Design, control and testing of a novel compact laparoscopic endoscope manipulator

Abstract This paper describes the development of a compact laparoscopic endoscope manipulator and its command interface for use as a surgical assistant during minimally invasive surgery. The defining feature of the endoscope manipulator is that it is sufficiently small and lightweight to be fixed directly on the abdomen of the patient. The mechanism of the manipulator controls the orientation of the endoscope and its insertion depth. It is actuated by cables inside flexible sleeves connected to a separate enclosure containing analogue controllers, servomotors and rack-and-pinion drives. Compared with floor-standing endoscope manipulators, the described device is easier to set up, cheaper, simpler and allows unrestricted access to the abdomen from all sides of the patient. The pointing accuracy of the device is reduced by the absence of a rigid base, but the resulting compliance to patient motion is an added benefit. The current prototype has been tested on a cadaver. The design and control of the endoscope manipulator continues to evolve in response to testing results and consultation with surgeons, with light weight, small size, simplicity and ease of use as primary considerations. A novel hands-free user control interface for orientation of the endoscope manipulator using an external optical localizer to track surgical instruments is also presented.