Fig 4 - uploaded by Adam Fiolka
Content may be subject to copyright.
Endoscopic view of the stomach: Left: Original image as produced by the endoscope Right: The same image is rotated clockwise into the position the laparoscopist is accustomed to.
Source publication
It is acknowledged by the medical community that further development of minimally invasive surgery is mainly driven by progress in medical engineering. To overcome many of the current barriers, computer science has to play a major role. In particular, improvement of spatial orientation, the development of intelligent mechatronic support systems, in...
Context in source publication
Context 1
... "upside down". With experience, some of this spatial incongruity can be overcome as it could be learned with the introduction of combined operations, but it will prevent complex procedures from being performed with the same speed and facility that total in-line visualization would allow. Automatic electronic image stabilization is a first step (Fig. 4), but translating the intended actions into a virtual straight-forward view when the telescope and the actuators are in a retroflected position is the next issue for CS. The use of augmented reality, based upon preoperative diagnostic work up and intraoperative navigation, would make surgeries safer and more efficient, since normal ...
Citations
This work presents a new robot platform developed for laparoscopic single-port surgery. As a new approach, this platform enables the introduction of flexible endoscopic instruments through the designed hollow manipulators with Ø12mm and 6 DOFs. Two such highly versatile manipulators and a 5 DOF telescope are combined in a unit that can be inserted through a 30mm incision into the abdominal cavity. The entire platform is actuated by bowden wires in 2m distance at the periphery. This design overcomes the problem of having a bulky and heavy platform near the patient. The design of the platform and the individual components are presented in this paper. The implemented control and simulation environment are also illustrated. The working range of one manipulator and the applicable forces were measured. Furthermore, the results of the accomplished in-vivo studies are presented.
This work presents the kinematics and control of a 6DOF manipulator for single-port surgery. Two such highly versatile manipulators and a semi-rigid telescope are combined in a unit that can be inserted through a 30mm incision into the abdominal cavity. A velocity-based task-space control was implemented in a simulation environment to evaluate the kinematics of the manipulator and position control of the instruments. The manipulators are operated with two space-mouse that are integrated as a new input device. An evaluation of the system in a pick-and-place scenario is also presented. Finally, a workspace analysis was accomplished to assess the capabilities and drawbacks of the realized system.
Our goal is to develop a surgical robot for minimally invasive surgery using selective laser sintering (SLS) of the polyamide PA2200. To drive the robot, we need a reliable interface to attach digital servomotors. Therefore we designed and fabricated a gear hub for a digital servomotor with a maximum torque of 24 Ncm. In an experiment we investigated the maximum torque the laser sintered gear hub can transmit with an error probability of 0.05%. The results show that such a gear hub is suitable for the application in the field of surgical robotics. In this paper we also present a simplified geometrical description for the construction of the gear hub and two minimally invasive interventions, which are in the focus of our research project.
Navigation of a flexible endoscope is a challenging surgical task: the shape of the end effector of the endoscope, interacting with surrounding tissues, determine the surgical path along which the endoscope is pushed. We present a navigational system that visualized the shape of the flexible endoscope tube to assist gastrointestinal surgeons in performing Natural Orifice Translumenal Endoscopic Surgery (NOTES). The system used an electromagnetic positional tracker, a catheter embedded with multiple electromagnetic sensors, and graphical user interface for visualization. Hermite splines were used to interpret the position and direction outputs of the endoscope sensors. We conducted NOTES experiments on live swine involving 6 gastrointestinal and 6 general surgeons. Participants who used the device first were 14.2% faster than when not using the device. Participants who used the device second were 33.6% faster than the first session. The trend suggests that spline-based visualization is a promising adjunct during NOTES procedures.
In minimally invasive surgery, trauma to the patient can be reduced by diminishing the number of entry ports. In addition
a single port access, attaining “high flexibility” in laparoscopic interventions is also of utmost importance. We developed
the “Highly Versatile Single Port System” (HVSPS), a two-armed device with an additional semi-flexible telescope, to meet
these requirements. Both manipulators and the telescope are inserted independently through a three-channel trocar which is
guided by a four degree of freedom telemanipulator. Furthermore, a simulation of the complete system including the surgical
environment is programmed for user training and design optimization. The first gallbladder could be successfully resected
in an animal experiment using the HVSPS. The manipulators were introduced into the abdominal cavity through a single incision.
After the ligation of the cystic duct and artery with coagulation current, the gallbladder was held with a grasper and dissected
using a TT knife. The complete surgical intervention, without technical set-up, was accomplished within 110 minutes. For the
first time, the feasibility of laparoscopic cholecystectomy using the HVSPS has been shown in this study. However, such elaborate
systems bring up new challenges such as the definition of an adequate human-machine interface and new control approaches for
retroflective manipulations which are possible with the kinematic structure of the HVSPS.
Since the publication of the first paper on NOTES, a dramatic increase of activities in this new surgical field is to be observed. However, a "pure" NOTES operation does not yet exist. Only NOTES-like operations have been proposed so far. One of the essential barriers is the limited intraoperative performance due to the lack of suitable mechatronic platforms. Some solutions have already been suggested but they are still far from having any practical impact upon the development of more advanced NOTES procedures. The "Highly Versatile Single Port System", a two-armed device with two manipulators and a semi-flexible telescope, was developed to overcome these drawbacks. A transsigmoid cholecystectomy on a NOTES simulator (the ELITE) could be accomplished successfully in 75 minutes. We could therefore show that the HVSPS is in principle applicable for such a NOTES procedure. However, before these mechatronic support systems can be used under clinical conditions, required human machine interface and extended intelligence have to be solved.
