Design, Analysis and Experimental Validation of a Novel 7-Degrees of Freedom Instrument for Laparoscopic Surgeries.

Laparoscopic surgery is widely used for treating intra-abdominal conditions involving the gallbladder, pancreas, liver, intestines and reproductive organs. Conventional laparoscopy instruments used in manual surgeries usually have straight shafts and four degrees of freedom (DOF) plus grasping. However, these are insufficient for the complete rotation of the instrument tip. This makes it challenging to access difficult-to-reach organs inside the abdomen during the surgeries. A few robotic instruments available in the market have higher maneuverability but are expensive. Instruments incorporating cable-based mechanisms require replacement after a few sterilization cycles. This paper describes a novel, reusable and affordable multi-DOF laparoscopy instrument that provides two additional DOF: (a) wrist articulation about one axis (wristed yaw) and (b) rotation of the jaw after articulation (jaw roll). The wrist can articulate up to 45° and also roll after articulation. The additional degrees of freedom enable better maneuverability, functionality and reach than conventional laparoscopy instruments. Further, the new instrument employs only rigid links, providing better strength and minimal loss of function after multiple sterilizations. The complete design of the novel instrument, followed by its kinematic analysis and force calculations are explained in this paper, concluding with its manufacture and experimental validation.

Surgeon perception of factors affecting the efficiency of conventional and robotic laparoscopy: A Pan India study.

Background: Laparoscopic surgery, being minimally invasive, offers many benefits including faster patient recovery, reduced scarring and lower mortality rate. It is, however, technically challenging and requires a long learning curve. These issues can be overcome by Robot-Assisted Surgery (RAS) systems, which incorporate computer-controlled motions enabling enhanced precision and accuracy. Methods: This study involves identifying and verifying various difficulties related to laparoscopy and the role of RAS in their mitigation. It involved 93 surgeons across India, covering a range of demographics, medical specialties and experience. They were interviewed to understand the current status and to compare RAS with conventional laparoscopy. The questionnaire developed for the purpose tests a set of hypotheses related to instruments, comfort, and other factors derived from the available literature as well as inputs from leading laparoscopy surgeons and domain experts. Results: A grading system was adopted to evaluate the hypotheses based on the surgeons' responses. A statistical method based on T-test was employed to gain useful inferences from the study. The results showed that early-career surgeons preferred haptic enabled systems. As the experience of the surgeon increases, tissue identification becomes easier, thereby reducing the need for haptic feedback-enabled instruments. Conclusions: The surgeons from across the demographics were strongly in the favour of the need for articulated instruments with surgeon-controlled camera systems. They reported a reduction in physical and mental discomfort during surgical procedures using RAS. They also confirmed the similarity in patient outcomes for both conventional laparoscopy and RAS. These insights are expected to be interesting and useful for further research and development in this field.

Innovation in robotic surgery: the Indian scenario.

Robotics is the science. In scientific words a "Robot" is an electromechanical arm device with a computer interface, a combination of electrical, mechanical, and computer engineering. It is a mechanical arm that performs tasks in Industries, space exploration, and science. One such idea was to make an automated arm - A robot - In laparoscopy to control the telescope-camera unit electromechanically and then with a computer interface using voice control. It took us 5 long years from 2004 to bring it to the level of obtaining a patent. That was the birth of the Swarup Robotic Arm (SWARM) which is the first and the only Indian contribution in the field of robotics in laparoscopy as a total voice controlled camera holding robotic arm developed without any support by industry or research institutes.