Literature DB >> 30465304

A robotic microsurgical forceps for transoral laser microsurgery.

Manish Chauhan1, Nikhil Deshpande2, Claudio Pacchierotti3, Leonardo Meli4, Domenico Prattichizzo5,4, Darwin G Caldwell5, Leonardo S Mattos5.   

Abstract

PURPOSE: In transoral laser microsurgery (TLM), the close curved cylindrical structure of the laryngeal region offers functional challenges to surgeons who operate on its malignancies with rigid, single degree-of-freedom (DOF) forceps. These challenges include surgeon hand tremors, poor reachability, poor tissue surface perception, and reduced ergonomy in design. The integrated robotic microsurgical forceps presented here is capable of addressing the above challenges through tele-operated tissue manipulation in TLM.
METHODS: The proposed device is designed in compliance with the spatial constraints in TLM. It incorporates a novel 2-DOF motorized microsurgical forceps end-effector, which is integrated with a commercial 6-DOF serial robotic manipulator. The integrated device is tele-operated through the haptic master interface, Omega.7. The device is augmented with a force sensor to measure tissue gripping force. The device is called RMF-2F, i.e. robotic microsurgical forceps with 2-DOF end-effector and force sensing. RMF-2F is evaluated through validation trials and pick-n-place experiments with subjects. Furthermore, the device is trialled with expert surgeons through preliminary tasks in a simulated surgical scenario.
RESULTS: RMF-2F shows a motion tracking error of less than 400 μm. User trials demonstrate the device's accuracy in task completion and ease of manoeuvrability using the Omega.7 through improved trajectory following and execution times. The tissue gripping force shows better regulation with haptic feedback (1.624 N) than without haptic feedback (2.116 N). Surgeons positively evaluated the device with appreciation for improved access in the larynx and gripping force feedback.
CONCLUSIONS: RMF-2F offers an ergonomic and intuitive interface for intraoperative tissue manipulation in TLM. The device performance, usability, and haptic feedback capability were positively evaluated by users as well as expert surgeons. RMF-2F introduces the benefits of robotic teleoperation including, (i) overcoming hand tremors and wrist excursions, (ii) improved reachability and accuracy, and (iii) tissue gripping feedback for safe tissue manipulation.

Entities:  

Keywords:  Minimally invasive surgery; Robot-assisted microsurgical forceps; Robotic medical instruments; Robotic teleoperation; Tissue gripping haptic feedback; Transoral laser microsurgery

Mesh:

Year:  2018        PMID: 30465304     DOI: 10.1007/s11548-018-1887-3

Source DB:  PubMed          Journal:  Int J Comput Assist Radiol Surg        ISSN: 1861-6410            Impact factor:   2.924


  7 in total

1.  Comparison of the phonation-related structures among pig, dog, white-tailed deer, and human larynges.

Authors:  J J Jiang; J R Raviv; D G Hanson
Journal:  Ann Otol Rhinol Laryngol       Date:  2001-12       Impact factor: 1.547

2.  Robot-assisted microsurgical forceps with haptic feedback for transoral laser microsurgery.

Authors:  Nikhil Deshpande; Manish Chauhan; Claudio Pacchierotti; Domenico Prattichizzo; Darwin G Caldwell; Leonardo S Mattos
Journal:  Conf Proc IEEE Eng Med Biol Soc       Date:  2016-08

3.  Morphological structure of the vocal cord as a vibrator and its variations.

Authors:  M Hirano
Journal:  Folia Phoniatr (Basel)       Date:  1974

4.  Laser surgery of the vocal cords. An experimental study with carbon dioxide lasers on dogs.

Authors:  G J Jako
Journal:  Laryngoscope       Date:  1972-12       Impact factor: 3.325

5.  Transoral robot-assisted CO2 laser supraglottic laryngectomy: experimental and clinical data.

Authors:  C Arturo Solares; Marshall Strome
Journal:  Laryngoscope       Date:  2007-05       Impact factor: 3.325

6.  Transoral robotic surgery using a carbon dioxide flexible laser for tumors of the upper aerodigestive tract.

Authors:  Shaun C Desai; Chih-Kwang Sung; David W Jang; Eric M Genden
Journal:  Laryngoscope       Date:  2008-12       Impact factor: 3.325

Review 7.  The value of haptic feedback in conventional and robot-assisted minimal invasive surgery and virtual reality training: a current review.

Authors:  O A J van der Meijden; M P Schijven
Journal:  Surg Endosc       Date:  2009-01-01       Impact factor: 4.584

  7 in total
  3 in total

Review 1.  Overcoming the impact of physiologic tremors in ophthalmology.

Authors:  Gurfarmaan Singh; Wilson Wong Jun Jie; Michelle Tian Sun; Robert Casson; Dinesh Selva; WengOnn Chan
Journal:  Graefes Arch Clin Exp Ophthalmol       Date:  2022-07-05       Impact factor: 3.117

Review 2.  Robotic Surgery Techniques to Improve Traditional Laparoscopy.

Authors:  Tovah Williamson; Sang-Eun Song
Journal:  JSLS       Date:  2022 Apr-Jun       Impact factor: 1.789

Review 3.  CO2 Transoral Laser Microsurgery in Benign, Premalignant and Malignant (Tis, T1, T2) Lesion of the Glottis. A Literature Review.

Authors:  Carlos Miguel Chiesa-Estomba; Jose Angel González-García; Ekhiñe Larruscain; Christian Calvo-Henríquez; Miguel Mayo-Yáñez; Jon A Sistiaga-Suarez
Journal:  Medicines (Basel)       Date:  2019-07-22
  3 in total

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