A novel, new robotic platform for natural orifice distal pancreatectomy

Research progress and development trend of surgical robot and surgical instrument arm

BACKGROUND

In recent years, surgical robots have become an indispensable part of the medical field. Surgical robots are increasingly being used in the areas of gynaecological surgery, urological surgery, orthopaedic surgery, general surgery and so forth. In this paper, the development of surgical robots in different operations is reviewed and analysed. In the type of master-slave surgical robotic system, the robotic surgical instrument arms were located in the execution terminal of a surgical robot system, as one of the core components, and directly contact with the patient during the operation, which plays an important role in the efficiency and safety of the operation. In clinical, the arm function and design in different systems varies. Furtherly, the current research progress of robotic surgical instrument arms used in different operations is analysed and summarised. Finally, the challenge and trend are concluded.

METHODS

According to the classification of surgical types, the development of surgical robots for laparoscopic surgery, neurosurgery, orthopaedics and microsurgery are analysed and summarised. Then, focusing on the research of robotic surgical instrument arms, according to structure type, the research and application of straight-rod surgical instrument arm, joint surgical instrument arm and continuous surgical instrument arm are analysed respectively.

RESULTS

According to the discussion and summary of the characteristics of the existing surgical robots and instrument arms, it is concluded that they still have a lot of room for development in the future. Therefore, the development trends of the surgical robot and instrument arm are discussed and analysed in the five aspects of structural materials, modularisation, telemedicine, intelligence and human-machine collaboration.

CONCLUSION

Surgical robots have shown the development trend of miniaturisation, intelligence, autonomy and dexterity. Thereby, in the field of science and technology, the research on the next generation of minimally invasive surgical robots will usher in a peak period of development.

Motion and Trajectory Constraints Control Modeling for Flexible Surgical Robotic Systems

Success of the da Vinci surgical robot in the last decade has motivated the development of flexible access robots to assist clinical experts during single-port interventions of core intrabody organs. Prototypes of flexible robots have been proposed to enhance surgical tasks, such as suturing, tumor resection, and radiosurgery in human abdominal areas; nonetheless, precise constraint control models are still needed for flexible pathway navigation. In this paper, the design of a flexible snake-like robot is presented, along with the constraints model that was proposed for kinematics and dynamics control, motion trajectory planning, and obstacle avoidance during motion. Simulation of the robot and implementation of the proposed control models were done in Matlab. Several points on different circular paths were used for evaluation, and the results obtained show the model had a mean kinematic error of 0.37 ± 0.36 mm with very fast kinematics and dynamics resolution times. Furthermore, the robot’s movement was geometrically and parametrically continuous for three different trajectory cases on a circular pathway. In addition, procedures for dynamic constraint and obstacle collision detection were also proposed and validated. In the latter, a collision-avoidance scheme was kept optimal by keeping a safe distance between the robot’s links and obstacles in the workspace. Analyses of the results showed the control system was optimal in determining the necessary joint angles to reach a given target point, and motion profiles with a smooth trajectory was guaranteed, while collision with obstacles were detected a priori and avoided in close to real-time. Furthermore, the complexity and computational effort of the algorithmic models were negligibly small. Thus, the model can be used to enhance the real-time control of flexible robotic systems.

Snake-like surgical forceps for robot-assisted minimally invasive surgery

BACKGROUND

Surgical instruments greatly impact the performance of robot-assisted minimally invasive surgery (RMIS) because they operate on tissues.

METHODS

A snake-like surgical instrument, designed with 4 degrees of freedom (DOFs), is proposed for RMIS. The DOFs are as follows: opening and closing motions of the forceps, rotation of the forceps and bi-directional bending of the instrument. The performance of the instrument was evaluated using a prototype in vitro.

RESULTS

All DOFs of the instrument were experimentally evaluated and proven sufficient for RMIS. In vitro testing showed that the operations of the proposed model were powerful and steady.

CONCLUSIONS

The position and posture of the surgical instrument could be adjusted in the body of the patient by its bending and rotational movements. The proposed model could therefore work as a competent assistant in multi-port RMIS and allow surgeons to perform better.

Current and emerging robotic assisted intervention for Notes

INTRODUCTION

Natural orifices transluminal endoscopic surgery (notes) procedures are limited by a number of factors including closure of the internal entry point, loss of triangulation, and unstable operative platform. Areas covered: In this paper, new technical developments in different aspects of robotic assisted NOTES interventions are reviewed. We further address new research opportunities for more widespread clinical acceptance of robotic assisted NOTES procedures. Expert commentary: The application of robotics in NOTES intervention is still in its infancy. The development of more compact, smart and intuitive robotic NOTES systems holds much promise for the future of NOTES application.

The First Interlaced Continuum Robot, Devised to Intrinsically Follow the Leader

Flexible probes that are safely deployed to hard-to-reach targets while avoiding critical structures are strategic in several high-impact application fields, including the biomedical sector and the sector of inspections at large. A critical problem for these tools is the best approach for deploying an entire tool body, not only its tip, on a sought trajectory. A probe that achieves this deployment is considered to follow the leader (or to achieve follow-the-leader deployment) because its body sections follow the track traced by its tip. Follow-the-leader deployment through cavities is complicated due to a lack of external supports. Currently, no definitive implementation for a probe that is intrinsically able to follow the leader, i.e., without relying on external supports, has been achieved. In this paper, we present a completely new device, namely the first interlaced continuum robot, devised to intrinsically follow the leader. We developed the interlaced configuration by pursuing a conceptual approach irrespective of application-specific constraints and assuming two flexible tools with controllable stiffness. We questioned the possibility of solving the previously mentioned deployment problem by harnessing probe symmetry during the design process. This study examines the entire development of the novel interlaced probe: model-based conceptual design, detailed design and prototyping, and preliminary experimental assessment. Our probe can build a track with a radius of curvature that is as small as twice the probe diameter, which enables it to outperform state-of-the-art tools that are aimed at follow-the-leader deployment. Despite the limitations that are inherently associated with its original character, this study provides a prototypical approach to the design of interlaced continuum systems and demonstrates the first interlaced continuum probe, which is intrinsically able to follow the leader.

Application of robotics in gastrointestinal endoscopy: A review

Multiple robotic flexible endoscope platforms have been developed based on cross specialty collaboration between engineers and medical doctors. However, significant number of these platforms have been developed for the natural orifice transluminal endoscopic surgery paradigm. Increasing amount of evidence suggest the focus of development should be placed on advanced endolumenal procedures such as endoscopic submucosal dissection instead. A thorough literature analysis was performed to assess the current status of robotic flexible endoscopic platforms designed for advanced endolumenal procedures. Current efforts are mainly focused on robotic locomotion and robotic instrument control. In the future, advances in actuation and servoing technology, optical analysis, augmented reality and wireless power transmission technology will no doubt further advance the field of robotic endoscopy. Globally, health systems have become increasingly budget conscious; widespread acceptance of robotic endoscopy will depend on careful design to ensure its delivery of a cost effective service.