Miniature In Vivo Robotics and Novel Robotic Surgical Platforms

Minimally Invasive and Robotic Surgery, University of Nebraska Medical Center, Omaha, NE 68198-3280, USA.
Urologic Clinics of North America (Impact Factor: 1.2). 06/2009; 36(2):251-63, x. DOI: 10.1016/j.ucl.2009.02.013
Source: PubMed


Robotic surgical systems, such as the da Vinci Surgical System (Intuitive Surgical, Inc., Sunnyvale, California), have revolutionized laparoscopic surgery but are limited by large size, increased costs, and limitations in imaging. Miniature in vivo robots are being developed that are inserted entirely into the peritoneal cavity for laparoscopic and natural orifice transluminal endoscopic surgical (NOTES) procedures. In the future, miniature camera robots and microrobots should be able to provide a mobile viewing platform. This article discusses the current state of miniature robotics and novel robotic surgical platforms and the development of future robotic technology for general surgery and urology.

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    • "Name Length [mm] Diameter [mm] Reference Miniature robot 180 (extended) ˜17 Lehman et al. (2011) Lehman et al. (2009) Tiwari et al. (2010) Lightning robot 110 12 Shah et al. (2009) Mobile endoluminal robot 75 12 Rentschler et al. (2007) Lehman et al. (2006) operation area where the planned surgical tasks have to be performed and a certain number of DoFs can be transmitted through the abdomen without any mechanical connections. Despite the overall system potentialities, MAGS have a lack of a stable magnetic anchoring force when the abdominal wall thickness is over 2.5 cm (Best et al., 2010); in addition, undesired interactions appear when multiple instruments are used, thus requiring a " safety distance " to be maintained between the respective external frames. "
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    ABSTRACT: Natural orifice transluminal endoscopic surgery (NOTES) is one of the modern surgical techniques that led to the miniaturization of surgical tools and brings the concept of inserting many robotic units into the peritoneal cavity for executing “scarless” surgical tasks. However, the development of transabdominal anchoring systems that guarantee stability is recognized as a challenging issue in the design of miniature intra-abdominal robotic devices. A dedicated platform, exploiting magnetic coupling for anchoring, has been designed by respecting anatomical constraints, maximizing the volume to increase the number of embedded magnets, and consequently incrementing operating distance. The device is equipped with a SMA (shape memory alloy) mechanism that allows configuration change from an extended cylindrical (compliant for deployment) to a compact triangular (rigid for providing stability) design. The feasibility and the potential of the proposed platform have been demonstrated both in in vitro and in in vivo conditions on a human phantom and a porcine model, respectively.
    The International Journal of Robotics Research 03/2013; 32(3):360-370. DOI:10.1177/0278364912469672 · 2.54 Impact Factor
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    ABSTRACT: Minimally invasive techniques have been used in the field of gynecology to conduct culdoscopies (examination of vaginal tissue and the cervix) since the early 20th century7. However, the modern era of laparoscopic surgery was triggered by a cholecystectomy (removal of the gall bladder) performed by the French surgeon Mouret in 19878 and 9. Since then, diverse surgical procedures such as the creation of an artificial opening for urine discharge (ureterostomy)10, urinary bladder reconstruction11, and the removal of the appendix (appendectomy)12, kidney (nephrectomy)13, adrenal gland (adrenalectomy)14, uterus (hysterectomy)15, gall bladder (cholecystectomy)16 and spleen (splenectomy)17 are routinely carried out using MIS. The push toward such procedures has even prompted hospitals, health centers and clinics to establish departments and centers dedicated to MIS. The impact of MIS has pervaded many branches of medicine including gynecology15 and 18, general surgery19 and 20, urology13 and 21, neurosurgery22 and 23, orthopedic surgery24 and 25, as well as cardiothoracic surgery26, 27 and 28. Recent research advances have included the use of robotics29 and 30 and the development of hybrid techniques such as Normal Orifice Translumenal Endoscopic Surgery (NOTES)31 and 32, which combines elements of flexible endoscopy with laparoscopy.
    Materials Today 10/2009; 12(10). DOI:10.1016/S1369-7021(09)70272-X · 14.11 Impact Factor

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