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Deployable, Variable Stiffness, Cable Driven Robot for Minimally Invasive Surgery.

Mark Runciman1, James Avery2, Ming Zhao1

  • 1Human-Centered Automation, Robotics and Monitoring in Surgery (HARMS) Lab, Department of Surgery and Cancer, The Hamlyn Center, Imperial College London, London, United Kingdom.

Frontiers in Robotics and AI
|January 27, 2021
PubMed
Summary
This summary is machine-generated.

A new cable-driven robot enhances flexible endoscope capabilities for complex procedures like Endoscopic Submucosal Dissection (ESD). This minimally invasive surgery (MIS) tool improves surgical control and reduces training needs for early gastric cancer treatment.

Keywords:
deployableminimally invasive surgeryrapid manufacturesoft roboticsvariable stiffness

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Area of Science:

  • Medical Robotics
  • Surgical Innovation
  • Gastroenterology

Background:

  • Minimally Invasive Surgery (MIS) presents a challenge in balancing non-invasive access with surgical capability.
  • Endoscopic Submucosal Dissection (ESD) for early gastric cancers >20mm is effective but technically demanding, requiring extensive training and long operation times.

Purpose of the Study:

  • To develop a deployable, cable-driven robot to enhance the surgical capabilities of flexible endoscopes.
  • To minimize the impact of the robotic system on endoscope access.
  • To facilitate challenging procedures like ESD.

Main Methods:

  • A low-profile, inflatable hexagonal prism robot designed to fold around a flexible endoscope.
  • A variable stiffness structure with a sheath delivering force transmission cables to two independent tubular end-effectors.
  • Haptic controllers for intuitive, cable-length-based control of instrument pose.
  • Measurement of forces exerted by instruments (max 8.29 N along a single axis).

Main Results:

  • The robot achieved a 73.16% increase in volume and enhanced radial stiffness upon deployment.
  • Standard endoscopic instruments can be passed and anchored through the end-effectors.
  • A novice user successfully performed a simulated ESD procedure using the robot.
  • Working channels and tip control of the endoscope were maintained.

Conclusions:

  • The developed robot significantly increases surgical capabilities for flexible endoscopy.
  • It facilitates complex procedures like ESD, potentially reducing training requirements.
  • The robot's design allows for customization, rapid production, and low cost.