ABSTRACT
INTRODUCTION: Flexible endoscopy allows diagnostic and therapeutic interventions on the gastrointestinal (GI) tract. Simple procedures can be performed endoscopically using currently available tools. More advanced endoscopic surgical interventions are much desired and anticipated, yet they await improvements in instrumentation. METHODS: Presented here is a master-slave robotic system designed for use with flexible endoscopy. The slave is a cable-driven flexible robotic manipulator that can be attached to an endoscope, allowing two-handed endoscopic manipulation with 9-12 degrees of freedom (DOF). RESULTS: Feasibility has been demonstrated in a porcine intragastric model. CONCLUSIONS: Further studies should determine whether this novel device can overcome some of the instrumentation-related challenges that have heretofore limited the development of natural orifice transluminal endoscopic surgery.
Subject(s)
Cicatrix/prevention & control , Endoscopes, Gastrointestinal , Minimally Invasive Surgical Procedures/instrumentation , Robotics/instrumentation , Surgery, Computer-Assisted/instrumentation , Animals , Equipment Design , Equipment Failure Analysis , Feasibility Studies , Man-Machine Systems , Minimally Invasive Surgical Procedures/methods , Surgery, Computer-Assisted/methods , SwineABSTRACT
Flexible endoscopy is used to inspect and treat disorders of the gastrointestinal (GI) tract without the need for creating an artificial opening on the patient's body. Simple surgical procedures (like polypectomy and biopsy) can be performed by introducing a flexible tool via a working channel to reach the site of interest at the distal end. More technically demanding surgical procedures like hemostasis for arterial bleeding, or suturing to mend a perforation cannot be effectively achieved with flexible endoscopy. The proposed robotic system enables the endoscopist to perform technically demanding therapeutic procedures (currently possible only with open surgery) in conjunction with conventional flexible endoscopes. The robotic system consists of a master console and a slave. The latter is a cable driven flexible robotic manipulator that can be inserted into tool channel of existing endoscopes or attached in tandem to the endoscopes. Together with the real time endoscopic view, the endoscopist would be capable of performing more intricate and difficult surgical procedures.
