissue. In other words, here, surgeon once again "feels" the virtual representation of tissue that may take preprogrammed specifications different from the real tissue likewise as somewhat dissimilar localization in space.

Read full chapter

URL:

https://www.sciencedirect.com/science/article/pii/B978012812939500015X

Robin Middle surgical robot: Description and future challenges

Zbigniew Nawrat , in Command Systems Design of Bio-Robotics and Bio-mechatronics with Advanced Applications, 2020

5.4 Software ergonomics

A surgical robot is now more a mechatronic tool than an IT (information technology) tool. However, the challenges of appropriate decision-making flexibility and precision (especially in the absenteeism of professional person staff in the conditions of demographic problems) indicate that the direction of development toward autonomous (partly or fully) medical robots is the about upwardly-to-appointment. The thought of spaceflight and establishing bases in distant objects from Earth and the need to secure medical service has likewise returned.

The principles of ergonomics should be applied when creating software—ensuring the effectiveness, efficiency, and satisfaction of the employee. These three backdrop make up the software utility. Let us mention a few principles (called heuristics) of software ergonomics: feedback (for each action at that place should be a reaction or system information); availability (providing tools and information according to the user's needs); simple and natural dialogue; application of the user'south language (linguistic communication of symbols from the user's environment); reducing the load on short-term retentivity (no need to memorize a lot of information); confirmation of activities (information on the outcome of activities); and emptying of errors. The software created every bit part of the Robin Centre project meets these principles.

The problems discussed are the fundamental to edifice the proper telemanipulator control system and software. Man, the operator of a surgical robot, can be treated equally an element of the control organization (nosotros accept into account both the processing of information in the brain and its dependent motor coordination of precise command—motion control, position, speed, and forcefulness—through the robot interfaces) connected by the system It and functioning of the robot electromechanical organisation with an executive tool. In terms of artificial organs—and so y'all can treat the robot (equally a prosthesis, prolonging the surgeon's manus)—it is a hybrid organ (considering it is necessary for proper operation to use cells, natural organs, simply man-operator) (Nawrat, 2011).

Read total chapter

URL:

https://www.sciencedirect.com/scientific discipline/article/pii/B9780128174630000034

Robotic interventions

Sang-Eun Vocal , in Handbook of Medical Epitome Calculating and Reckoner Assisted Intervention, 2020

34.3 Master–slave organisation

Teleoperated surgical robots provide superior instrumentation and versatile motion through minor incisions controlled by the physician. Typically, the physician manipulates an ergonomic chief input device in a visualization environment (physician console) and these inputs are translated into motion by a 3D vision organization (endoscope) and wristed laparoscopic surgical instruments. The major advantage over the traditional (mitt operated) surgical method is that it can compensate for man hand tremors and tin can likewise minimize the manus motion for surgical tasks, thereby reducing procedure fourth dimension.

da Vinci [fourteen,15] is used in multiple fields of surgery such as caput and neck, thoracic, colorectal, gynecology, and urology in the form of laparoscopic surgery. The robot is equipped with iii or 4 robotic artillery. Incisions will be fabricated for each instrument. 1 of the arms will exist equipped with a 3D endoscope that displays on the visual system. In order to reduce trauma, the arms motion around a stock-still pivot signal. Dissimilar instruments are designed with a specific purpose. Contempo advancements include a single port organisation shown in Fig. 34.2.

Figure 34.2

Effigy 34.2. da Vinci SP arrangement for single incision (port) robotic surgery. The robot provides three fully-wristed, elbowed instruments through a unmarried two.5 cm cannula. © 2019 Intuitive Surgical.

Monarch platform [16,17] past Auris is intended for diagnostic and therapeutic bronchoscopic procedures. The teleoperated endolumenal robot can navigate inside the body, image, and treat atmospheric condition without making incisions. Monarch Platform is a neither a haptic feedback nor monitoring tool, equally the robot only transmits visual information to the physician. Information technology is not autonomous. Monarch Platform uses a custom controller to let the medico to directly control the endoscope as the doctor navigates the lungs. Visual feedback is given from the endoscope as well as an image brandish for navigation. The robot is mounted on a stationary platform that controls the feed rate of the endoscope. The feed rate and navigation are all controlled by the physician at the visual platform in a master–slave human relationship.

Virtual Incision'due south miniaturized robot [xviii] is used for gastrointestinal operations. The Virtual Incision robot is inserted into the abdominal cavity after an incision is made at the omphalos. The ii-arm manipulator robot, equipped with an HD photographic camera, performs the operation inside the belly. It is mounted onto the side of the operating tabular array with an adjustable positioning arm. Virtual Incision provides neither haptic feedback nor monitoring. Information is received through a monitor organization for arm positioning. Video footage shows physicians controlling the robot with two Geomagic Bear on devices and a custom principal device. The slave device is a telemanipulator using a wireless connection betwixt the main–slave system. Video is streamed from the Hard disk drive camera for an endoscope prototype-based navigation.

Revo-I [19,20] is a laparoscopic surgical robot. Revo-I has been marketed in South Korea to be more than cost effective than the da Vinci of Intuitive Surgical. Like da Vinci, Revo-I is a 4-arm robotic platform with one arm equipped with a 3D camera. Different end effector attachments allow customization of the operating process. It is currently designed with tactile feedback, which results in decreased grasping strength but improved functioning. Haptic feedback will exist implemented in future revisions after development of kinesthetic feedback is added. A periscopic control station is used by the physician for the custom master device in the primary–slave system with visual imaging used for navigation.

Avatera [21] is based on a 4-arm robot platform pattern with interchangeable tools. Avatera is still in early evolution so little is known equally to whether haptic feedback or monitoring systems will be used. Imagery shows a command unit with an HD monitor for open display too as a periscopic side periphery.

ARTAS [22] is a hair restoration robot developed by Restoration Robotics Inc. It restores pilus to a patient's caput through the transplantation of hair follicles. A dissecting punch removes sections of healthy hair follicles and grafts the hair by inserting the plugs at the transplant location. A robot arm and guidance system determine the angle and location of the operating tool while post-obit the doctor's operative plan. ARTAS operates via a monitoring style system with a standard chief device that allows control through a keyboard or touch interface. The robot arm acts as a telemanipulator and operates semiautonomously.

Canady Hybrid Plasma Scalpel [23] is also a laparoscopic surgical robot. Canady Robotic Surgical System's chief tools are the Canady Flex Lapo Wrist and Canady Hybrid Plasma Scalpel. The Lapo Wrist is a vii DOF, direct operated surgical musical instrument with a grasping tool at the end. The Plasma Scalpel delivers a axle that simultaneously cuts and coagulates the operating tissue. Canady Robotic Surgical System is neither haptic nor monitoring, as the physician receives optical feedback from an endoscope. The Canady is a true easily-on organization with the physician straight manipulating the instruments.

Overall, master and slave type surgical robots are found in large numbers due to the fact that they combine the performance and precision of a robot while allowing the surgeon, who is practiced in performing that item surgical activity, to maintain overall control.

Read total affiliate

URL:

https://www.sciencedirect.com/scientific discipline/article/pii/B9780128161760000399

Haptics in Surgical Robots

Peter Culmer , ... David Jayne , in Handbook of Robotic and Image-Guided Surgery, 2020

xv.2.2.1 General surgery: Senhance

Senhance is a surgical robot platform developed for laparoscopy, originally conceived and developed by the Joint Research Centre of the European Commission in collaboration with SOFAR SpA (Italian republic) as the Telelap Alf-x and afterward rebranded every bit Senhance surgical robot system when the technology was acquired by TransEnterix (Morrisville, North Carolina, United States). The organization was approved for general surgical procedures in Europe in 2012 and obtained FDA approving for the U.s.a. in 2017 [55,57].

There is niggling detailed technical information on the Senhance system, only the capabilities of the system can be inferred from a series of publications evaluating its clinical efficacy (see Section xv.two.3). The system was designed to be both cost-effective and to minimize disruption to existing operating theater environments and workflows. Instruments are held past a series of up to 4 robot arms, each situated on individual mobile carts to allow a flexible configuration around the patient. Senhance promotes that its instruments are similar to those used in transmission laparoscopy, designed to promote familiarity with the surgeon they also lack the additional "wristed" degrees of freedom (DoFs) institute in competing systems similar da Vinci [58]. The surgeon sits at a console providing iii-dimensional (3D) visualization, eye-tracking control of the endoscope, and haptic feedback via two forcefulness feedback manipulators which resemble laparoscopic instruments [55,57]. The manipulators transmit grasp force, enabling tissue consistency, or object manipulation, to be felt by the surgeon [57]. It is reported that the capabilities are instructive during thread and needle manipulation when suturing [58].

Read total chapter

URL:

https://www.sciencedirect.com/science/article/pii/B9780128142455000153

Robotics for minimally invasive surgery (MIS) and natural orifice transluminal endoscopic surgery (NOTES)

J. Reynoso , ... D. Oleynikov , in Medical Robotics, 2012

9.3 Natural orifice transluminal endoscopic surgery (NOTES)

Natural orifice transluminal endoscopic surgery (NOTES) utilizes natural orifices to access the peritoneal cavity. The feasibility of the NOTES technique was demonstrated in creature studies utilizing peroral gastrotomy, transurethral cystotomy, transvaginal and transcolonic approaches. several procedures including organ resection, gastrojejunostomy, gastrojejunal anastomosis, oopherectomy, salpingectomy, cholecystectomy and appendectomy accept been performed in animal studies. NOTES cholecystectomy, appendectomy and nephrectomy have since been performed in humans (santos and Hungness, 2011).

Initially, a standard flexible endoscope was introduced through a NOTES incision, to visualize the intraperitoneal cavity. This approach has several inherent limitations when compared with open up or laparoscopic surgery. Triangulation is lost when the standard endoscopic channels are used, as the instruments passed though these ports are in line with the videoimaging. In this configuration, forces must be practical off-axis in order to combat this limitation. one is also express by the bachelor instruments that may pass through the endoscope. Dexterity is significantly decreased owing to the constraints of this platform. To overcome these constraints, prototypes such as the EndoSAMURAI (Olympus Corp., Tokyo, Japan) have been adult. This endoscopic platform has two independent finish effectors with five degrees-of-liberty, besides as a standard endoscopic channel. The operator interface includes controllers which are very similar in design to standard laparoscopic handles. An overtube has been used with this device to increase stability. The EndoSAMURAI has been used in NOTES porcine cholecystectomy via the transgastric approach and has been demonstrated in benchtop experiments to exist able to perform surgical tasks such as suturing and knot-tying (Spaun et al., 2009). The Send multichannel access device (USGI Medical, san Clemente, CA, United states of america) is an endoscope with four ports (6, 6, 4 and 4   mm) available for passing flexible instruments. This device has been used in clinical studies to perform transgastric appendectomy, transumbilical appendectomy and endoluminal pouch and stoma reduction (Horgan et al., 2011). The Anubiscope (Karl-storz, Tuttlingen, Deutschland) is a flexible endoscopic platform for NOTES that has a light and video source. The articulating head contains two opposing movable arms, capable of triangulation, that contain ii 4.2   mm working channels. The distal head has jaws that open to reveal the functioning artillery but when closed serve as a edgeless tipped trocar during insertion (Dallemagne and Marescaux, 2010). The Straight-Drive Endoscopic System (Boston Scientific, Natick, MA, Us) has iii lumens through which interchangeable 4   mm flexible instruments tin can be inserted. Available flexible instruments include graspers, scissors, needle drivers and cautery. This flexible laparoscopic multitasking platform is capable of 7 degrees of freedom. This device is controlled by rails-guided bulldoze handles and has a sheath that can lock into position (Shaikh and Thompson, 2010).

The master and slave translumenal endoscopic robot (Chief) developed past Phee et al. (2010) at the National University of Singapore represents some other novel solution to the decreased dexterity inherently found in the endoscopic NOTES platform. It is similar to the EndoSAMURAI in that information technology has two robotic arms which cap the end of an endoscope. Nonetheless, with the MASTER, any standard upper endoscope may be outfitted with these robotic arms that are capable of tissue manipulation, triangulation, off-axis forces and monopolar cautery. Mechanical forces are applied to the end effectors through a tendon-sheath power transmission mechanism which allows for nine degrees of freedom. The surgical interface is a 'passive, steerable, motion-sensing exoskeleton with 2 articulating arms'. The surgeon'south hand and wrist movements are directly mirrored by the robotic grasper and cautery end effectors. In a porcine animal study, this organisation was able to perform a transgastric hepatic wedge resection with minimal bleeding. All imaging and lighting was provided by a standard upper endoscope. A sterile endotube was placed through the esophagus. The gastrotomy was created using the monopolar cautery of the robotic arm. The standard upper endoscope was retroflexed in the peritoneal cavity to provide the surgical robot admission to the liver. Tissue retraction provided access for the robotic cautery arm to excise a suitable liver sample. The specimen was then extracted though the oral cavity. The gastrotomy was non airtight in this not-survivable fauna study ( Phee et al., 2010).

The standard NOTES flexible endoscope platform is unstable, and forces practical to the target organ are transmitted to the endoscope. This results in a need to continually reposition the endoscope. To overcome the instability produced by flexible endoscopes passed through a hollow lumen, fixation and stiffening of the endoscope has been employed. A flexible robotics platform aims to drive a stiffened endoscope through a 3D space with calculator assist. At the Stanford University School of Medicine, a prototype has been demonstrated by Eisenberg et al. (2010) to be feasible in cadaver studies in which a multichannel flexible robotic endoscope was navigated using a joystick interface. Transgastric intraperitoneal access was achieved, and the platform was able to tolerate forces generated by tissue manipulation and endoclipping. Imaging was provided by the endoscope for this report. Additionally, the endoscope was repositioned without difficulty for access to dissimilar target organs.

The dVSS has been used to perform a robot-assisted NOTES nephrectomy in a porcine model, although an additional transabdominal port was placed for laparoscopic visualization. Intraperitoneal admission was achieved via transvaginal and transcolonic placement of the robotic artillery. The renal avenue and vein were dissected using the robot so transected using standard vascular endoscopic staplers through the vaginal port. The kidney was removed through the vagina. The NOTES technique with the dVSS was also utilized for a porcine pyeloplasty.

Use of the dVSS for NOTES has been confined to animal written report and has not been used to date in humans. Although the surgical system provides several advantages, such as multiple degrees of freedom, increased dexterity and stereovision, its size has precluded a widespread application of the dVSS for NOTES. Additionally, the robotic artillery are prone to collide and do not adjust to the geometry of the intraperitoneal space. For this reason, novel prototypes, as described below, have been created to further develop a robotic platform for NOTES.

nine.3.i Miniature surgical robots for NOTES

Miniature in vivo surgical robots offer an culling solution to the inherent limitations of NOTES. Every bit previously mentioned, the flexible endoscopic and flexible robotics platform for NOTES are constrained by the distribution of instruments through a hollow visceral lumen into the abdominal cavity while all the same coupled to external control. Multiple miniature robots may exist serially deployed through a single transvisceral access, allowing for a virtually unlimited number of surgical instruments. in this paradigm each miniature robot can serve a separate function, a distinct advantage over any unmarried instrument that must provide all functionality. separate robots may provide imaging, lighting, tissue manipulation, and mobility. A family unit of these robots can cooperate to perform a NOTES procedure, and take done so in experimental models ( Tiwari et al., 2010). standard upper endoscopes have been used to place an esophageal overtube through which these miniature robots have been sequentially placed in the stomach and and so into the abdominal cavity. The gastrotomy is created with a standard endoscopic needle knife.

Initial prototypes of in vivo miniature robots for NOTES included a fixed-base imaging robot meaning, once placed, it was unable to self navigate to an alternative intraperitoneal position. The creation and use of the pan and tilt camera has resolved this navigational barrier. This fifteen   mm metallic cylinder has three retractable legs, which provide stability when this device is placed on its end. Ii independent motors afforded 360° panning and 45° tilting capability. However, the motor originally used for the panning mechanism was later employed for image focusing. visual feedback from this instrument was used in a porcine cholecystectomy.

Advancing this applied science further are self navigating, mobile robots powered by two helical-profiled wheels. Each wheel moves independently, allowing for forrard, contrary and turning motions. initial prototypes included a cylindrical robot that measured 15   mm in diameter and 75   mm in length (Fig. 9.3). The small diameter allows this mobile imaging robot to be hands deployed through a transgastric incision or a small abdominal incision. The condom and feasibility of this design was demonstrated in animal studies. The side by side paradigm of this pattern included a camera, and the bore was increased to 20   mm. The mobile adaptable-focus robotic camera (MARC) was able to transverse the deformable intraperitoneal cavity utilizing the dual helical-profiled wheel pattern. During a porcine cholecystectomy, this miniature imaging robot supplied the sole video required to consummate the process.

9.3. In vivo miniature robot for NOTES.

In a subsequent prototype, the mobile in vivo surgical imaging robot was augmented with a 2.four   mm broad robotic grasper. All of the imaging and mobility capabilities inherent in previous designs were present in this blueprint. The strength generated from powered wheels was sufficient to procure a tissue biopsy. The camera on this miniature robot was used for visual feedback while selecting a porcine hepatic biopsy site. This robot was deployed in animate being studies through the intestinal wall and demonstrated self navigation, imaging and tissue biopsy adequacy.

The mobile endoluminal robot was the beginning in vivo miniature surgical robot to exist used in a NOTES process. In a porcine study, a standard upper endoscope was introduced per ora into the stomach, and a sterile esophageal overtube was placed with direct visualization. The 12   mm (diameter) and 75   mm (length) miniature robot explored the gastric cavity under endoscopic imaging. A gastrotomy was created with an endoscopic needle-knife and this robot was placed into the intraperitoneal space. Utilizing the same helical-profiled wheels design, the robot was able to cocky navigate over the liver and the deformable territory of the porcine intestines. Visualization was provided via the endoscope. After this robot was retracted back into the stomach, the gastrotomy was closed with two standard endoclips and one endoloop.

In vivo co-operative robots represent the side by side footstep in NOTES prototypes. In this concept, the functions of imaging, lighting and tissue manipulation are executed separately past a family of robots. Equally previously demonstrated, these miniature robots were deployed into the porcine intraperitoneal space through a sterile esophageal overtube. A standard upper endoscope was used to create a gastrotomy using a needle-knife. The lighting, imaging and retraction robots were serially placed into the abdominal cavity and held in place against the intestinal wall using magnets. Using this technique, the family of co-operative robots was able to dispense tissue nether their own lighted imaging. These initial prototypes were tethered by wires for both ability source and control. Currently in development at the University of Nebraska are in vivo miniature robots, powered by on-board batteries and radio-controlled.

These initial NOTES porcine experiments included miniature robots with minimal ability to manipulate tissue. The in vivo dexterous robot was designed to improve dexterity. Six degrees of freedom were accomplished with two artillery fastened to a key trunk. Ane arm was fitted with monopolar cautery and the other a grasper. Triangulation is fabricated possible by stereovision cameras placed on the body of the robot between the two arms. A lower arm telescopes in and out of the upper arm, which is attached to the body via a rotational shoulder joint. Robotic arms were remotely controlled at a surgical console consisting of ii analog joysticks and a pes pedal that controlled the monopolar cautery. The feasibility of NOTES cholecystectomy was demonstrated over several fauna studies. Transabdominal and transgastric placement were both employed. Using the onboard imaging, the porcine gallbladder was dissected free from its hepatic attachments and the cystic duct was severed. Transabdominal magnets were used to maintain the robot's position. The ability to triangulate, employ off-axis forces, provide visualization and dexterously manipulate tissue was demonstrated in these in vivo dexterous robot brute studies.

Every bit previously mentioned, in current prototypes of this multifunctional dexterous robot, the SILS technique has been employed. The proficiency of both the surgical robot and the surgical console has increased significantly, and circuitous tasks such as intracorporeal suturing are now possible. Continuing design of this robot includes decreasing size, increasing the adequacy of the surgical interface, and expanding the surgical applications to more complex procedures such as colectomy.

Read full chapter

URL:

https://www.sciencedirect.com/science/article/pii/B9780857091307500090

South-Surge: A Portable Surgical Robot Based on a Novel Machinery With Force-Sensing Capability for Robotic Surgery

Uikyum Kim , ... Hyouk Ryeol Choi , in Handbook of Robotic and Prototype-Guided Surgery, 2020

16.v Implementation

16.5.i Surgical manipulator

We implemented the surgical robot using the designs of the above robots and instruments. Fig. xvi.nine shows an assembled RCM manipulator with iii-DoF motion forming a cone with a vertex angle of 90 degrees.

Figure 16.9. Implementation of the proposed surgical manipulator.

The robot consists of three brushless DC (BLDC) motors and four DC motors for controlling the RCM robot and instrument, respectively, controlled in position control manner. Three viii-West BLDC motors are used as linear actuators (EC-max 16, Maxon Motor AG, Switzerland). BLDC motors were chosen because of their high power density, which provides 8   W of continuous power at a xvi-mm diameter. For linear motility, we utilise a commercial ball-spiral mechanism (Spindle drive GP sixteen, Maxon Motor AG, Switzerland), which includes a 5.4:1 planetary gear head. For angular and insertion movements, the ball screws accept a pitch of 2   mm and a length of 200   mm. We use a iii-aqueduct 512-pulse/speed encoder for position measurement (MR, Maxon Motor AG, Switzerland). The linear movement has a resolution of 256 pulses/mm. For the position control of BLDC motors, nosotros apply a commercial motor controller (EPOS2, Maxon Motor AG, Switzerland).

And then, in the manipulator, we include the drive module for the actuation unit of the instrument. From Fig. xvi.9, we apply grooves to transmit power to the joints of the instrument. Fig. xvi.ix shows how four DC motors (DC1724, Faulhaber Mini-Motor SA, Switzerland) are embedded in the drive module to start the instrument. The DC motor is besides controlled past two position controllers embedded in the bulldoze module. The DC motor is controlled by an embedded position controller in the instrument drive unit of measurement. Owing to the limited infinite of the instrument bulldoze unit, nosotros developed a new DC motor controller that tin command dual DC motors in a single circuit. As a driver, we employ the L6205, a DMOS dual full-span driver (ST Micro, United States); information technology tin can provide 2.8   A for each channel. For controller fries, we employ an STM32F103 (ST Micro, The states) microcontroller, which has a Cortex M3 architecture and operates at 70   MHz. Nosotros perform the position control of the DC motors based on a traditional proportional-integral derivative command scheme. In order to drive iv DC motors, two of the controller's drive units are stacked. In improver, three low-level controllers for linear actuators are connected to the host PC using universal serial autobus (USB) communication (version ii.0). Two DC motor controllers utilise a control area network (Can) for communication between loftier-level controllers.

For linear actuators, we connect three low-level controllers to the host PC using a USB link (version 2.0). Ii DC motor controllers utilize Tin can to communicate between the loftier-level controllers. Similarly, the force sensor controller shares the CAN coach to transmit the measured force information to the high-level controller.

16.5.two Sensorized surgical instrument

Fig. 16.10 shows an assembled sensor surgical instrument for mounting a four-centrality forcefulness-sensing system. To measure the force sensing, a three-centrality force sensor and two torque sensors are integrated into the wrist and actuation unit of measurement, respectively. Four joints (rolling, wrist, and two gripping joints) are placed at the end of the musical instrument. Based on the tendon-driven actuation mechanism, the joints and pulleys in the actuation unit are connected by a drive cable. The range of motion and transmission of each joint are shown in Tabular array 16.2. Furthermore, the information nigh the drive module of the instrument joint is explained higher up. The knobs shown in Fig. 16.10 are used to receive power from the drive module of the manipulator.

Figure xvi.10. Implementation of the sensorized surgical instrument.

The capacitance generated in the sensor is measured past a single-chip configuration of a capacitance-to-digital converter (AD7147, Analog Devices Inc., MA). The sampling frequency and sensing range are one.three   kHz and 16   pF, respectively. The chip is integrated in the sensor. Fig. sixteen.ten shows the implemented force sensor controller. In the controller, nosotros use an STM32F103 controller scrap as the controller bit. The controller contains two I 2 C channels that detect the measured force from the iii-axis force sensor and ii torque sensors.

xvi.5.three Entire surgical robot: S-surge

Fig. 16.11 shows an assembled surgical robot consisting of an RCM manipulator and musical instrument. The robot has seven-DoF motion and 4-axis force sensing. Information technology weighs 4.7  kg and measures 34×18×20   cm3. Tabular array xvi.iii lists the detailed specifications of the robot.

Figure xvi.11. Implementation of the entire surgical robot called "S-surge" and comprising the developed manipulator and instrument.

Table 16.three. Specifications of the adult surgical robot.

Quantity Value
Weight 4.vii   kg
Maximum workspace ninety degrees circular cone (radius of 15   cm)
Degrees of freedom 7
Force sensing Four-centrality force
Ability consumption 34   Due west

Read full chapter

URL:

https://world wide web.sciencedirect.com/science/article/pii/B9780128142455000165

Robotic Retinal Surgery

Emmanuel Vander Poorten , ... Iulian Iordachita , in Handbook of Robotic and Prototype-Guided Surgery, 2020

36.5.vii General considerations with respect to safety and usability

Regardless of the surgical robot used, at that place is still a chance of human error, which may pb to iatrogenic trauma and blindness. For instance, excessive tool pivoting around the entry incision may lead to astigmatism, wound leak, or hypotony. Adventitious motions of the tool may still puncture the retina or cause bleeding, or fifty-fifty bear on the intraocular lens and cause a cataract [180]. All of these risks are indeed present, since the previously described robotic systems exercise not demonstrate "intelligence," they merely replicate or calibration-downwardly the motions of the commanding surgeon. Thus, robots can improve surgical dexterity but not necessarily surgical performance. Functionalization of the tools with strength or pressure level sensors, also every bit ophthalmic prototype processing, can improve the perception of the surgeon and enable him/her to link with artificial intelligence algorithms toward further improving the success charge per unit of interventions.

A typical step in retinal surgery is a rotation of the eye in its orbit to visualize different regions of the retina. This is accomplished by applying forces at the scleral trocars with the instrument shafts. When done bimanually, surgeons have force feedback to ensure that their hands are working together to attain the rotation, without putting undue stress on the sclera. When using more than one robotic manipulator in retinal surgery, whether in a cooperative or teleoperated paradigm, the control arrangement must ensure that the robots work in a coordinated fashion. This kinematically constrained trouble is solved in Ref. [142].

Further, all teleoperation systems and especially systems using curved and shape-changing instruments or untethered agents require retraining of the surgical personnel to get accustomed to this remote-manipulation epitome, which may disrupt surgical workflow. Many of the master interfaces have been designed to brand this transition every bit intuitive equally possible, and are based on either recreating the kinematic constraints of handheld and cooperative-control systems (i.due east., with the surgeon'due south manus on the instrument handle outside of the eye) or on creating kinematics that effectively place the surgeon's hand at the end-effector of the instrument inside the eye (with the kinematic constraint of the trocar explicitly implemented in the interface). However, recent work suggests that placing the surgeon's hand at the stop-effector of the instrument, only not explicitly presenting the kinematic constraints of the trocar to the user, may lead to improved performance, probable due to the improved ergonomics that information technology affords [181].

Read full chapter

URL:

https://www.sciencedirect.com/science/article/pii/B9780128142455000360

Slender snake-like endoscopic robots in surgery

Shumei Yu , ... Hongliang Ren , in Flexible Robotics in Medicine, 2020

1.3.2 Statics and dynamics

A ophidian-similar surgical robot's static modeling solves the relationship of the force, moment, and deformation. For tendon-driven snake-similar surgical robots, statics is usually combined with kinematics when Cosserat Rod Theory is applied in the modeling. Based on Cosserat Rod Theory, Gao et al. [17] built a shape prediction model for a helical bound backboned snake robot, in which the deformation of the robot is related to the tendon force, friction strength, and external forces. Lumped-parameter model is an culling ground for static analysis, for example, Kato et al. [sixteen] congenital the tension propagation model with friction between the wires and the robot body. The principle of virtual piece of work was used to compute the actuation force on building a load transmission model in the work of Roy et al. [48]. Dong et al. [29] analyzed the cable tension and stiffness of a compliant articulation backboned snake robot based on the Jacobian. A dynamic model to compensate for the uncertainty and asymmetry has been proposed by Haraguchi et al. [31] past defining the driving forces related to the bending angle, friction force, and elastic forces.

Read full chapter

URL:

https://www.sciencedirect.com/science/article/pii/B9780128175958000171

Single-port multichannel multi-caste-of-freedom robot with variable stiffness for natural orifice transluminal endoscopic surgery

Changsheng Li , ... Hongliang Ren , in Flexible Robotics in Medicine, 2020

17.two.2 System overview

Fig. 17.1 presents a surgical robot with variable stiffness for NOTES. This robot is composed of two same manipulators attached to an endoscopic platform and a driver. The endoscopic platform has 2 channels with the diameters of 2.8 and 3.8   mm for surgical tools, respectively, a aqueduct for the camera, and 2 channels for the air/water nozzle. The diameter of each manipulator is 3.half-dozen   mm, with 6 DOFs. The distribution of the manipulator DOFs in Fig. 17.two includes three parts: a compliant arm, a flexible wrist joint, and a gripper. The stiffness of the compliant arm with 2 DOFs tin be tuned in real-time during the operation to fulfill the accuracy and safety requirements of the surgery environment. The wrist joint is flexible with 1 DOF. The gripper can bend in a wide range with 2 DOFs. A spiral motor–based driver drives the manipulators via Bowden cables. The primary parameters of each manipulator are summarized in Table 17.1.

Figure 17.1. Surgical robotic arrangement with variable stiffness for NOTES. (A) 3D model. (B) Prototype.

Effigy 17.2. The distribution of the DOFs. (A) DOF 1: translation forth the centrality. (B) DOF 2: abduction. (C) DOF 3: adduction. (D) DOF four: bending of the wrist. (Due east) DOF v: angle of the forceps. (F) DOF vi: grasping of the forceps.

Table 17.one. Main parameters of the robotic arrangement.

Parameters Values Units References
Channels 3 – A minimum of three endoscopic channels [15]
Length 40 mm –
The bore of the manipulator 3.vi mm The size of the electric current robotics for NOTES mainly ranges from ∅5 to ∅xiv [xvi]
Angle angle of the arm 30 Degrees –
Angle bending of the wrist joint ±90 degrees – –
DOF 6 for each manipulator – DOFs should not be less than 4 [14]
Drive way Bowden cable – –
Textile 45# steel – –
Features Compliance; variable stiffness – –

Read full chapter

URL:

https://www.sciencedirect.com/science/article/pii/B9780128175958000183