Page 189 - Control Theory in Biomedical Engineering

Medical robotics 173

Fig. 17 The da Vinci SP surgical system performing a single-port surgery for a benign
gynecologic disease. (A) Operating room setup. (B) The da Vinci SP cannula can be
inserted through the Gel Pass and one additional trocar is inserted 1.5 cm away from
the cannula. Reproduced with permission from Shin, H. J., et al., 2020. Robotic single-port
®
surgery using the da Vinci SP surgical system for benign gynecologic disease: a preliminary
report, Taiwan. J. Obstet. Gynecol. 59(2), 243–247. doi: 10.1016/j.tjog.2020.01.012, Copyright
Elsevier, 2020.

be more ergonomic (Fig. 18). The EndoWrist SP instruments and camera
have joggle joints in combination with snake-like wrist joints that mimic
the human wrist, shoulder, and elbow. Also, the wrist joint allows for seven
degrees of freedom and the elbow joint maintains intracorporeal triangula-
tion. A more remarkable feature is the instrument guidance system, which
tracks the locations of the robot camera, port, and instruments within the
operational field and simultaneously repositions the instruments. With this
system, it is possible to operate efficiently in a narrow space without clashing
the instrument.
Fig. 19 shows a new conceptual design for microrobots to be developed
for NOTES. For these robots, the tools are attached directly to the magnetic
joint, which is coupled to the external magnetic handle. The advantage of
the design lies in its simple structure and compact size. Each modular robot
has an ingestible size and can be ingested/inserted into the lumen through
the natural orifices/endoscope channels. After reaching the working space,
the robots start the self-assembly process by magnetic force. An external
controller is operated by the surgeon for wireless control of the robotic
configuration, the assembly, and the surgical task. After completion of the
surgical procedure, the robots either reassemble into a snake shape or disas-
semble into individual modules and excrete naturally. The self-assembly
design not only reduces the size of each module but also enables convenient
addition and replacement of different interventional functions/modules
even during the operation (Nakadate and Hashizume, 2018).