Miniature In Vivo Robots for NOTES

Eliminating all external incisions would be a significant step in reducing the invasiveness of surgical procedures. Accessing the peritoneal cavity through a natural orifice, as in Natural Orifice Translumenal Endoscopic Surgery (NOTES), promises distinct patient advantages, but is surgically challenging. Performing laparoscopic surgeries through a single transumbilical incision is also gaining renewed interest as a potential bridge to enabling NOTES. Both of these types of surgical procedures are inherently limited by working with multiple instruments through a constrained insertion point. New technologies are necessary to overcome these limitations and provide the surgeon with adequate visual feedback and triangulation. Miniature in vivo robots provide a unique approach by providing a platform that is completely inserted into the peritoneal cavity to enable minimally invasive surgery. This chapter describes the design and feasibility testing of miniature in vivo robots that can provide stable visualization and manipulation platforms for NOTES and single incision surgery.

[1]  Vikesh K. Singh,et al.  Flexible transgastric peritoneoscopy: A novel approach to diagnostic and therapeutic interventions in the peritoneal cavity , 2000 .

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

[3]  D. Faigel,et al.  ASGE guideline: guideline on the use of endoscopy in the management of constipation. , 2005, Gastrointestinal endoscopy.

[4]  Russell H. Taylor,et al.  Computer-Integrated Surgery: Technology and Clinical Applications , 1995 .

[5]  Jason Dumpert,et al.  Surgery with cooperative robots , 2008, Computer aided surgery : official journal of the International Society for Computer Aided Surgery.

[6]  Peter K. Allen,et al.  Comparison of Monoscopic Insertable, Remotely Controlled Imaging Device With a Standard Laparoscope in a Porcine Model , 2008, Surgical innovation.

[7]  Pradeep Rao,et al.  Single-port-access nephrectomy and other laparoscopic urologic procedures using a novel laparoscopic port (R-port). , 2008, Urology.

[8]  Sangtae Park,et al.  Trocar-less Instrumentation for Laparoscopy: Magnetic Positioning of Intra-abdominal Camera and Retractor , 2007, Annals of surgery.

[9]  A. Rané,et al.  Devices for laparoendoscopic single-site surgery in urology , 2009, Expert review of medical devices.

[10]  D. Rattner,et al.  ASGE/SAGES Working Group on Natural Orifice Translumenal Endoscopic Surgery , 2006, Surgical Endoscopy And Other Interventional Techniques.

[11]  D. Oleynikov,et al.  The current state of miniature in vivo laparoscopic robotics , 2007, Journal of robotic surgery.

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

[13]  L. Swanstrom,et al.  Developing essential tools to enable transgastric surgery , 2008, Surgical Endoscopy.

[14]  N. A. Wood,et al.  Natural orifice cholecystectomy using a miniature robot , 2009, Surgical Endoscopy.

[15]  Christopher C Thompson,et al.  Peroral transgastric organ resection: a feasibility study in pigs. , 2006, Gastrointestinal endoscopy.

[16]  Paul Swain,et al.  Transgastric anastomosis by using flexible endoscopy in a porcine model (with video). , 2006, Gastrointestinal endoscopy.

[17]  R. Satava Surgical Robotics: The Early Chronicles: A Personal Historical Perspective , 2002, Surgical laparoscopy, endoscopy & percutaneous techniques.

[18]  S. C. Low,et al.  Robotic system for no‐scar gastrointestinal surgery , 2008, The international journal of medical robotics + computer assisted surgery : MRCAS.

[19]  William J. Peine,et al.  Design of an endoluminal NOTES robotic system , 2007, 2007 IEEE/RSJ International Conference on Intelligent Robots and Systems.

[20]  R. Zorron,et al.  NOTES Transvaginal Cholecystectomy: Report of the First Case , 2007, Surgical innovation.

[21]  N. A. Wood,et al.  Dexterous miniature in vivo robot for NOTES , 2008, 2008 2nd IEEE RAS & EMBS International Conference on Biomedical Robotics and Biomechatronics.

[22]  Mark E. Rentschler In vivo abdominal surgical robotics: Tissue mechanics modeling, robotic design, experimentation, and analysis , 2006 .

[23]  C. Esposito,et al.  One-trocar appendectomy in pediatric surgery , 1998, Surgical Endoscopy.

[24]  Richard Bergs,et al.  Completely transvaginal NOTES cholecystectomy using magnetically anchored instruments , 2007, Surgical Endoscopy.

[25]  A. Kalloo,et al.  Per-oral transgastric abdominal surgery. , 2006, Chinese journal of digestive diseases.

[26]  A. Gumbs,et al.  Totally Transumbilical Laparoscopic Cholecystectomy , 2009, Journal of Gastrointestinal Surgery.

[27]  A. Rosemurgy,et al.  Laparoendoscopic Single Site (LESS) Cholecystectomy , 2009, Journal of Gastrointestinal Surgery.

[28]  Sebastien Crouzet,et al.  Robotic single‐port transumbilical surgery in humans: initial report , 2009, BJU international.

[29]  D. Fowler,et al.  Transvaginal laparoscopically assisted endoscopic cholecystectomy: a hybrid approach to natural orifice surgery. , 2007, Gastrointestinal endoscopy.

[30]  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).

[31]  Georges-Pascal Haber,et al.  Consensus statement on natural orifice transluminal endoscopic surgery and single-incision laparoscopic surgery: heralding a new era in urology? , 2008, European urology.

[32]  Tiago Henriques-Coelho,et al.  Transvesical thoracoscopy: A natural orifice translumenal endoscopic approach for thoracic surgery , 2007, Surgical Endoscopy.

[33]  Mitchell J. H. Lum,et al.  Multidisciplinary Approach for Developing a New Minimally Invasive Surgical Robotic System , 2006, The First IEEE/RAS-EMBS International Conference on Biomedical Robotics and Biomechatronics, 2006. BioRob 2006..

[34]  Shashikant Mishra,et al.  Scarless single port transumbilical nephrectomy and pyeloplasty: first clinical report , 2007, BJU international.

[35]  Jason Dumpert,et al.  Natural orifice surgery with an endoluminal mobile robot , 2007, Surgical Endoscopy.

[36]  Chad R. Tracy,et al.  Laparoendoscopic single-site surgery in urology: where have we been and where are we heading? , 2008, Nature Clinical Practice Urology.

[37]  G Piskun,et al.  Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus. , 1999, Journal of laparoendoscopic & advanced surgical techniques. Part A.

[38]  Vikesh K. Singh,et al.  Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. , 2004, Gastrointestinal endoscopy.

[39]  Tie Hu,et al.  Insertable stereoscopic 3D surgical imaging device with pan and tilt , 2008, 2008 2nd IEEE RAS & EMBS International Conference on Biomedical Robotics and Biomechatronics.

[40]  G. Rao,et al.  NOTES: human experience. , 2008, Gastrointestinal endoscopy clinics of North America.

[41]  Paolo Dario,et al.  Bio-inspired solutions for locomotion in the gastrointestinal tract: background and perspectives , 2003, Philosophical Transactions of the Royal Society of London. Series A: Mathematical, Physical and Engineering Sciences.

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