A Hand-Held Non-Robotic Surgical Tool With a Wrist and an Elbow
A Hand-Held Non-Robotic Surgical Tool With a Wrist and an Elbow
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DOI：
10.1109/tbme.2019.2901751
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发表时间：
2019-11-01
影响因子：
4.6
通讯作者：
Webster, Robert J., III
中科院分区：
文献类型：
--
作者：
Riojas, Katherine E.;Anderson, Patrick L.;Webster, Robert J., III
目的：描述一种既能提供腕部和肘部灵活性又不需要电机或电子设备的手术装置。该设备在通常与机器人系统相关的微创手术中提供了灵活性优势，但使用的组件要少得多。这种类型的全机械设计有望以比目前的外科机器人系统更低的财务成本提供“机器人般的灵活性”。方法：迄今为止开发的大多数非机器人关节外科手术工具的特征是靠近工具尖端的一个或两个自由度(DOF)(即“手腕”)。在这篇文章中，我们描述了一种新的工具，它不仅具有两个自由度的手腕，而且还通过一个两个自由度的“肘部”来增强其灵活性，该“肘部”由以前仅在机器人系统中看到的多脊椎设计组成。这样的弯头在薄的外形因素中提供了高的刚性。这个肘部需要静态平衡，我们使用手柄上的弹簧来完成这一点，这样外科医生就可以从僵硬中受益，而不会在使用设备时感觉到它。结果：我们报告了总体的工具设计和实验，评估了我们的静态平衡机制如何很好地补偿了多脊椎肘部的固有僵硬。结论：我们首次演示了多脊椎肘部在手动工具中的使用，并展示了如何在全机械(即非机器人)工具中将肘部与销关节腕相结合。意义：这篇论文是朝着高灵巧、低成本的手术器械迈出的一步，这些器械以较低的成本为患者和外科医生带来了外科机器人系统的一些好处。
Objective: This paper describes a surgical device that provides both wrist and elbow dexterity without motors or electronics. The device provides dexterity advantages in minimally invasive surgery typically associated with robotic systems, but does so with many fewer components. Fully mechanical designs of this type promise to deliver "robot-like dexterity" at a lower financial cost than current surgical robotic systems. Methods: Most non-robotic articulated surgical tools developed to date feature one or two degrees-of-freedom (DOF) close to the tool tip (i.e., a "wrist"). In this paper, we describe a new tool that not only features a two-DOF wrist, but also augments its dexterity with a two-DOF "elbow" consisting of a multi-backbone design seen previously only in robotic systems. Such an elbow offers high stiffness in a thin form factor. This elbow requires static balancing, which we accomplish with springs in the handle, so that the surgeon can benefit from the stiffness without feeling it while using the device. Results: We report the overall tool design and experiments evaluating how well our static balance mechanism compensates for the multi-backbone elbow's intrinsic stiffness. Conclusion: We demonstrate the use of a multi-backbone elbow in a manual tool for the first time and show how to combine the elbow with a pin joint wrist in a fully mechanical (i.e., non-robotic) tool. Significance: This paper is a step toward high dexterity, low-cost surgical instruments that bring some benefits of surgical robotic systems to patients and surgeons at a lower cost.