Design and Development of a Task Specific Robot for Endoscopic Submucosal Dissection of Early Gastrointestinal Cancers

This paper presents a task specific robot for the procedure of endoscopic sub mucosal dissection (ESD). This robot has two arms with nine degrees of freedom (DOF), and the capability of tissue elevation and dissection. An optimal design of these robot arms requires the use of shape memory alloy (SMA) wire and steel wire actuators to develop an improved actuation mechanism, which enables force to be transmitted to the distal tip of the robot arms for an efficient tissue dissection. The details of the robot such as robot arm design and kinematics, driven unit mechanism and novel controller design are presented. Two endoscopists, who are also upper gastrointestinal surgeons, independently evaluated our robot in a bench porcine model ex vivo. Both of them were able to complete the procedure within 75-85% of the marked sub mucosal tissue and within 30 minutes.

[1]  B. Bardou,et al.  Design of a telemanipulated system for transluminal surgery ‡ , 2009, 2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[2]  G. Fichtinger,et al.  The Hamlyn Symposium on Medical Robotics , 2018 .

[3]  L. Swanstrom,et al.  Development of a new access device for transgastric surgery , 2005, Journal of Gastrointestinal Surgery.

[4]  Michio Asano,et al.  Endoscopic submucosal dissection and surgical treatment for gastrointestinal cancer. , 2012, World journal of gastrointestinal endoscopy.

[5]  Peter K. Allen,et al.  Design and Coordination Kinematics of an Insertable Robotic Effectors Platform for Single-Port Access Surgery , 2013, IEEE/ASME Transactions on Mechatronics.

[6]  M Oya,et al.  Endoscopic submucosal dissection using a novel grasping type scissors forceps , 2007, Endoscopy.

[7]  Naoki Suzuki,et al.  Scorpion Shaped Endoscopic Surgical Robot for NOTES and SPS With Augmented Reality Functions , 2010, MIAR.

[8]  Shinji Tanaka,et al.  Advantage of endoscopic submucosal dissection compared with EMR for early gastric cancer. , 2006, Gastrointestinal endoscopy.

[9]  Juergen Hochberger,et al.  Endoscopic Mucosal Resection and Endoscopic Submucosal Dissection , 2011 .

[10]  C. Mathers,et al.  GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer , 2013 .

[11]  S. J. Phee,et al.  Master and slave transluminal endoscopic robot (MASTER) for natural Orifice Transluminal Endoscopic Surgery (NOTES) , 2009, 2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[12]  Ian D. Walker,et al.  Kinematics for multisection continuum robots , 2006, IEEE Transactions on Robotics.

[13]  Christopher D. Rahn,et al.  Design of Continuous Backbone, Cable-Driven Robots , 2002 .

[14]  L. Swanström,et al.  A multitasking platform for natural orifice translumenal endoscopic surgery (NOTES): a benchtop comparison of a new device for flexible endoscopic surgery and a standard dual-channel endoscope , 2009, Surgical Endoscopy.

[15]  C. Mathers,et al.  Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008 , 2010, International journal of cancer.

[16]  C. Thompson,et al.  Evaluation of a manually driven, multitasking platform for complex endoluminal and natural orifice transluminal endoscopic surgery applications (with video). , 2009, Gastrointestinal endoscopy.

[17]  Philip Wai Yan Chiu,et al.  Difficulties and outcomes in starting endoscopic submucosal dissection , 2010, Surgical Endoscopy.