Hand-held transendoscopic robotic manipulators: A transurethral laser prostate surgery case study.

Hand-held transendoscopic robotic manipulators: A transurethral laser prostate surgery case study.
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DOI:
10.1177/0278364915585397
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发表时间:
2015-11
期刊:
The International journal of robotics research
影响因子:
--
通讯作者:
Webster RJ 3rd
Webster RJ 3rd
中科院分区:
其他
文献类型:
--
作者:
Hendrick RJ;Mitchell CR;Herrell SD;Webster RJ 3rd

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自然腔道内镜手术可以实现无切口入路,但主要挑战是缺乏小型和灵巧的器械。手术机器人有可能满足这一需求,但往往会扰乱临床工作流程。结合联合收割机和内窥镜的手持式机器人有可能通过无缝集成到临床工作流程中并提高灵活性来解决这一问题。作为说明这种方法潜力的案例研究,我们描述了一种手持式机器人系统,该系统将两个同心管操纵器通过刚性内窥镜中的5 mm端口,用于经尿道激光前列腺手术。该系统预期用于促进良性前列腺增生的临床上级但很少尝试的手术的使用。本文介绍了系统的设计和实验,以评估外科医生的功能工作空间和精度使用机器人。体模和尸体实验证明通过前列腺叶切除成功完成了目标手术。
Natural orifice endoscopic surgery can enable incisionless approaches, but a major challenge is the lack of small and dexterous instrumentation. Surgical robots have the potential to meet this need yet often disrupt the clinical workflow. Hand-held robots that combine thin manipulators and endoscopes have the potential to address this by integrating seamlessly into the clinical workflow and enhancing dexterity. As a case study illustrating the potential of this approach, we describe a hand-held robotic system that passes two concentric tube manipulators through a 5 mm port in a rigid endoscope for transurethral laser prostate surgery. This system is intended to catalyze the use of a clinically superior, yet rarely attempted, procedure for benign prostatic hyperplasia. This paper describes system design and experiments to evaluate the surgeon’s functional workspace and accuracy using the robot. Phantom and cadaver experiments demonstrate successful completion of the target procedure via prostate lobe resection.
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