Pneumatically Attachable Flexible Rails for Track-Guided Ultrasound Scanning in Robotic-Assisted Partial Nephrectomy—A Preliminary Design Study

Robotic-assisted partial nephrectomy is a surgical operation in which part of a kidney is removed typically because of the presence of a mass. Pre-operative and intraoperative imaging techniques are used to identify and outline the target mass, thus the margins of the resection area on the kidney surface. Drop-in ultrasound probes are used to acquire intraoperative images: the probe is inserted through a trocar port, grasped with a robotic-assisted laparoscopic gripper and swiped on the kidney surface. Multiple swipes are performed to define the resection area. This is marked swipe by swipe using an electrocautery tool. During this procedure the probe often requires repositioning because of slippage from the target organ surface. Furthermore, the localization can be inaccurate when the target mass is in locations particularly hard to reach, and thus kidney repositioning could be required. A highly skilled surgeon is typically required to successfully perform this pre-operatory procedure. We propose a novel approach for the navigation of drop-in ultrasound probes: the use of pneumatically attachable flexible rails to enable swift, effortless, and accurate track-guided scanning of the kidney. The proposed system attaches on the kidney side surface with the use of a series of bio-inspired vacuum suckers. In this letter, the design of the proposed system and its use in robotic-assisted partial nephrectomy are presented for the first time.