A new safe laparoscopic manipulator system with a five-bar linkage mechanism and an optical zoom.

This paper describes a new type of laparoscopic manipulator system designed with regard to its safety and sterilization in medical settings. It consists of a laparoscope manipulator using a five-bar linkage mechanism, an optical zoom called the automatic microzoom laparoscope, and a man-machine interface called the Head-Mouse system. The movement of the laparoscope manipulator in the X-Y plane determines the angle of the laparoscope, and the optical zoom substitutes for back-and-forth movements. This system achieves intrinsic safety and ease of sterilization due to limitations in the range of movement. The system achieves high reliability because of the simplicity of both its mechanism and its software. The newly developed optical zoom avoids the possibility of contact with organs by eliminating the back-and-forth movements of the laparoscope required for close-up observation while preserving a high-quality laparoscopic image. The Head-Mouse system for man-machine interface was designed to avoid incorrect inputs by the surgeon. To evaluate the performance of this newly developed system, an experiment was conducted in which a surgeon used the system to perform an in vivo laparoscopic cholecystectomy on a pig. Copyright 1999 Wiley-Liss, Inc.