Minimally invasive surgery of the throat and upper
airways is limited to procedures not involving suituring or
complex tissue manipulation. As a result of instrument dexterity deficiencies, accurate tissue reconstruction susequent to excision of tumors is not possible. Our goal is to overcome this limitation in order to reduce invasiveness and to ensure preservation of normal vocal fold function subject to surgery.
Figure 1 shows the layout of the system developed by the ERC-CISST and ARMA. This system uses a new
generation of tele-robotic slaves capable of manipulating several
dexterous instruments through a single access port - i.e. the patient's
Figure 1: A system for Minimally Invasive Surgery of the thorat and the upper airways
focus of ARMA's research is on investigating novel distal dexterity units
designed to manipulate surgical tools inside the patient's throat.
These distal dexterity units are hybrid robots with each one composed
from a snake-like unit and a parallel manipulation unit. Both the
snake-like unit and the parallel manipulation unit implement NiTi
super-elastic links to support downsize scalability of these device. A
good description of the ongoing advances in this project can be found
in our publications listed below.
The following figure shows
our current snake-like unit demonstrating basic 3D positioning
capabilities. The diameter of this unit is 4.2 mm. We implement
actuation redundancy to optimize the load distribution on the backbones
of the snake-like unit.
Figure 2: the Distal Dexterity Unit (DDU): a single segment (top), a two-segment DDU (bottom)
are some small size movies demonstrating both early design simulations
modelling and experimental prototypes (Please click the pictures below
to see the movies).
The movie below demostrates the capability of segments of the DDU to act as parallel robots capable of transmitting rotation along the central backbone by careful synchronized actuation of all secondary backbones.
We have extended this rotation-about-backbone operation mode to allow suturing in confined spaces. Successful implememntation of this operation mode in a multi-segment DDU is predicated on very exact synchronous actuation of all secondary backbones while compensating for any modeling errors, friction, backlash, and extensibility of actuiation lines. The following movie shows the 2-segment DDU of figure 1 and figure 2 performing rotation about its central backbone. The movie shows the performance of this task with and without proper actuation compensation.
Russell H. Taylor, Peter Kazanzides, Ankur Kapoor,
Allison Okamura: ERC-CISST, Johns Hopkins University.
Paul Flint, Johns Hopkins School of Medicine,
department of Otolaryngology - Head & Neck Surgery.
Simaan, N., Xu, K., Wei Wei, Kapoor, A., Kazanzides, P., Flint, P., Taylor, R., “Design and Integration of a Telerobotic System for Minimally Invasive Surgery of the Throat,” International Journal of Robotics Research (IJRR) special issue on medical robotics, first published on OnlineFirst on May 27, 2009 as doi:10.1177/0278364908104278, 2009.
Alexander T. Hillel, Ankur Kapoor, Nabil Simaan, Russell H. Taylor and Paul Flint, " Applications of Robotics for Laryngeal Surgery," Laryngeal Cancer -Otolaryngologic Clinics of North America, Nasir Bhatti & Ralph P. Tufano Eds., Volume 41, Issue 4, Pages 781-791, August 2008.
Simaan, N., Taylor, R., Hillel, A., Flint, P., “Minimally Invasive Surgery of the Upper Airways: Addressing the Challenges of Dexterity Enhancement in Confined Spaces” Book chapter in Surgical Robotics - History, Present and Future Applications, Russell Faust (Ed.), Nova Science Publishing, 2007.
Wei, W., Ku, K., Simaan, N. “A Compact Two-Armed Slave Manipulator for Minimally Invasive Surgery of the Throat,” The first IEEE/RAS-EMB International Conference on Biomedical Robotics and Biomechatronics (BIOROB’2006), Pisa, Italy, pp. 287-292, 2006.