Total mesorectal excision using a soft and flexible robotic arm: a feasibility study in cadaver models
Total mesorectal excision using a soft and flexible robotic arm: a feasibility study in cadaver models
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DOI：
10.1007/s00464-016-4967-x
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发表时间：
2017-01-01
影响因子：
3.1
通讯作者：
Morino, Mario
中科院分区：
文献类型：
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作者：
Arezzo, Alberto;Mintz, Yoav;Morino, Mario
由欧盟委员会资助的FP7 STIFF-FLOP项目旨在开发一种刚度可控的柔性和可学习的外科手术机械臂，以克服当前刚性连杆机器人技术的局限性。在此，我们描述了第一个尸体系列的全肠系膜切除术（TME）使用柔软和灵活的机械臂的视觉在尸体模型。在STIFF-FLOP机器人光学辅助下，成功地在两具防腐男性尸体上进行了TME。这个柔软而灵活的光学原型由两个模块组成，每个模块长60毫米，最大外径14.3毫米。该机器人连接在刚性轴上，刚性轴与拟人机械臂相连，具有6个自由度。控制器装置配有两个操纵杆。尸体（BMI为25和28 kg/m(2)）采用Thiel防腐法制备。该手术使用三种标准的腹腔镜器械进行牵引和解剖，并在后部使用30A度刚性光学器件进行记录。在左结肠屈曲的活动和肠系膜下血管的分裂后，TME完成至骨盆底。STIFF-FLOP机械视觉臂似乎获得了骨盆手术视野的优越视角，导致两例患者的直肠系完整。手术完成时间分别为165分钟和145分钟。无术中并发症发生。没有出现技术故障。事实证明，STIFF-FLOP柔软灵活的机器人光学臂在协助人类尸体的腹腔镜TME方面是有效的，与标准腹腔镜视力相比，它具有优越的视野，特别是骨盆低处。引入柔软和灵活的机器人设备可能有助于克服基于标准刚性仪器的困难腹腔镜手术的技术挑战。
Sponsored by the European Commission, the FP7 STIFF-FLOP project aimed at developing a STIFFness controllable Flexible and Learn-able manipulator for surgical operations, in order to overcome the current limitations of rigid-link robotic technology. Herein, we describe the first cadaveric series of total mesorectal excision (TME) using a soft and flexible robotic arm for optic vision in a cadaver model.TME assisted by the STIFF-FLOP robotic optics was successfully performed in two embalmed male human cadavers. The soft and flexible optic prototype consisted of two modules, each measuring 60 mm in length and 14.3 mm in maximum outer diameter. The robot was attached to a rigid shaft connected to an anthropomorphic manipulator robot arm with six degrees of freedom. The controller device was equipped with two joysticks. The cadavers (BMI 25 and 28 kg/m(2)) were prepared according to the Thiel embalming method. The procedure was performed using three standard laparoscopic instruments for traction and dissection, with the aid of a 30A degrees rigid optics in the rear for documentation.Following mobilization of the left colonic flexure and division of the inferior mesenteric vessels, TME was completed down to the pelvic floor. The STIFF-FLOP robotic optic arm seemed to acquire superior angles of vision of the surgical field in the pelvis, resulting in an intact mesorectum in both cases. Completion times of the procedures were 165 and 145 min, respectively. No intraoperative complications occurred. No technical failures were registered.The STIFF-FLOP soft and flexible robotic optic arm proved effective in assisting a laparoscopic TME in human cadavers, with a superior field of vision compared to the standard laparoscopic vision, especially low in the pelvis. The introduction of soft and flexible robotic devices may aid in overcoming the technical challenges of difficult laparoscopic procedures based on standard rigid instruments.