A development of assistant surgical robot system based on surgical-operation-by-wire and hands-on-throttle-and-stick

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Abstract

Background

Robot-assisted laparoscopic surgery offers several advantages compared with open surgery and conventional minimally invasive surgery. However, one issue that needs to be resolved is a collision between the robot arm and the assistant instrument. This is mostly caused by miscommunication between the surgeon and the assistant. To resolve this limitation, an assistant surgical robot system that can be simultaneously manipulated via a wireless controller is proposed to allow the surgeon to control the assistant instrument.

Methods

The system comprises two novel master interfaces (NMIs), a surgical instrument with a gripper actuated by a micromotor, and 6-axis robot arm. Two NMIs are attached to master tool manipulators of da Vinci research kit (dVRK) to control the proposed system simultaneously with patient side manipulators of dVRK. The developments of the surgical instrument and NMI are based on surgical-operation-by-wire concept and hands-on-throttle-and-stick concept from the earlier research, respectively. Tests for checking the accuracy, latency, and power consumption of the NMI are performed. The gripping force, reaction time, and durability are assessed to validate the surgical instrument. The workspace is calculated for estimating the clinical applicability. A simple peg task using the fundamentals of laparoscopic surgery board and an in vitro test are executed with three novice volunteers.

Results

The NMI was operated for 185 min and reflected the surgeon’s decision successfully with a mean latency of 132 ms. The gripping force of the surgical instrument was comparable to that of conventional systems and was consistent even after 1000 times of gripping motion. The reaction time was 0.4 s. The workspace was calculated to be 8397.4 cm ³. Recruited volunteers were able to execute the simple peg task within the cut-off time and successfully performed the in vitro test without any collision.

Conclusions

Various experiments were conducted and it is verified that the proposed assistant surgical robot system enables collision-free and simultaneous operation of the dVRK’s robot arm and the proposed assistant robot arm. The workspace is appropriate for the performance of various kinds of surgeries. Therefore, the proposed system is expected to provide higher safety and effectiveness for the current surgical robot system.

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Most cited references 35

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Robotic surgery: a current perspective.

Anthony Lanfranco, Andres E. Castellanos, Jaydev Desai … (2004)

To review the history, development, and current applications of robotics in surgery. Surgical robotics is a new technology that holds significant promise. Robotic surgery is often heralded as the new revolution, and it is one of the most talked about subjects in surgery today. Up to this point in time, however, the drive to develop and obtain robotic devices has been largely driven by the market. There is no doubt that they will become an important tool in the surgical armamentarium, but the extent of their use is still evolving. A review of the literature was undertaken using Medline. Articles describing the history and development of surgical robots were identified as were articles reporting data on applications. Several centers are currently using surgical robots and publishing data. Most of these early studies report that robotic surgery is feasible. There is, however, a paucity of data regarding costs and benefits of robotics versus conventional techniques. Robotic surgery is still in its infancy and its niche has not yet been well defined. Its current practical uses are mostly confined to smaller surgical procedures.

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Advantages and limits of robot-assisted laparoscopic surgery: preliminary experience.

Julian C. Esposito, F Amato, A Settembre … (2004)

In the last few years, robotics has been applied in clinical practice for a variety of laparoscopic procedures. This study reports our preliminary experience using robotics in the field of general surgery to evaluate the advantages and limitations of robot-assisted laparoscopy. Thirty-two consecutive patients were scheduled to undergo robot-assisted laparoscopic surgery in our units from March 2002 to July 2003. The indications were cholecystectomy, 20 patients; right adrenalectomy, two points; bilateral varicocelectomy, two points; Heller's cardiomyotomy, two points; Nissen's fundoplication, two points; total splenectomy, one point; right colectomy, one point; left colectomy, 1 point; and bilateral inguinal hernia repair, one point. In all cases, we used the da Vinci surgical system, with the surgeon at the robotic work station and an assistant by the operating table. Twenty-nine of 32 procedures (90.6%) were completed robotically, whereas three were converted to laparoscopic surgery. Conversion to laparoscopy was due in two patients to minor bleeding that could not be managed robotically and to robot malfunction in the third patient. There were no deaths. Median hospital stay was 2.2 days (range, 2-8). The main advantages of robot-assisted laparoscopic surgery are the availability of three-dimensional vision and easier instrument manipulation than can be obtain with standard laparoscopy. The learning curve to master the robot was >or= 10 robotic procedures. The main limitations are the large diameter of the instruments (8 mm) and the limited number of robotic arms (maximum, three). We consider these technical shortcomings to be the cause for our conversions, because it is difficult to manage bleeding episodes with only two operating instruments. The benefit to the patient must be evaluated carefully and proven before this technology can become widely accepted in general surgery.

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Feasibility of robotic laparoscopic surgery: 146 cases.

Marianne Vandromme, M Degueldre, J Bruyns … (2001)

Theoretically, in laparoscopic surgery, a computer interface in command of a mechanical system (robot) allows the surgeon: (1) to recover a number a number of lost degrees of freedom, thanks to intraabdominal articulations; (2) to obtain better visual control of instrument manipulation, thanks to three-dimensional vision; (3) to modulate the amplitude of surgical motions by downscaling and stabilization; (4) to work at a distance from the patient. These advances improve the quality of surgical tasks in a perfect ergonomic position. The purpose of this paper is to evaluate the feasibility of utilizing a robot in laparoscopic surgery. The first robot-assisted procedure in humans was performed in March 1997 by our team. One hundred forty-six patients underwent robot-assisted laparoscopic surgery. Between March 1997 and February 2001 a nonconsecutive series was performed of 39 antireflux procedures, 48 cholecystectomies, 28 tubal reanastomoses, 10 gastroplasties for obesity, 3 inguinal hernias, 3 intrarectal procedures, 2 hysterectomies, 2 cardiac procedures, 2 prostactectomies, 2 arteriovenous fistulas, 1 lumbar sympathectomy, 1 appendectomy, 1 laryngeal exploration, 1 varicocele ligation, 1 endometriosis cure, 1 neosalpingostomy, 1 deferent canal. The robot (Da Vinci system, Intuitive Surgical, Mountain View, CA), consists of a console and a cart with three articulated robot arms. The surgeon sits in front of the console, manipulating joysticklike handles while observing the operative field through binoculars that provide a three-dimensional picture. This computer is capable of modulating these data by eliminating physiologic tremor and by downscaling the amplitude of motions by a factor 5 or 3 to one. This study has demonstrated the feasibility of several laparoscopic robotic procedures. There is no morbidity related to the system. Operating time and the hospital stay were within acceptable limits. The system seems most beneficial in intra-abdominal microsurgery or for manipulations in a very small space. Optimized ergonomics and increased mobility of the instrument tips are beneficial in many steps of abdominal surgical procedures.

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Author and article information

Contributors

Myungjoon Kim: kimmj08@snu.ac.kr

Chiwon Lee: lcwkf16@snu.ac.kr

Woo Jung Park: intuitive@snu.ac.kr

Yun Suhk Suh: ysksuh@snu.ac.kr

Han Kwang Yang: hkyang@snu.ac.kr

H. Jin Kim: hjinkim@snu.ac.kr

Sungwan Kim: sungwan@snu.ac.kr

Journal

Journal ID (nlm-ta): Biomed Eng Online

Journal ID (iso-abbrev): Biomed Eng Online

Title: BioMedical Engineering OnLine

Publisher: BioMed Central (London )

ISSN (Electronic): 1475-925X

Publication date (Electronic): 20 May 2016

Publication date PMC-release: 20 May 2016

Publication date Collection: 2016

Volume: 15

Electronic Location Identifier: 58

Affiliations

[ ]Interdisciplinary Program for Bioengineering, Graduate School, Seoul National University, Seoul, 110-744 South Korea

[ ]Institute of Medical and Biological Engineering, Seoul National University, Seoul, 151-742 South Korea

[ ]Department of Surgery, Seoul National University College of Medicine, Seoul, 110-799 South Korea

[ ]Department of Mechanical & Aerospace Engineering, Seoul National University College of Engineering, Seoul, 151-742 South Korea

[ ]Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, 110-799 South Korea

Article

Publisher ID: 189

DOI: 10.1186/s12938-016-0189-7

PMC ID: 4875655

PubMed ID: 27206350

SO-VID: 0d492432-79ee-4536-9645-82430a250481

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 13 August 2015

Date accepted : 11 May 2016

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100002551, Seoul National University;

Award ID: Grant no. 800-20150090

Award Recipient : Sungwan Kim

Funded by: FundRef http://dx.doi.org/10.13039/501100003725, National Research Foundation of Korea (KR);

Award ID: Grant 2014H1A2A1020384

Award Recipient : Myungjoon Kim

Custom metadata

ScienceOpen disciplines: Biomedical engineering

Keywords: assistant surgical robot system,minimally invasive surgery (mis),end-effector of surgical robot,novel master interface (nmi),da vinci research kit (dvrk),surgical-operation-by-wire (sobw),hands-on-throttle-and-stick (hotas)

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ScienceOpen disciplines: Biomedical engineering

Keywords: assistant surgical robot system, minimally invasive surgery (mis), end-effector of surgical robot, novel master interface (nmi), da vinci research kit (dvrk), surgical-operation-by-wire (sobw), hands-on-throttle-and-stick (hotas)

A development of assistant surgical robot system based on surgical-operation-by-wire and hands-on-throttle-and-stick

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Abstract

Background

Methods

Results

Conclusions

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Journal of Disability Research

Most cited references 35

Robotic surgery: a current perspective.

Advantages and limits of robot-assisted laparoscopic surgery: preliminary experience.

Feasibility of robotic laparoscopic surgery: 146 cases.

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