This document describes the design of a surgical robot for single port endoscopic surgery. The robot aims to address limitations in vision and maneuverability through a dynamic vision field control manipulator and dual arm tool manipulators. The vision field manipulator allows intuitive changing of the endoscope view using 6 degrees of freedom. The tool manipulators provide precise tissue manipulation. A prototype was evaluated in experiments demonstrating its ability to accurately cut and resection tissue through manipulation of both vision and tools.

1. EMBC 2010
MS 2. Surgical Robotics – Image-Guided Robotized Surgery
Design of a Surgical Robot
with Dynamic Vision Field Control
for Single Port Endoscopic Surgery
Yo Kobayashi,
Y. Sekiguchi, Y. Tomono, H. Watanabe, M. G. Fujie
Waseda University
K. Toyoda, K. Konishi,
M. Tomikawa, S. Ieiri, K. Tanoue, M. Hashizume
Kyushu University Hospital

2. 2/18
Outline Waseda
University
 Introduction
- Single port surgery
 Approach
- Vision field control
- Dual arm intervention
 System overview
 Design of prototype
 Experiment
 Summary

3. 3/18
Outline Waseda
University
 Introduction
- Single port surgery
- Problem : Limitation of vision field
- Concept
Dynamic vision field control
& Dual arm intervention
 Design of prototype
 Evaluation
 Summary
EMBC 2010 1, September, 2010

4. 4/18
Introduction
Waseda
Single Port Surgery (SPS) University
 More advanced minimally invasive surgery
 SPS reduces the number of skin incisions to ONE
• Advantage
- Physical damage of patient
• Disadvantage
- Difficulty in
tissue manipulation &
visual orientation
EMBC 2010 1, September, 2010

5. 5/18
Introduction
Waseda
Related works : SPS & NOTES University
J. Ding et al., Columbia University, B. Bardou et al., University of S.J. Phee et al., Nanyang Technological
ICRA’10 Strasbourg, EMBC’09 University, EMBC’09
 Development of a robotic effectors
- Precise tissue manipulation inside patient body
 Static positioning of the endoscope and work space
- initially inserted and positioned within the surgical workspace
and maintains a motionless state
- a manual change of vision field is not intuitive
is a time-consuming task for surgeons
EMBC 2010 1, September, 2010

6. 6/18
Introduction
Waseda
Concept & Novelty (cont’d) University
 Robotic system with “Dynamic vision field control”
- Master-slave function for
manipulation of the robotic arm & control of vision field
- Six DOFs only for the dynamic changes of vision field
- Different DOFs for dual robotic arms to manipulate effector
- A flexible endoscope at the forefront of the manipulator
EMBC2010 1, September, 2010

7. 7/18
Introduction
Waseda
System overview University
 Dynamic vision field control manipulator
- Six DOFs only for the control of vision field
: change of endoscope view to arbitrary position and orientation
- Intuitive change of endoscope view and work space to a target tissue
 Dual arm tool manipulator
- Precise tissue manipulation
EMBC 2010 1, September, 2010

8. 8/18
Outline Waseda
University
 Introduction
 Design of prototype
- Vision field control manipulator
( Positioning manipulator & Insertable tool )
- Dual arm tool manipulators
 In vitro experiment
 Summary
EMBC 2010 1, September, 2010

9. 9/18
Design
Waseda
Vision field control manipulator University
Positioning manipulator
- Outside the body
- One rotation and
two orientation
at pivot point
for insertable tool
Insertable tool
- One translation
at pivot point
total of six DOFs for
- Two bending DOF
positioning of the endoscope
inside patient body
and tool manipulator
EMBC 2010 1, September, 2010

10. 10/18
Design
Waseda
Positioning manipulator [Oura et al. BioRob’06] University
1) Two DOF-orientations
- Two gimbals at the tip of the SCARA
at the tip of the fixed-bar
- Horizontal motion of the SCARA
2) One DOF for axis of the insertable tool
- Top gimbal can rotate about its own axis
by using timing belt
1) 2)
M. Oura, et al., “Development of MRI Compatible Versatile Manipulator for Minimally Invasive Surgery”
2006 IEEE Biomedical Robotics and Biomechatronics, pp.176-181, 2006
EMBC 2010 1, September, 2010

11. 11/18
Design
Waseda
Insertable tool (sheath manipulator) University
 Sheath manipulator
- Two DOFs for bending motion inside the body
- Spring back bone with a hole in the center of the shaft
in order to pass through the power transmission and endoscope
- Wires controls the compression and steering motions
 Telescope mechanism : Ball screw mechanism on the drive unit
EMBC 2010 1, September, 2010

12. 12/18
Design
Waseda
Tool manipulators [Sekiguchi et al. , BioRob’10] University
- A surgical slave for dual arm interventions
- End effectors can be used for various endoscopic instruments
: a gripper and a cautery end-effector for resection task
- A flexible endoscope shares a mechanical base with the tool manipulators
- Four DOFs for the prototype
: two-bendng DOFs, a one-DOF for rotation around the axis, one- translation
endoscope
cautery
gripper
Yuta Sekiguchi et al., “Development of a Tool Manipulator Driven by a Flexible Shaft for Single Port Endoscopic Surgery”,
EMBC 2010 in 2010 IEEE International Conference on Biomedical Robotics and Biomechatronics
1, September, 2010

13. 13/18
Outline Waseda
University
 Introduction
 System overview
 Design of prototype
 in vitro experiment
- Method
- Result
- Discussion
 Summary
EMBC 2010 1, September, 2010

14. 14/18
Evaluation
Waseda
Method University
- Objectives : evaluation of the cutting and resection performance
- Setup: breast tissue placed on the metallic table
- Task : cutting the tissue in a wide range over a view from a certain location
by the engineers & medical doctors
1) Cut and vision field control : cutting tasks with tool manipulator
2) Cut by vision field control : cutting tasks with sheath manipulator
3) Resection
1)
Return
electrode
2)
Wall Chicken
EMBC 2010 1, September, 2010

15. 15/18
Evaluation
Waseda
Result (cont’d) University
 Cut and vision field control  Cut by vision field control
Three-times vision field repositioning Three repeated cuts on the same path
- Length : about 20 mm in total - Length : about 20 mm in total
- Time : about 200 seconds in total - Time : about 40 seconds in total
 Accurate cutting of tissues  Rapid macro cutting of tissues
 Time-consuming  Dynamic change of endoscope image
EMBC 2010 1, September, 2010

16. 16/18
Evaluation
Waseda
Result University
 Resection
Manipulation capabilities : the operator to perform resection tasks
- First: “cut by vision field control” for macro cutting of tissues
- Second: “cut and vision field control” for precise cutting
EMBC 2010 1, September, 2010

17. 17/18
Evaluation
Waseda
Discussion University
 Accuracy and force
- A stable mounting platform with smooth repositioning
- Sufficient force and precision to perform the task
 Expansion of approach path
- The bending movement:
the perpendicular approach to the tissue
 DOF and ROM
- Enough DOF and ROM for resection task
- Contribution to reducing the DOFs and ROM of robotic effectors
 Global position
- Possibility to lost the global positioning
- Necessity of diagnostic image-based navigation system
 Hand-eye triangulation
- Prevention for the surgeon from seeing the end-effectors J. Ding et al., ICRA’10
- positioning the endoscope for a view from above the tool manipulators
EMBC 2010 1, September, 2010

18. 18/18
Conclusion Waseda
University
Summary
A surgical robot with vision field control for SPS
- The design and prototype of proposed system
- The preliminary in vitro experiments
to evaluate its performance
Future work
- Triangulation problem
- Navigation system
- In vivo experiment to evaluate the design configuration
EMBC 2010 1, September, 2010

19. 19/18
Waseda
University
Thank you
for your attentions
Contact
Yo Kobayashi: you-k@aoni.waseda.jp
Masakatsu G. Fuie: mgfujie@waseda.jp
This work was supported by
Global COE (Centers of Excellence) Program “Global Robot Academia”
High-Tech Research Center Project
Grant Scientific Research (A) (90198664)
Waseda University Grant for Special Research Project (2009B-207)
EMBC 2010 1, September, 2010