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Hamza H, Baez VM, Al-Ansari A, Becker AT, Navkar NV. User interfaces for actuated scope maneuvering in surgical systems: a scoping review. Surg Endosc 2023:10.1007/s00464-023-09981-0. [DOI: 10.1007/s00464-023-09981-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/25/2023] [Indexed: 03/29/2023]
Abstract
Abstract
Background
A variety of human computer interfaces are used by robotic surgical systems to control and actuate camera scopes during minimally invasive surgery. The purpose of this review is to examine the different user interfaces used in both commercial systems and research prototypes.
Methods
A comprehensive scoping review of scientific literature was conducted using PubMed and IEEE Xplore databases to identify user interfaces used in commercial products and research prototypes of robotic surgical systems and robotic scope holders. Papers related to actuated scopes with human–computer interfaces were included. Several aspects of user interfaces for scope manipulation in commercial and research systems were reviewed.
Results
Scope assistance was classified into robotic surgical systems (for multiple port, single port, and natural orifice) and robotic scope holders (for rigid, articulated, and flexible endoscopes). Benefits and drawbacks of control by different user interfaces such as foot, hand, voice, head, eye, and tool tracking were outlined. In the review, it was observed that hand control, with its familiarity and intuitiveness, is the most used interface in commercially available systems. Control by foot, head tracking, and tool tracking are increasingly used to address limitations, such as interruptions to surgical workflow, caused by using a hand interface.
Conclusion
Integrating a combination of different user interfaces for scope manipulation may provide maximum benefit for the surgeons. However, smooth transition between interfaces might pose a challenge while combining controls.
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De Pauw T, Kalmar A, Van De Putte D, Mabilde C, Blanckaert B, Maene L, Lievens M, Van Haver AS, Bauwens K, Van Nieuwenhove Y, Dewaele F. A novel hybrid 3D endoscope zooming and repositioning system: Design and feasibility study. Int J Med Robot 2019; 16:e2050. [PMID: 31677219 DOI: 10.1002/rcs.2050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 09/12/2019] [Accepted: 10/11/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND Manipulation of the endoscope during minimally invasive surgery is a major source of inconvenience and discomfort. This report elucidates the architecture of a novel one-hand controlled endoscope positioning device and presents a practicability evaluation. METHODS AND MATERIALS Setup time and total surgery time, number and duration of the manipulations, side effects of three-dimensional (3D) imaging, and ergonomic complaints were assessed by three surgeons during cadaveric and in vivo porcine trials. RESULTS Setup was accomplished in an average (SD) of 230 (120) seconds. The manipulation time was 3.87 (1.77) seconds for angular movements and 0.83 (0.24) seconds for zooming, with an average (SD) of 30.5 (16.3) manipulations per procedure. No side effects of 3D imaging or ergonomic complaints were reported. CONCLUSIONS The integration of an active zoom into a passive endoscope holder delivers a convenient synergy between a human and a machine-controlled holding device. It is shown to be safe, simple, and intuitive to use and allows unrestrained autonomic control of the endoscope by the surgeon.
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Affiliation(s)
- Tim De Pauw
- Department of Neurosurgery, Ghent University Hospital, Ghent, Belgium
| | - Alain Kalmar
- Department of Anesthesia and Intensive Care Medicine, Maria Middelares Hospital, Ghent, Belgium
| | - Dirk Van De Putte
- Department of Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium
| | - Cyriel Mabilde
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
| | - Bart Blanckaert
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
| | - Lieven Maene
- Department of Thoracic and Vascular Surgery, Onze-Lieve-Vrouw Hospital, Aalst, Belgium
| | - Mauranne Lievens
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
| | | | - Kevin Bauwens
- Division of Robotic Surgery and Training, ORSI Academy, Melle, Ghent, Belgium
| | - Yves Van Nieuwenhove
- Department of Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium
| | - Frank Dewaele
- Department of Neurosurgery, Ghent University Hospital, Ghent, Belgium
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Gruijthuijsen C, Borghesan G, Reynaerts D, Poorten EV. A Hybrid Active/Passive Wrist Approach for Increasing Virtual Fixture Stiffness in Comanipulated Robotic Minimally Invasive Surgery. IEEE Robot Autom Lett 2019. [DOI: 10.1109/lra.2019.2923950] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Abstract
SUMMARYA new minimally invasive surgical (MIS) robot consisting of a spherical remote center motion (RCM) mechanism with modular design is proposed. A multi-objective dimensional synthesis model is presented to obtain the excellent performance indices. There are four objectives: a global kinematic index, a compactness index, a global comprehensive stiffness index, and a global dynamic index. Other indices characterizing the design requirement, such as workspace, mechanical parameter, and mass, are chosen as constraints. A new decoupled mechanism is raised to solve the coupled motion between the linear platform and the four degrees of freedom (DoF) of surgical instrument as a result of post-driving motors. Another new mechanical decoupled method is proposed to eliminate the coupled motion between the wrist and the forceps, enhance the dexterity of surgical instrument, and improve the independence of each motor. Then, a 7-DoF MIS robotic prototype based on optimization results has been built up. Experiment results validate the effectiveness of the two mechanical decoupled methods. The position change of the RCM point, accuracy, and repeatability of the MIS robot meet the requirements of MIS. Successful animal experiments validate the effectiveness of the novel MIS robot.
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Tadano K, Kawashima K. A pneumatic laparoscope holder controlled by head movement. Int J Med Robot 2014; 11:331-340. [PMID: 25156175 DOI: 10.1002/rcs.1606] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2014] [Indexed: 11/06/2022]
Abstract
BACKGROUND In traditional laparoscopic surgery, the laparoscope is handled by a camera assistant according to verbal instructions from the surgeon. Thus there is a strong need for a laparoscope holder who intuitively provides the appropriate view with excellent stability. METHODS A pneumatically driven robotic arm was developed to hold and manipulate a laparoscope. The robotic arm is operated by the user's head movement, which is measured with gyroscopes attached to the operator's head and body. RESULTS We confirmed experimentally that head tracking can be performed accurately using the proposed method. The experimental results indicated that the robotic camera holder has sufficient dynamic characteristics to quickly follow the operator's head movement. CONCLUSIONS A laparoscope holder control system has been developed. In this system, a laparoscope is held by a pneumatically driven robotic arm that is controlled to follow the operator's head movement. The experimental results prove the effectiveness of the system. Copyright © 2014 John Wiley & Sons, Ltd.
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Affiliation(s)
- Kotaro Tadano
- Precision and Intelligence Laboratory, Tokyo Institute of Technology, 4259 Nagatsuta-cho, Midori-ku, Yokohama, Kanagawa, 226-8503, Japan
| | - Kenji Kawashima
- Precision and Intelligence Laboratory, Tokyo Institute of Technology, 4259 Nagatsuta-cho, Midori-ku, Yokohama, Kanagawa, 226-8503, Japan
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Solo Surgeon Single-Port Laparoscopic Surgery With a Homemade Laparoscope-Anchored Instrument System in Benign Gynecologic Diseases. J Minim Invasive Gynecol 2014; 21:695-701. [DOI: 10.1016/j.jmig.2014.02.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 01/25/2014] [Accepted: 02/01/2014] [Indexed: 11/15/2022]
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Rosa B, Gruijthuijsen C, Van Cleynenbreugel B, Sloten JV, Reynaerts D, Poorten EV. Estimation of optimal pivot point for remote center of motion alignment in surgery. Int J Comput Assist Radiol Surg 2014; 10:205-15. [PMID: 24830535 DOI: 10.1007/s11548-014-1071-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 05/02/2014] [Indexed: 11/24/2022]
Affiliation(s)
- Benoît Rosa
- KU Leuven, Department of Mechanical Engineering, 3001 , Leuven, Belgium,
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Gillen S, Pletzer B, Heiligensetzer A, Wolf P, Kleeff J, Feussner H, Fürst A. Solo-surgical laparoscopic cholecystectomy with a joystick-guided camera device: a case-control study. Surg Endosc 2013; 28:164-70. [PMID: 23990155 DOI: 10.1007/s00464-013-3142-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Accepted: 07/22/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND This study aimed to evaluate the implementation of a joystick-controlled camera holder (Soloassist; Actormed, Barbing, Germany) in laparoscopic cholecystectomy as so-called solo-surgery compared with the standard operation. METHODS Of the 123 patients included in this study, 63 underwent laparoscopic cholecystectomy using the Soloassist system and were compared with 60 patients who underwent laparoscopic cholecystectomy with human assistance. The two groups did not differ significantly in terms of age, sex, body mass index, or American Society of Anesthesiology classification. The surgeons were divided into those highly experienced and those experienced with the new camera holder. The operation times were measured, including setup and dismantling of the system. The assessment also included complications, postoperative hospital stay, measurement of human resources in terms of personnel/minutes/operation, and subjective evaluation of the camera-guiding device by the surgeons. RESULTS The hospital stay and operation-related complications were not enhanced in the Soloassist group. The differences in core operation time (p = 0.008) and total operating time (p = 0.001) significantly favored the human assistant. Whereas the absolute duration of surgery was longer, the relative operating time (in personnel/minutes/operation) was significantly shorter (p < 0.001). In 4.8 % of the cases, the operation could not be performed completely with the camera-holding device. Clinically relevant postoperative complications did not occur. The experience of the surgeons did not differ significantly. The subjective evaluation regarding handling, image quality, effort, and satisfaction demonstrated high acceptance of the Soloassist system. CONCLUSIONS The camera-guiding device can be implemented without increased complications. The Soloassist system is safe and can be operated even by colleagues without system experience. All the surgeons rated their satisfaction with the system as very good to excellent. Although the operating times were longer than with the standard camera guidance, the absolute overall staff time was reduced.
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Affiliation(s)
- Sonja Gillen
- Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
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Trévillot V, Sobral R, Dombre E, Poignet P, Herman B, Crampette L. Innovative endoscopic sino-nasal and anterior skull base robotics. Int J Comput Assist Radiol Surg 2013; 8:977-87. [PMID: 23568018 DOI: 10.1007/s11548-013-0839-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Accepted: 03/25/2013] [Indexed: 11/24/2022]
Abstract
PURPOSE Design a compact, ergonomic, and safe endoscope positioner dedicated to the sino-nasal tract, and the anterior and middle-stage skull base. METHODS A motion and force analysis of the surgeon's movement was performed on cadaver heads to gather objective data for specification purposes. An experimental comparative study was then performed with three different kinematics, again on cadaver heads, in order to define the best architecture satisfying the motion and force requirements. RESULTS We quantified the maximal forces applied on the endoscope when traversing the sino-nasal tract in order to evaluate the forces that the robot should be able to overcome. We also quantified the minimal forces that should not be exceeded in order to avoid damaging vital structures. We showed that the entrance point of the endoscope into the nostril could not be considered, as in laparoscopic surgery, as a fixed point but rather as a fixed region whose location and dimensions depend on the targeted sinus. CONCLUSION From the safety and ergonomic points of view, the best solution would be a co-manipulated standard 6-degree of freedom robot to which is attached a gimbal-like passive remote manipulator holding the endoscope.
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Affiliation(s)
- Vincent Trévillot
- LIRMM, UMR 5506, CNRS-Université Montpellier 2, 161 Rue Ada, 34095 , Montpellier Cedex 05, France
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Jarry J, Moreau Gaudry A, Long JA, Chipon E, Cinquin P, Faucheron JL. Miniaturized robotic laparoscope-holder for rectopexy: first results of a prospective study. J Laparoendosc Adv Surg Tech A 2013; 23:351-5. [PMID: 23477369 DOI: 10.1089/lap.2012.0233] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Thanks to the technical progress in instrumentation, laparoscopic surgery has made considerable advances over the last decade. Various robotic systems have been introduced to assist laparoscopic procedures. A new prototype of miniaturized laparoscope-holder (called the Light Endoscope Robot [LER]) has been developed by the TIMC-IMAG-CNRS Laboratory in Grenoble, France and is now currently marketed by the French company Endocontrol™ (La Tronche, Grenoble). The aim of this pilot study was to assess the LER in clinical practice. SUBJECTS AND METHODS This was a prospective, single-center study. The LER had already been successfully validated on preclinical laboratory and cadaveric trials. The study was conducted at the Grenoble University Hospital during standardized laparoscopic rectopexies on adult patients. Demographic and operative data and qualitative results were collected prospectively and analyzed retrospectively. All patients provided written informed consent, and the study was approved by the Regional Committee for Medical and Health Research Ethics. RESULTS Between March 2008 and September 2010, 16 adult patients underwent laparoscopic rectopexy assisted by the LER. All the patients were women with an average age of 63.6 years and an average body mass index of 24 kg/m(2). The procedure was completed in 15 patients. No conversion to open surgery was required. The postoperative mortality rate was 0%, and a complication occurred in 1 patient. The surgeon graded ease of use as 7 ± 2, global comfort as 8 ± 2, and quality of vision as 8 ± 2. CONCLUSIONS This pilot study demonstrated the feasibility, safety, and comfort for the surgeon of the laparoscopic rectopexy assisted by the miniaturized light endoscope-holder LER.
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Affiliation(s)
- Julien Jarry
- Department of Surgery, Desgenettes Hospital, Lyon, France.
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Kuo CH, Dai JS, Dasgupta P. Kinematic design considerations for minimally invasive surgical robots: an overview. Int J Med Robot 2012; 8:127-45. [PMID: 22228671 DOI: 10.1002/rcs.453] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2011] [Indexed: 11/07/2022]
Abstract
BACKGROUND Kinematic design is a predominant phase in the design of robotic manipulators for minimally invasive surgery (MIS). However, an extensive overview of the kinematic design issues for MIS robots is not yet available to both mechanisms and robotics communities. METHODS Hundreds of archival reports and articles on robotic systems for MIS are reviewed and studied. In particular, the kinematic design considerations and mechanism development described in the literature for existing robots are focused on. RESULTS The general kinematic design goals, design requirements, and design preferences for MIS robots are defined. An MIS-specialized mechanism, namely the remote center-of-motion (RCM) mechanism, is revisited and studied. Accordingly, based on the RCM mechanism types, a classification for MIS robots is provided. A comparison between eight different RCM types is given. Finally, several open challenges for the kinematic design of MIS robotic manipulators are discussed. CONCLUSIONS This work provides a detailed survey of the kinematic design of MIS robots, addresses the research opportunity in MIS robots for kinematicians, and clarifies the kinematic point of view to MIS robots as a reference for the medical community.
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Affiliation(s)
- Chin-Hsing Kuo
- Department of Mechanical Engineering, National Taiwan University of Science and Technology, Taipei 106, Taiwan.
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Bibliography: Current world literature. Female urology. Curr Opin Urol 2010; 20:343-6. [PMID: 20531093 DOI: 10.1097/mou.0b013e32833bd73a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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