Page 230 - Flexible Robotics in Medicine

218 Chapter 9

9.1 Introduction

Tracheostomy is the most common surgical procedure performed in patients with severe
acute respiratory failure. The traditional approach to tracheostomy performs an open
procedure to create a channel for air fluctuation [1]. This surgical procedure faces highly
potential risk of trachea and esophageal injury due to the drill practice from the external
body to the trachea lumen.

As technology advances and robotics are integrated into surgical procedures, minimally
invasive surgeries (MIS) and natural orifice transluminal endoscopic surgery are
possible. The procedures are inserting the surgical instruments by robotic arms together
with a camera or other form of sensors into the patient’s body through small incisions or
natural orifices, such as nose or mouth. Compared to conventional open surgery that
requires larger incisions for the surgical instrument to enter through and for
visualization of the operation area, using of robots brings about multiple benefits such
as greater stability and precision during surgery, addressing the advantage of less
injuries for subject tissues [2,3].
In order to reduce the potential risk of tissue injure during tracheostomy, a surgical robot
that can arrive the target site by transoral access is proposed as shown in Fig. 9.1. The
flexible robot firstly conforms to the interior cavity of the trachea, and then, a flexible
driller will be inserted through the internal channel of the flexible robot to drill through the
tracheal wall. A number of scientists and engineers have been developing dexterous

Figure 9.1
Transoral access for tracheostomy.