Vision and Task Assistance Using Modular Wireless In Vivo Surgical Robots

Minimally invasive abdominal surgery (laparoscopy) results in superior patient outcomes compared to conventional open surgery. However, the difficulty of manipulating traditional laparoscopic tools from outside the body of the patient generally limits these benefits to patients undergoing relatively low complexity procedures. The use of tools that fit entirely inside the peritoneal cavity represents a novel approach to laparoscopic surgery. Our previous work demonstrated that miniature mobile and fixed-based in vivo robots using tethers for power and data transmission can successfully operate within the abdominal cavity. This paper describes the development of a modular wireless mobile platform for in vivo sensing and manipulation applications. Design details and results of ex vivo and in vivo tests of robots with biopsy grasper, staple/clamp, video, and physiological sensor payloads are presented. These types of self-contained surgical devices are significantly more transportable and lower in cost than current robotic surgical assistants. They could ultimately be carried and deployed by nonmedical personnel at the site of an injury to allow a remotely located surgeon to provide critical first response medical intervention irrespective of the location of the patient.

[1]  M. Mack,et al.  Minimally invasive and robotic surgery. , 2001, JAMA.

[2]  G. Meron The development of the swallowable video capsule (M2A). , 2000, Gastrointestinal endoscopy.

[3]  P. Dario,et al.  Shape memory alloy clamping devices of a capsule for monitoring tasks in the gastrointestinal tract , 2005 .

[4]  Arianna Menciassi,et al.  Modeling and Experiments on a Legged Microrobot Locomoting in a Tubular, Compliant and Slippery Environment , 2006, Int. J. Robotics Res..

[5]  Blake Hannaford,et al.  The BlueDRAGON - a system for measuring the kinematics and dynamics of minimally invasive surgical tools in-vivo , 2002, Proceedings 2002 IEEE International Conference on Robotics and Automation (Cat. No.02CH37292).

[6]  N A Patronik,et al.  Preliminary evaluation of a mobile robotic device for navigation and intervention on the beating heart , 2005, Computer aided surgery : official journal of the International Society for Computer Aided Surgery.

[7]  D I Watson,et al.  Laparoscopic Nissen fundoplication: five-year results and beyond. , 2001, Archives of surgery.

[8]  S. Shankar Sastry,et al.  Applications of micromechatronics in minimally invasive surgery , 1998 .

[9]  A. Glukhovsky,et al.  The development and application of wireless capsule endoscopy , 2004, The international journal of medical robotics + computer assisted surgery : MRCAS.

[10]  Wei Tech Ang,et al.  Active tremor compensation in handheld instrument for microsurgery , 2004 .

[11]  Shane M. Farritor,et al.  Mechanical Design of Robotic In Vivo Wheeled Mobility , 2007 .

[12]  Cameron N. Riviere,et al.  Toward active tremor canceling in handheld microsurgical instruments , 2003, IEEE Trans. Robotics Autom..

[13]  G. Ballantyne Robotic surgery, telerobotic surgery, telepresence, and telementoring , 2002, Surgical Endoscopy And Other Interventional Techniques.

[14]  Shoichi Iikura,et al.  Development of flexible microactuator and its applications to robotic mechanisms , 1991, Proceedings. 1991 IEEE International Conference on Robotics and Automation.

[15]  Jason Dumpert,et al.  Microrobot assisted laparoscopic urological surgery in a canine model. , 2008, The Journal of urology.

[16]  James A. Young,et al.  Early Experience with Telemanipulative Robot-Assisted Laparoscopic Cholecystectomy Using da Vinci , 2002, Surgical laparoscopy, endoscopy & percutaneous techniques.

[17]  D. Nio,et al.  Efficiency of manual versus robotical (Zeus) assisted laparoscopic surgery in the performance of standardized tasks , 2001, Surgical Endoscopy And Other Interventional Techniques.

[18]  Kazuhiro Kosuge,et al.  Micro active catheter system with multi degrees of freedom , 1994, Proceedings of the 1994 IEEE International Conference on Robotics and Automation.

[19]  LU,et al.  Telesurgery and Surgical Simulation : Haptic Interfaces to Real and Virtual Surgical Environments , 2001 .

[20]  Shane Farritor,et al.  Modeling, Analysis, and Experimental Study of In Vivo Wheeled Robotic Mobility , 2006, IEEE Transactions on Robotics.

[21]  J.T. Wen,et al.  Robotic assistants aid surgeons during minimally invasive procedures , 2001, IEEE Engineering in Medicine and Biology Magazine.

[22]  Blake Hannaford,et al.  Spherical mechanism analysis of a surgical robot for minimally invasive surgery -- analytical and experimental approaches. , 2005, Studies in health technology and informatics.

[23]  M. E. Rentschler,et al.  Mobile in vivo camera robots provide sole visual feedback for abdominal exploration and cholecystectomy , 2005, Surgical Endoscopy And Other Interventional Techniques.

[24]  Peter K. Allen,et al.  In-vivo pan/tilt endoscope with integrated light source , 2007, 2007 IEEE/RSJ International Conference on Intelligent Robots and Systems.

[25]  Shane Farritor,et al.  In vivo robots for laparoscopic surgery. , 2004, Studies in health technology and informatics.

[26]  Shane Farritor,et al.  Towards an In Vivo Wireless Mobile Robot for Surgical Assistance , 2008, MMVR.

[27]  S. Ramel,et al.  Comparison of laparoscopic and open Nissen fundoplication 2 years after operation. A prospective randomized trial. , 2000, Surgical endoscopy.

[28]  M. Gagner,et al.  Comparison of laparoscopic skills performance between standard instruments and two surgical robotic systems , 2003, Surgical Endoscopy And Other Interventional Techniques.

[29]  David B. Camarillo,et al.  Robotic technology in surgery: past, present, and future. , 2004, American journal of surgery.

[30]  A. Darzi,et al.  Dexterity enhancement with robotic surgery , 2004, Surgical Endoscopy And Other Interventional Techniques.

[31]  S. Shankar Sastry,et al.  Robotics for telesurgery: second generation Berkeley/UCSF laparoscopic telesurgical workstation and looking towards the future applications , 2003, Ind. Robot.

[32]  Jason Dumpert,et al.  An In Vivo Mobile Robot for Surgical Vision and Task Assistance , 2007 .

[33]  Blake Hannaford,et al.  Optimization of a spherical mechanism for a minimally invasive surgical robot: theoretical and experimental approaches , 2006, IEEE Transactions on Biomedical Engineering.

[34]  F. Pirozzi,et al.  Advantages and limits of robot-assisted laparoscopic surgery: preliminary experience , 2004, Surgical Endoscopy And Other Interventional Techniques.

[35]  Paolo Dario,et al.  Analysis and development of locomotion devices for the gastrointestinal tract , 2002, IEEE Transactions on Biomedical Engineering.

[36]  David S. Barrett,et al.  Tomorrow's surgery: Micromotors and microrobots for minimally invasive procedures , 1998 .

[37]  Dennis Fowler,et al.  In-vivo stereoscopic imaging system with 5 degrees-of-freedom for minimal access surgery. , 2004, Studies in health technology and informatics.

[38]  Paul Breedveld,et al.  Locomotion Through the Intestine by Means of Rolling Stents , 2004 .

[39]  P. Dario,et al.  Locomotion of a legged capsule in the gastrointestinal tract: theoretical study and preliminary technological results , 2004, The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[40]  Marco A. Zenati,et al.  Crawling on the Heart: A Mobile Robotic Device for Minimally Invasive Cardiac Interventions , 2004, MICCAI.