The Future of NOTES Instrumentation: Flexible Robotics and In Vivo Minirobots
Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Ohio 44195, USA.Journal of endourology / Endourological Society (Impact Factor: 1.71). 06/2009; 23(5):787-92. DOI: 10.1089/end.2008.0318
Natural orifice translumenal endoscopic surgery (NOTES) bridges the gap between standard endoluminal and extraluminal surgery and, as such, presents unique instrumentation challenges, including lack of stable platforms, loss of spatial orientation, and limited instrument tip maneuverability. The proper instrumentation remains to be established, and the incorporation of robotic technology will be essential moving forward. Flexible robotics has been applied to ureteroscopy and holds promise for NOTES. Miniature in vivo robots will potentially play a role. The current status and future implications of these technologies are reviewed.
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ABSTRACT: This article is dedicated to present a review on existing challenges and latest developments in surgical robotics in attempts to overcome the obstacles lying behind. Rather than to perform an exhaustive evaluation, we would emphasize more on the new insight by digesting the emerging bio-inspired surgical technologies with potentials to revolutionize the field. Typical approaches, possible applications, advantages and technical challenges were discussed. Evolutions of surgical robotics and future trends were analyzed. It can be found that, the major difficulties in the field of surgical robots may not be properly addressed by only using conventional approaches. As an alternative, bio-inspired methods or materials may shed light on new innovations. While endeavors to deal with existing strategies still need to be made, attentions should be paid to also borrow ideas from nature.Frontiers of Mechanical Engineering 12/2012; 7(4). DOI:10.1007/s11465-012-0352-1
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ABSTRACT: In therapeutic flexible endoscopy a team of physician and assistant(s) is required to control all independent translations and rotations of the flexible endoscope and its instruments. As a consequence the physician lacks valuable force feedback information on tissue interaction, communication errors easily occur, and procedures are not cost-effective. Current tools are not suitable for performing therapeutic procedures in an intuitive and user-friendly way by one person. A shift from more invasive surgical procedures that require external incisions to endoluminal procedures that use the natural body openings could be expected if enabling techniques were available. This paper describes the design and evaluation of a robotic system which interacts with traditional flexible endoscopes to perform therapeutic procedures that require advanced maneuverability. The physician uses one multi-degree-of-freedom input device to control camera steering as well as shaft manipulation of the motorized flexible endoscope, while the other hand is able to manipulate instruments. We identified critical use aspects that need to be addressed in the robotic setup. A proof-of-principle setup was built and evaluated to judge the usability of our system. Results show that robotic endoscope control increases efficiency and satisfaction. Participants valued its intuitiveness, its accuracy, the feeling of being in control, and its single-person setup. Future work will concentrate on the design of a system that is fully functional and takes safety, cleanability, and easy positioning close to the patient into account.Journal of Robotic Surgery 09/2013; DOI:10.1007/s11701-013-0405-4
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ABSTRACT: A natural numerical measure of consanguinity is developed that applies to individuals with arbitrary multiple kinship connections. For simple relationships the consanguineal distance specializes to the civil degree, less two if the relationship goes through full siblings. This measure is deduced from axioms motivated by an heuristic picture of blood mixtures. The formula suggests a quantum mechanical probability interpretation whose classical counterpart yields a generalization of the Murdock degree of consanguinity.
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