Intelligent surgical instrument system ISIS. Concept and preliminary experimental application of components and prototypes.

The recent progress in endoscopic surgery, which is highlighted by the complexity of fundoplication, stomach surgery and colorectal surgery, has revealed major restrictions with difficult surgical manipulations. Mobilisation, dissection and suturing techniques are hampered mainly by the limited degrees of freedom of the conventional rigid instruments (translation along and rotation around the longitudinal axis and the limited play in the access channel). The frequent interchange of instruments such as coagulation forceps, scissors and suction-irrigation probe is time-consuming. We have established an interdisciplinary development model with the aim of improving surgical technology, instrument systems, the operation theatre and its environment. Concepts of electronic instrument control and sensoric feedback, and the features of the surgical man-machine-interface are described. The first prototypes of an intelligent steerable instrument system, ISIS, and its optional effectors, e.g. semiautomatic sewing device and multifunctional coagulation instrument, were tested in phantom and animal experiments. System analysis will lead to specially designed operating theatres (minimal invasive surgical operating system MINOS).