Robotic, Multi-Articulated Endoscopic Surgical Tools for Natural Orifice Translumenal Endoscopic Surgery

Presented at the Doctoral Consortium for Medical Simulation and Robotics held on March 11, 2010 in Chicago, IL in conjunction with the American College of Surgeons Accredited Education Institutes Consortium.

Cite: http://dx.doi.org/10.6084/m9.figshare.785746

Transcript

1. Dept. of Mechanical Engineering Robotic, Multi-Articulated Endoscopic Surgical Tools for Natural Orifice Translumenal Endoscopic Surgery Devin R. Berg1, Perry Y. Li1, Arthur G. Erdman1, Tianhong Cui1, and Timothy P. Kinney2 1Department of Mechanical Engineering 2Division of Gastroenterology - Hennepin County Medical Center University of Minnesota, Minneapolis, MN
2. Dept. of Mechanical Engineering Outline • Background / Introduction to NOTES • Current developments in the field • Our approach • Progress thus far – Problem characterization – Concept development – Prototyping • Future work
3. Dept. of Mechanical Engineering What is NOTES? • Natural Orifice: Tool insertion through the mouth, urethra, vagina, or anus. • Translumenal: Accessing the abdominal cavity through an incision in the stomach, bladder, vagina, or colon. • Endoscopic Surgery: Typically performed with a tool resembling a traditional endoscope.
4. Dept. of Mechanical Engineering NOTES Advantages • Faster recovery time • Less physical discomfort • No visible scars • These things may also lead to greater patient willingness to receive an important procedure.
5. Dept. of Mechanical Engineering Developing Technology USGI Medical Olympus Important features include: Multiple tool channels Tool articulation Imaging, suction, and irrigation Rigidity when necessary Triangulation
6. Dept. of Mechanical Engineering Our Approach to the Problem • Achieve teleoperated robotic control • Produce all necessary device movements from within the tool end itself • Device should be portable and field deployable (taking advantage of teleoperation) Fluid Power
7. Dept. of Mechanical Engineering Why Fluid Power? • Remotely located power source • Can maintain force / torque with minimal energy consumption • Precise control • High power density
8. Dept. of Mechanical Engineering Problem Characterization Diameter limitation of ~ 18 - 22 mm Organ manipulation force requirements of ~ 1.5 - 4 N
9. Dept. of Mechanical Engineering Conceptual Development Multi-directional articulation – Spherical joints (prototyped) – Cantilever beams Need to be mobilized and modeled for controls
10. Dept. of Mechanical Engineering Conceptual Development (Cont.) Force and displacement of articulation joint – Need high force with limited space Must balance the force requirement at the tool with the force input to the joint.
11. Dept. of Mechanical Engineering Conceptual Development (Cont.) Fluid flow control – Need to provide bi-direction flow control in small package – Each actuator requires its own valve MEMS Microfluidic Proportional Control Valve
12. Dept. of Mechanical Engineering Conceptual Development (Cont.) Force-Feedback Control Methods – Provide tool load information to the surgeon – Enable precise robotic control over tool position
13. Dept. of Mechanical Engineering Prototyping
14. Dept. of Mechanical Engineering Future Work • Additional characterization of tool force requirements (e.g. suturing, biopsy, etc.) • Experimental testing – Microfluidic valve – Articulation joint / Actuators / Controls • Assembly of components into all-inclusive prototype • Scaling
15. Dept. of Mechanical Engineering Summary • NOTES as the next step in MIS • Other devices currently under development • Applying fluid power for compact solution • Progress thus far – Identifying the problem – Concept development – Prototypes have been produced, more coming • Future work in testing and prototyping
16. Dept. of Mechanical Engineering References 1. Bardaro, S.J. and Swanstrom, L., 2006. Development of advanced endoscopes for Natural Orifice Transluminal Endoscopic Surgery (NOTES). Minimally Invasive Surgery, 15(6), pp. 378-383. 2. Bergman, S. and Melvin, W.S., 2008. Natural orifice translumenal endoscopic surgery. Surgical Clinics of North America, 88, pp. 1131-1148. 3. Caldwell, D.G., Medrano-Cerda, G.A., and Goodwin, M., 1995. Control of pneumatic muscle actuators. Control Systems Magazine, 15(1), pp. 40-48. 4. Davis, S. and Caldwell, D.G., 2006. Braid effects on contractile range and friction modeling in pneumatic muscle actuators. The International Journal of Robotics Research, 25(4), pp. 359-369. 5. Granosik, G. and Borenstein, J., 2005. Pneumatic actuators for serpentine robot. 8th International Conference on Walking and Climbing Robots, pp. 719-726, London. 6. Gostout, C.J., 2009. Update on the use of NOTES procedures. Advances in Endoscopy, 5(6), pp. 401-405. 7. Kalloo, A.N., Singh, V.K., Jagannath, S.B., Niiyama, H., Hill, S.L., Vaughn, C.A., Magee, C.A., and Kantsevoy, S.V., 2004. Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointestinal Endoscopy, 60(1), pp. 114-117. 8. Rattner, D. and Kalloo, A., 2006. ASGE/SAGES Working Group on Natural Orifice Translumenal Endoscopic Surgery. Surgical Endoscopy, 20, pp. 329-333. 9. Reynolds, D.B., Repperger, D.W., Phillips, C.A., and Bandry, G., 2003. Modeling the dynamic characteristics of pneumatic muscle. Annals of Biomedical Engineering, 31, pp. 310-317. 10. Swanstrom, L.L., Khajanchee, Y., and Abbas, M.A., 2008. Natural Orifice Transluminal Endoscopic Surgery: The future of gastrointestinal surgery. The Permanente Journal, 12(2), pp. 42-47.
17. Dept. of Mechanical Engineering Thank You