Ayumu Sasaki1, Toshikazu Kawai2, Yuji Nishizawa3, Atsushi Nishikawa4, Tatsuo Nakamura5. 1. Graduate School of Robotics and Design, Osaka Institute of Technology, Osaka, 530-8568, Japan. 2. Graduate School of Robotics and Design, Osaka Institute of Technology, Osaka, 530-8568, Japan. toshikazu.kawai@oit.ac.jp. 3. Department of Colorectal Surgery, National Cancer Center Hospital East, Kashiwa, 277-8577, Japan. 4. Graduate School of Engineering Science, Osaka University, Toyonaka, 560-8531, Japan. 5. Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan.
Abstract
PURPOSE: A surgeon in a sterilized area can perform robotically assisted laparoscopic solo surgery while controlling a laparoscope-holding robot for view stabilization and a forceps robot for pulling organs. At present, no locally operated surgical assistant manipulator with a mechanical remote center of motion (RCM) is available to operate within a small space while providing a wide range of movement. The present study describes a new locally operated detachable end-effector manipulator (LODEM) with diagonal joints and multi-stage telescopic screws. METHODS: A forceps manipulator attached to commercial surgical forceps was developed. This manipulator uses RCM diagonal joints for the yaw and pitch axes, providing an intuitive pivot point and free rotation, and telescopic nested screws with multiple sliders clamp the commercial forceps for the axis of insertion. The manipulator placed above the abdominal wall using a fixed arm connected to a bed rail is motor controlled by a handheld interface with button switches for precise traction and is controlled manually for easy rough positioning. RESULTS: Positional accuracy at the tip with a load of 5 N was under 0.5 mm. Mechanical deflection was under 2.1 mm. The manually controlled force was under 4.4 N. Successful simulated laparoscopic cholecystectomy using the prototype manipulator to handle the target and maintain stability was performed on a surgically realistic gallbladder model. CONCLUSIONS: A LODEM with diagonal joints and multi-stage telescopic screws was developed to facilitate minimally invasive, robotically assisted laparoscopic solo surgery by a surgeon working near the patient. This electric motor-controlled laparoscopic instrument holder by the surgeon in the surgical field could be used for such applications.
PURPOSE: A surgeon in a sterilized area can perform robotically assisted laparoscopic solo surgery while controlling a laparoscope-holding robot for view stabilization and a forceps robot for pulling organs. At present, no locally operated surgical assistant manipulator with a mechanical remote center of motion (RCM) is available to operate within a small space while providing a wide range of movement. The present study describes a new locally operated detachable end-effector manipulator (LODEM) with diagonal joints and multi-stage telescopic screws. METHODS: A forceps manipulator attached to commercial surgical forceps was developed. This manipulator uses RCM diagonal joints for the yaw and pitch axes, providing an intuitive pivot point and free rotation, and telescopic nested screws with multiple sliders clamp the commercial forceps for the axis of insertion. The manipulator placed above the abdominal wall using a fixed arm connected to a bed rail is motor controlled by a handheld interface with button switches for precise traction and is controlled manually for easy rough positioning. RESULTS: Positional accuracy at the tip with a load of 5 N was under 0.5 mm. Mechanical deflection was under 2.1 mm. The manually controlled force was under 4.4 N. Successful simulated laparoscopic cholecystectomy using the prototype manipulator to handle the target and maintain stability was performed on a surgically realistic gallbladder model. CONCLUSIONS: A LODEM with diagonal joints and multi-stage telescopic screws was developed to facilitate minimally invasive, robotically assisted laparoscopic solo surgery by a surgeon working near the patient. This electric motor-controlled laparoscopic instrument holder by the surgeon in the surgical field could be used for such applications.
Authors: Jens J Rassweiler; Riccardo Autorino; Jan Klein; Alex Mottrie; Ali Serdar Goezen; Jens-Uwe Stolzenburg; Koon H Rha; Marc Schurr; Jihad Kaouk; Vipul Patel; Prokar Dasgupta; Evangelos Liatsikos Journal: BJU Int Date: 2017-04-22 Impact factor: 5.588
Authors: John G Meara; Andrew J M Leather; Lars Hagander; Blake C Alkire; Nivaldo Alonso; Emmanuel A Ameh; Stephen W Bickler; Lesong Conteh; Anna J Dare; Justine Davies; Eunice Dérivois Mérisier; Shenaaz El-Halabi; Paul E Farmer; Atul Gawande; Rowan Gillies; Sarah L M Greenberg; Caris E Grimes; Russell L Gruen; Edna Adan Ismail; Thaim Buya Kamara; Chris Lavy; Ganbold Lundeg; Nyengo C Mkandawire; Nakul P Raykar; Johanna N Riesel; Edgar Rodas; John Rose; Nobhojit Roy; Mark G Shrime; Richard Sullivan; Stéphane Verguet; David Watters; Thomas G Weiser; Iain H Wilson; Gavin Yamey; Winnie Yip Journal: Lancet Date: 2015-04-26 Impact factor: 79.321