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Natural orifice cholecystectomy using a miniature robot.

Amy C Lehman¹, Jason Dumpert, Nathan A Wood

¹N104 Walter Scott Engineering Center, University of Nebraska-Lincoln, P.O. Box 880656, Lincoln, NE 68588-0656, USA.

Surgical Endoscopy

|December 6, 2008

Summary

A miniature in vivo robot enhances visualization and manipulation for challenging natural orifice translumenal endoscopic surgery (NOTES). This robotic system overcomes current endoscopic tool limitations, improving surgical capabilities.

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Area of Science:

Minimally invasive surgery
Robotics in medicine
Surgical innovation

Background:

Natural orifice translumenal endoscopic surgery (NOTES) presents significant surgical challenges.
Current endoscopic tools lack adequate visualization and manipulation for complex NOTES procedures.
A novel miniature in vivo robot is proposed to address these limitations.

Purpose of the Study:

To demonstrate the feasibility of a miniature in vivo robot for enhancing NOTES.
To provide improved visualization and dexterous, off-axis manipulation capabilities.
To overcome the inherent limitations of existing endoscopic surgical platforms.

Main Methods:

Development of a dexterous, six-degrees-of-freedom miniature robot with cautery and forceps end-effectors.

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Introduction of the robot via the esophagus, with transgastric insertion into the peritoneal cavity.

Utilizing an external magnetic handle for robot attachment to the abdominal wall and remote control via a console.

Main Results:

Successful demonstration of the robot in three nonsurvivable porcine procedures: abdominal exploration, bowel manipulation, and cholecystectomy.
The robot was effectively attached to the abdominal wall and repositioned for optimal visualization and manipulation.
Surgeons remotely controlled the robot to assist in complex surgical tasks.

Conclusions:

A dexterous miniature in vivo robot significantly enhances visualization and manipulation for NOTES procedures.
The robot can apply substantial forces in various directions, overcoming current endoscopic tool limitations.
This technology shows promise for advancing the capabilities and safety of NOTES surgery.