Susumu Oguri

Development of a robotic system with six-degrees-of-freedom robotic tool manipulators for single-port surgery.

Current robotic systems have limitations for single‐port surgery (SPS) because the instruments are large, the arms collide and the field of vision requires manual readjustment. We have developed an SPS robotic system that manipulates the vision field.

Gastric endoscopic submucosal dissection using novel 2.6-mm articulating devices: an ex vivo comparative and in vivo feasibility study.

BACKGROUND AND STUDY AIMS The conventional procedure of endoscopic submucosal dissection (ESD) is technically demanding. This study investigated the efficiency of novel articulating devices (maximum diameter 2.6 mm), which can be used with commercially available, standard endoscopes. PATIENTS AND METHODS In an ex vivo comparative study, eight endoscopists were divided into novices and experienced operators, and performed ESD using new devices and the conventional setup. An in vivo animal experiment was performed by two experts. Procedure times for incision and dissection were recorded, and unit times for circumferential length and area of specimens were calculated. RESULTS All procedures were successfully completed with en bloc resection. In the ex vivo study, the unit procedure times for incision and dissection by novices were significantly shorter using the new system (P < 0.01 and P < 0.05), whereas there was no significant difference for experienced endoscopists. Perforation occurred during one procedure in which the new system was used. The in vivo experiments were successfully completed without adverse events. CONCLUSIONS ESD using novel articulating devices was feasible. These devices were able to reduce the procedure time for novices.

Improving the strength of sutureless laser-assisted vessel repair using preloaded longitudinal compression on tissue edge

Little is known about the approximation of coapted edges in sutureless laser‐assisted vessel welding. Tissue shrinkage by laser irradiation may cause coapted edges to separate, reducing strength of welding. This may be avoided by preloaded longitudinal compression on the tissue edges to be welded. This study compared welding strength with and without preloaded compression in ex vivo animal experiments.

Mechanism study for micro surgical robotic system that can induce multisensory illusion

In recent years, robotic technology has been introduced in surgery in the form of master slave system and its applicable surgical area is widely spreading. Minimally invasive surgery and microsurgery are the representing applications of the robotic surgery that the surgeon performs the dexterous and fine operations in the deep or narrow surgical area in micro-scale. The intuitiveness is thus highly desirable to perform the highly elaborated surgical tasks such as suturing for surgical master slave systems. To increase the operability, time-delay of system response, haptic feedback and eye-hand coordination issues have mainly been discussed in the field of robotics. In addition to these approaches, we propose a surgical robotic system that induces multisensory illusion. In our previous study, we reported that the robotic instruments enhances the multisensory illusion. In this paper, we determine the requirements for inducing the multisensory illusion on a multi-DOF master slave system and the first stage of prototype implementation based on the given requirements is described.

A new robotic-assisted flexible endoscope with single-hand control: endoscopic submucosal dissection in the ex vivo porcine stomach

BackgroundDifficulties in endoscopic operations and therapeutic procedures seem to occur due to the complexity of operating the endoscope dial as well as difficulty in performing synchronized movements with both hands. We developed a prototype robotic-assisted flexible endoscope that can be controlled with a single hand in order to simplify the operation of the endoscope. The aim of this study was to confirm the operability of the robotic-assisted flexible endoscope (RAFE) by performing endoscopic submucosal dissection (ESD).MethodsStudy 1: ESD was performed manually or with RAFE by an expert endoscopist in ex vivo porcine stomachs; six operations manually and six were performed with RAFE. The procedure time per unit circumferential length/area was calculated, and the results were statistically analyzed. Study 2: We evaluated how smoothly a non-endoscopist can move a RAFE compared to a manual endoscope by assessing the designated movement of the endoscope.ResultsStudy 1: En bloc resection was achieved by ESD using the RAFE. The procedure time was gradually shortened with increasing experience, and the procedure time of ESD performed with the RAFE was not significantly different from that of ESD performed with a manual endoscope. Study 2: The time for the designated movement of the endoscope was significantly shorter with a RAFE than that with a manual endoscope as for a non-endoscopist.ConclusionsThe RAFE that we developed enabled an expert endoscopist to perform the ESD procedure without any problems and allowed a non-endoscopist to control the endoscope more easily and quickly than a manual endoscope. The RAFE is expected to undergo further development.

A Microsurgical Robotic System that Induces a Multisensory Illusion

Intuitiveness in robotic surgery is highly desirable when performing highly elaborate surgical tasks using surgical master–slave systems (MSSs), such as suturing. To increase the operability of such systems, the time delay of the system response, haptic feedback, and eye–hand coordination are the issues that have received the most attention. In addition to these approaches, we propose a surgical robotic system that induces a multisensory illusion. In our previous study, we reported that a robotic instrument we devised enhances the multisensory illusion. In this paper, we determine the requirements for inducing this multisensory illusion in a multi-degree-of-freedom (DOF) MSS, and the first stage of prototype implementation based on the given requirements is described.

Operability study on the multisensory illusion inducible in microsurgical robotic systems

The Rubber Hand Illusion is a well known multisensory illusion in which the participant feels their own unseen hand become a rubber hand that is placed at the position where their hand is supposedly placed, triggered by synchronized haptic stimuli on their hand and the rubber hand. Our previous study showed that a robotized 1-degree-of-freedom rubber hand in the form of a master-slave system significantly enhanced the illusion compared with the classic rubber hand illusion. The illusion gives the sense that the part of body becomes part of the robot - it is thus assumed that this multisensory illusion is a potentially effective way to increase intuitiveness, and therefore increase the operability of a multi-degrees-of-freedom master-slave system. To further investigate the concept, we built a multisensory illusion inducible microsurgical robotic system based on the findings of the previous study and conducted a series of psychophysical experiments. The experimental results reveal that the multisensory illusion and operability is significantly correlated.