Tyler D. Wortman

Laparoendoscopic single-site surgery using a multi-functional miniature in vivo robot

Existing methods used to perform laparoendoscopic single‐site surgery (LESS) require multiple laparoscopic tools that are inserted into the peritoneal cavity through a single, specialized port. These methods are inherently limited in visualization and dextrous capabilities by working through a single access point. A miniature in vivo robotic platform that is completely inserted into the peritoneal cavity through a single incision can address these limitations, providing more intuitive manipulation capabilities and improved visualization.

Miniature surgical robot for laparoendoscopic single-incision colectomy

BackgroundThis study aimed to demonstrate the effectiveness of using a multifunctional miniature in vivo robotic platform to perform a single-incision colectomy. Standard laparoscopic techniques require multiple ports. A miniature robotic platform to be inserted completely into the peritoneal cavity through a single incision has been designed and built. The robot can be quickly repositioned, thus enabling multiquadrant access to the abdominal cavity.MethodsThe miniature in vivo robotic platform used in this study consists of a multifunctional robot and a remote surgeon interface. The robot is composed of two arms with shoulder and elbow joints. Each forearm is equipped with specialized interchangeable end effectors (i.e., graspers and monopolar electrocautery).ResultsFive robotic colectomies were performed in a porcine model. For each procedure, the robot was completely inserted into the peritoneal cavity, and the surgeon manipulated the user interface to control the robot to perform the colectomy. The robot mobilized the colon from its lateral retroperitoneal attachments and assisted in the placement of a standard stapler to transect the sigmoid colon. This objective was completed for all five colectomies without any complications.ConclusionsThe adoption of both laparoscopic and single-incision colectomies currently is constrained by the inadequacies of existing instruments. The described multifunctional robot provides a platform that overcomes existing limitations by operating completely within one incision in the peritoneal cavity and by improving visualization and dexterity. By repositioning the small robot to the area of the colon to be mobilized, the ability of the surgeon to perform complex surgical tasks is improved. Furthermore, the success of the robot in performing a completely in vivo colectomy suggests the feasibility of using this robotic platform to perform other complex surgeries through a single incision.

Single-Site Colectomy With Miniature In Vivo Robotic Platform

There has been a continuing push to reduce the invasiveness of surgery by accessing the abdominal cavity through a single incision, such as with laparoendoscopic single-site (LESS) surgery. Although LESS procedures offer significant benefits, added complexities still inhibit the procedures. Robotic surgery is proving to be an excellent option to overcome these limitations. This paper presents the experimental results of the single-incision in vivo surgical robot (SISR), a multifunctional, dexterous, two-armed robot capable of performing surgical tasks while overcoming the issues associated with manual LESS operations. In vivo surgical procedures have been used to demonstrate the efficacy of using a robotic platform over traditional laparoscopic tools. The most recent experimental test resulted in the first successful in vivo robotic LESS colectomy utilizing a robot completely contained within the abdominal cavity. In this test, SISR showed significant benefits including access to all quadrants in the peritoneal cavity and improved dexterity.

Kinematic and Workspace Comparison of Four and Five Degree of Freedom Miniature In Vivo Surgical Robot

The adoption of Laparo-Endoscopic Single-Site Surgery (LESS) provides potential for surgical procedures to be performed with the use of a single incision into the peritoneal cavity. Benefits of this technique include faster recovery times, decreased chance of infection, and improved cosmetic results as compared to traditional surgery. Current technology in this area relies on multiple laparoscopic tools which are inserted into the peritoneal cavity through a specialized port, resulting in poor visualization, limited dexterity, and unintuitive controls occur. To mitigate these problems, this research group is developing a multi-functional, two-armed miniature in vivo surgical robot with a remote user interface for use in LESS. While this platform’s feasibility has been demonstrated in multiple nonsurvival surgeries in porcine models, including four cholecystectomies, previous prototypes have been too large to be inserted through a single incision. Work is currently being performed to reduce the overall size of the robot while increasing dexterity. Using the knowledge gained from the development of a four degree of freedom (DOF) miniature in vivo surgical robot, another robot prototype was designed which was smaller, yet was able to utilize five DOF instead of four. The decreased size of the five DOF robot allows it to be completely inserted into the peritoneal cavity through a single incision for use in LESS. Each arm of the surgical robot is inserted independently before being mated together and attached to a central control rod. Once inserted, this platform allows for gross repositioning of the robot to provide surgical capabilities in all four quadrants of the abdominal cavity by rotating the control rod. The additional degree of freedom allows for reaching positions in the surgical workspace from varied angles. This paper will provide a comparison of the four DOF and five DOF miniature in vivo surgical robots. The implications of the added degree of freedom on the forward and inverse kinematics will be discussed and the workspace of each robot will be compared. Additionally, the increased complexity of the control system for the remote surgical interface in moving from four DOF to five DOF will be demonstrated. Finally, results from non-survival procedures using a porcine model will be presented for both robots. This comparison will provide useful information for further development of miniature in vivo surgical robots as the goals of decreased size and improved dexterity are approached. INTRODUCTION Performing surgery using long instruments while working through small incisions in the abdominal wall, such as in laparoscopy, offers recognized patient advantages including shortened recovery times, improved cosmetics, and reduced expense. While replacing a large open incision with three to five small incisions offers significant patient advantages, continuing work focuses on further reducing the invasiveness of surgical procedures. Laparo-Endoscopic Single-Site surgery (LESS) is a new alternative to laparoscopic procedures that completely eliminates all but one small external incision. Existing methods for performing LESS use multiple articulating, bent, or flexible laparoscopic instruments that are inserted into the abdominal cavity through a single specialized

Multi-Functional Surgical Robot for Laparo-Endoscopic Single-Site Colectomies

This paper presents work to develop a miniature in vivo robot for Laparo-Endoscopic Single-Site (LESS) colectomy. Colon resections are generally not done laparoscopically and would benefit from a robotic platform that reduces the limitations that are currently encountered. This paper looks at the workspace, forces, and speeds of a recently developed miniature in vivo surgical robot platform and analyzes the ability to perform a colon resection based on these criteria. The robotic platform used in this study consists of a two armed robotic prototype and a remote surgeon interface. For the surgical procedure, each arm of the robot is inserted individually into a single five centimeter incision and then assembled within the abdominal cavity. A surgeon then utilizes a user interface that is remotely located within the operating room. The current robotic platform has recently been demonstrated successfully in an in vivo procedure.Copyright