Enhancement of a master-slave robotic system for natural orifice transluminal endoscopic surgery.
- Author:
Zhenglong SUN
1
;
Rui Yee ANG
;
Ed Wyn LIM
;
Zheng WANG
;
Khek Yu HO
;
Soo Jay PHEE
Author Information
- Publication Type:Journal Article
- MeSH: Animals; Disease Models, Animal; Feasibility Studies; Humans; Imaging, Three-Dimensional; Natural Orifice Endoscopic Surgery; instrumentation; methods; Robotics; instrumentation; methods; Stomach; surgery; Surgery, Computer-Assisted; instrumentation; methods; Surgical Procedures, Operative; methods; Swine
- From:Annals of the Academy of Medicine, Singapore 2011;40(5):223-230
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTIONA novel robotic platform for Natural Orifice Transluminal Endoscopic Surgery (NOTES) is presented in this paper. It aims to tackle two crucial technical barriers which hinder its smooth transition from animal studies to clinical trials: providing effective instrumentations to perform complex NOTES procedures and maintaining the spatial orientation for endoscopic navigation.
MATERIALS AND METHODSThe technical barriers are overcome by the design of the robotic system considering size, triangulation, dexterity, maneuverability and complexity. It is also shown that haptic feedback and interventional navigation system could solve the problem of off-axis manipulation of the camera angle and loss of spatial orientation upon entering the peritoneal cavity in transgastric NOTES procedure, respectively.
RESULTSSuccessful ESD (endoscopic submucosal dissection) and wedge hepatic resection have been performed on live pigs with our Master And Slave Transluminal Endoscopic Robot (MASTER) system, showing its capability to perform advanced endoscopic surgical and NOTES procedures. It is found that the MASTER exhibited good grasping and cutting efficiency. And the lesion resection time could be significantly reduced with more practice between the endoscopist and the robot operator.
CONCLUSIONThis study evaluates the feasibility of MASTER system as a platform overcoming the barriers to NOTES. It is also demonstrated that the MASTER could effectively mitigate the technical constraints normally encountered in NOTES procedures.