Deployable, variable stiffness, cable driven robot for minimally invasive surgery
File(s)AcceptedArticle.pdf (14.2 MB)
Published version
Author(s)
Runciman, Mark
Avery, James
Zhao, Ming
Darzi, Ara
Mylonas, George P
Type
Journal Article
Abstract
Minimally Invasive Surgery (MIS) imposes a trade-off between non-invasive access and surgical capability. Treatment of early gastric cancers over 20 mm in diameter can be achieved by performing Endoscopic Submucosal Dissection (ESD) with a flexible endoscope; however, this procedure is technically challenging, suffers from extended operation times and requires extensive training. To facilitate the ESD procedure, we have created a deployable cable driven robot that increases the surgical capabilities of the flexible endoscope while attempting to minimize the impact on the access that they offer. Using a low-profile inflatable support structure in the shape of a hollow hexagonal prism, our robot can fold around the flexible endoscope and, when the target site has been reached, achieve a 73.16% increase in volume and increase its radial stiffness. A sheath around the variable stiffness structure delivers a series of force transmission cables that connect to two independent tubular end-effectors through which standard flexible endoscopic instruments can pass and be anchored. Using a simple control scheme based on the length of each cable, the pose of the two instruments can be controlled by haptic controllers in each hand of the user. The forces exerted by a single instrument were measured, and a maximum magnitude of 8.29 N observed along a single axis. The working channels and tip control of the flexible endoscope remain in use in conjunction with our robot and were used during a procedure imitating the demands of ESD was successfully carried out by a novice user. Not only does this robot facilitate difficult surgical techniques, but it can be easily customized and rapidly produced at low cost due to a programmatic design approach.
Date Issued
2020-01-10
Date Acceptance
2019-12-05
Citation
Frontiers in Robotics and AI, 2020, 6, pp.1-16
ISSN
2296-9144
Publisher
Frontiers Media
Start Page
1
End Page
16
Journal / Book Title
Frontiers in Robotics and AI
Volume
6
Copyright Statement
© 2020 Runciman, Avery, Zhao, Darzi and Mylonas. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY)(http://creativecommons.org/licenses/by/4.0/). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Sponsor
National Institute of Health Research
Imperial College Healthcare NHS Trust- BRC Funding
National Institute for Health Research
Identifier
https://www.frontiersin.org/articles/10.3389/frobt.2019.00141/full
Grant Number
RDB04
NF SI 061710038
Subjects
Science & Technology
Technology
Robotics
soft robotics
minimally invasive surgery
rapid manufacture
deployable
variable stiffness
ENDOSCOPIC SUBMUCOSAL DISSECTION
SOFT ROBOTICS
FABRICATION
RESECTION
DESIGN
ESD
EMR
deployable
minimally invasive surgery
rapid manufacture
soft robotics
variable stiffness
0801 Artificial Intelligence and Image Processing
0906 Electrical and Electronic Engineering
Publication Status
Published
Article Number
141
Date Publish Online
2020-01-10