Toward a Flexible Variable Stiffness Endoport for Single-Site Partial Nephrectomy

Toward a Flexible Variable Stiffness Endoport for Single-Site Partial Nephrectomy Laparoscopic partial nephrectomy for localized renal tumors is an upcoming standard minimally invasive surgical procedure. However, a single-site laparoscopic approach would be even more preferable in terms of invasiveness. While the manual approach offers rigid curved tools, robotic single-site systems provide high degrees of freedom manipulators. However, they either provide only a straight deployment port, lack of instrument integration, or cannot be reconfigured. Therefore, the current main shortcomings of single-site surgery approaches include limited tool dexterity, visualization, and intuitive use by the surgeons. For partial nephrectomy in particular, the accessibility of the tumors remains limited and requires invasive kidney mobilization (separation of the kidney from the surrounding tissue), resulting in patient stress and prolonged surgery. We address these limitations by introducing a flexible, robotic, variable stiffness port with several working channels, which consists of a two-segment tendon-driven continuum robot with integrated granular and layer jamming for stabilizing the pose and shape. We investigate biocompatible granules for granular jamming and demonstrate the stiffening capabilities in terms of pose and shape accuracy with experimental evaluations. Additionally, we conduct in vitro experiments on a phantom and prove that the visualization of tumors at various sites is increased up to 38% in comparison to straight endoscopes. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Annals of Biomedical Engineering Springer Journals

Toward a Flexible Variable Stiffness Endoport for Single-Site Partial Nephrectomy

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Publisher
Springer Journals
Copyright
Copyright © 2018 by Biomedical Engineering Society
Subject
Biomedicine; Biomedicine, general; Biomedical Engineering; Biological and Medical Physics, Biophysics; Classical Mechanics; Biochemistry, general
ISSN
0090-6964
eISSN
1573-9686
DOI
10.1007/s10439-018-2060-4
pmid
29855754
Publisher site
See Article on Publisher Site

Abstract

Laparoscopic partial nephrectomy for localized renal tumors is an upcoming standard minimally invasive surgical procedure. However, a single-site laparoscopic approach would be even more preferable in terms of invasiveness. While the manual approach offers rigid curved tools, robotic single-site systems provide high degrees of freedom manipulators. However, they either provide only a straight deployment port, lack of instrument integration, or cannot be reconfigured. Therefore, the current main shortcomings of single-site surgery approaches include limited tool dexterity, visualization, and intuitive use by the surgeons. For partial nephrectomy in particular, the accessibility of the tumors remains limited and requires invasive kidney mobilization (separation of the kidney from the surrounding tissue), resulting in patient stress and prolonged surgery. We address these limitations by introducing a flexible, robotic, variable stiffness port with several working channels, which consists of a two-segment tendon-driven continuum robot with integrated granular and layer jamming for stabilizing the pose and shape. We investigate biocompatible granules for granular jamming and demonstrate the stiffening capabilities in terms of pose and shape accuracy with experimental evaluations. Additionally, we conduct in vitro experiments on a phantom and prove that the visualization of tumors at various sites is increased up to 38% in comparison to straight endoscopes.

Journal

Annals of Biomedical Engineering – Springer Journals

Published: May 31, 2018

References

  • Continuum robots for medical applications: a survey
    Burgner-Kahrs, J; Rucker, DC; Choset, H
  • Soft robotics technologies to address shortcomings in today’s minimally invasive surgery: the STIFF-FLOP approach
    Cianchetti, M; Ranzani, T; Gerboni, G; Nanayakkara, T; Althoefer, K; Dasgupta, P; Menciassi, A
  • Laparoendoscopic single-site nephrectomy compared with conventional laparoscopic nephrectomy: a systematic review and meta-analysis of comparative studies
    Fan, X; Lin, T; Xu, K; Yin, Z; Huang, H; Dong, W; Huang, J
  • Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012
    Ferlay, J; Steliarova-Foucher, E; Lortet-Tieulent, J; Rosso, S; Coebergh, JW; Comber, H; Forman, D; Bray, F
  • L1-medial skeleton of point cloud
    Huang, H; Wu, S; Cohen-Or, D; Gong, M; Zhang, H; Li, G; Chen, B
  • Development of urologic laparoscopy in Germany, Austria, and Switzerland: a survey among urologists
    Imkamp, F; Herrmann, TR; Stolzenburg, JU; Rassweiler, J; Sulser, T; Zimmermann, U; Dziuba, S; Kuczyk, MA; Burchardt, M
  • Increased incidence of serendipitously discovered renal cell carcinoma
    Jayson, M; Sanders, H
  • 7-year oncological outcomes after laparoscopic and open partial nephrectomy
    Lane, BR; Gill, IS
  • Endoscopeshaft-rigidity control mechanism: “FORGUIDE”
    Leove, AJ; Breedveld, P; Plettenburg, DH; Dankelman, J
  • EAU guidelines on renal cell carcinoma: 2014 update
    Ljungberg, B; Bensalah, K; Canfield, S; Dabestani, S; Hofmann, F; Hora, M; Kuczyk, MA; Lam, T; Marconi, L; Merseburger, AS; Mulders, P; Powles, T; Staehler, M; Volpe, A; Bex, A
  • Stiffening in soft robotics: a review of the state of the art
    Manti, M; Cacucciolo, V; Cianchetti, M
  • Design of a novel bimanual robotic system for single-port laparoscopy
    Piccigallo, M; Scarfogliero, U; Quaglia, C; Petroni, G; Valdastri, P; Menciassi, A; Dario, P
  • A bioinspired soft manipulator for minimally invasive surgery
    Ranzani, T; Gerboni, G; Cianchetti, M; Menciassi, A
  • Positive surgical margins increase risk of recurrence after partial nephrectomy for high risk renal tumors
    Shah, PH; Moreira, DM; Okhunov, Z; Patel, VR; Chopra, S; Razmaria, AA; Alom, M; George, AK; Yaskiv, O; Schwartz, MJ; Desai, M; Vira, MA; Richstone, L; Landman, J; Shalhav, AL; Gill, I; Kavoussi, LR
  • Lessons learned using the insertable robotic effector platform (IREP) for single port access surgery
    Simaan, N; Bajo, A; Reiter, A; Wang, L
  • A novel new robotic platform for natural orifice distal pancreatectomy
    Thakkar, S; Awad, M; Gurram, KC; Tully, S; Wright, C; Sanan, S; Choset, H
  • A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma
    Poppel, H; Pozzo, L; Albrecht, W; Matveev, V; Bono, A; Borkowski, A; Colombel, M; Klotz, L; Skinner, E; Keane, T; Marreaud, S; Collette, S; Sylvester, R
  • Emerging robotic platforms for minimally invasive surgery
    Vitiello, V; Lee, S-L; Cundy, TP; Yang, G-Z
  • Development of the SJTU unfoldable robotic system (SURS) for single port laparoscopy
    Xu, K; Zhao, J; Fu, M
  • A single-port robotic platform for laparoscopic surgery with a large central channel for additional instrument
    Yung, KL; Cheung, JLK; Chung, SW; Singh, S; Yeung, CK
  • Surgical robots for SPL and NOTES: a review
    Zhao, J; Feng, B; Zheng, M-H; Xu, K

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