Page 130 - Flexible Robotics in Medicine

116 Chapter 5

with compression-based coupling with the backbone, which stabilizes the structure
sufficiently to perform surgery.

The MOJO device is positioned to be a joint system that enhances the functionalities of
noninvasive surgical robots at a low cost. In addition, the operation of endoscopic devices
traditionally requires surgically trained personnel. MOJO aims to provide an alternative
manipulator with more intuitive control that is easier to learn to use. The device should
perform comparably to traditional cable-actuated flexible endoscopes capable of navigating
the trachea through a natural orifice such as the mouth. The novelty of the MOJO’s design
is derived from the coupling of the origami foldable universal joint and the backbone
structure as well as the compressive action of the cables to achieve a bistable conformation.

5.2.4.2 Preferred embodiments
Transoral tracheostomy is a procedure aimed at providing a less invasive alternative to current
methods of tracheostomy, such as open and PT. In this procedure, an endoscopic device is
inserted through the oral cavity (which is minimally invasive) and into the trachea, a
cartilaginous tube where the device is required to navigate the curves of the pharynx and
larynx. The aim of this procedure is to create an incision between the first and second tracheal
cartilage as a part of the Ciaglia technique [13]. In the case of minimally invasive TT, the
incision will be made from within the trachea. Currently, available tracheostomy tubes have a
curvature of 120 130 degrees, which is within the MOJO’s design specifications [14].The
MOJO contains the added feature of a tip able to achieve a deflection of 90 degrees.

In comparison to current devices used in performing tracheostomies and conducting
surveillance during these procedures, the use of MOJO has several advantages both in
operation and fabrication.
First, the MOJO provides an operational advantage in terms of its ability to be positioned
within the subject’s trachea during tracheostomies. Conventional tracheotomies involve the use
of a scalpel to perform a small incision followed by using a manual dilator to push apart fat,
smooth muscle, and cartilage to gain access to the trachea [15]. This blunt method of gaining
access to the trachea has a considerable risk of damaging surrounding tissue and can only be
performed by experienced personnel and is only applicable to a specific class of subjects
(Children, obese patients, and patients with anterior neck problems are contraindications for
PDT [13].) MOJO allows tracheostomies to be performed and stabilized from within the
trachea, reducing the risk of complications arising from perforating layers of tissue.

Second, the MOJO further provides an operational advantage of being able to be actively
controlled and stabilized while navigating the trachea. Current flexible endoscopes available
on the market are passive devices that rely on the flexural properties of the catheter to
follow the contours of the trachea, so they are unable to navigate anatomical obstacles
without a sufficiently skilled operator. Through its unique coupling of joints and rigid
backbone, MOJO can remotely stiffen its structure and provide sufficient support to