Global vision system in laparoscopy. / Sistema de visión global en laparoscopia.

OBJECTIVE: The main difficulty in laparoscopic or robot-assisted surgery is the narrow visual field, restricted by the endoscope's access port. This restriction is coupled with the difficulty of handling the instruments, which is due not only to the access port but also to the loss of depth of field and perspective due to the lack of natural lighting. In this article, we describe a global vision system and report on our initial experience in a porcine model. MATERIAL AND METHODS: The global vision system consists of a series of intraabdominal devices, which increase the visual field and help recover perspective through the simulation of natural shadows. These devices are a series of high-definition cameras and LED lights, which are inserted and fixed to the wall using magnets. The system's efficacy was assessed in a varicocelectomy and nephrectomy. RESULTS: The various intraabdominal cameras offer a greater number of intuitive points of view of the surgical field compared with the conventional telescope and appear to provide a similar view as that in open surgery. Areas previously inaccessible to the standard telescope can now be reached. The additional light sources create shadows that increase the perspective of the surgical field. CONCLUSION: This system appears to increase the possibilities for laparoscopic or robot-assisted surgery because it offers an instant view of almost the entire abdomen, enabling more complex procedures, which currently require an open pathway.

A minimally invasive surgery robotic assistant for HALS-SILS techniques.

This paper is focused in the design and implementation of a robotic surgical motion controller. The proposed control scheme addresses the issues related to the application of a robot assistant in novel surgical scenario, which combines hand assisted laparoscopic surgery (HALS) with the single incision laparoscopic surgery (SILS) techniques. It is designed for collaborating with the surgeon in a natural way, by performing autonomous movements, in order to assist the surgeon during a surgical maneuver. In this way, it is implemented a hierarchical architecture which includes an upper auto-guide velocity planner connected to a low-level force feedback controller. The first one, based on a behavior approach, computes a collision free trajectory of the surgical instrument tip, held by the robot, for reaching a goal location inside of the abdominal cavity. On the other hand, the force feedback controller uses this trajectory for performing the instrument displacement by taking into account the holonomic movement constraints introduced by the fulcrum point. The aim of this controller is positioning the surgical instrument by minimizing the forces exerted over the abdominal wall due to the fulcrum location uncertainty. The overall system has been integrated in the control architecture of the surgical assistant CISOBOT, designed and developed at the University of Malaga. The whole architecture performance has been tested by means of in vitro trials.

A new robotic endoscope manipulator. A preliminary trial to evaluate the performance of a voice-operated industrial robot and a human assistant in several simulated and real endoscopic operations.

We report our learning experience in simulated and real surgical tasks with a new voice-controlled robotic endoscope manipulator: an industrial robot with the tool-holder arm modified to support the optic and camera. The manipulator control-card programs have been rewritten to meet the needs of endoscopic surgeons. For this preliminary work, systems engineers with an additional monitor monitored, recorded, and compared the percentage effectiveness and precision of the responses of the robotic and human assistant to successive oral commands during the several different experimental surgical tasks. Simultaneously, to help develop this voice-commanded system for future, more precise robotic manipulation of surgical instruments, they measured the cartesian and spherical coordinates of successive positions of the optic. In unexpectedly difficult experimental conditions, the tireless robot proved more precise and effective than the demonstrably fatigable human: the steadier screen images of the robotic manipulations helped the surgeon tie knots in 7-0 sutures.