Norihito Wada, MD, PhD, FACS1, Kyoko Okuda, MA1, Kazumi Kuboi, RN1, Tetsuya Nakamura, MD, PhD2, Tadateru Maehata, MD, PhD1, Takuya Matsunaga3, Takahiro Nozaki, PhD3, Kouhei Ohnishi, PhD3, Naohisa Yahagi, MD, PhD1, Yuko Kitagawa, MD, PhD, FACS1. 1Keio University School of Medicine, 2Fujita Health University School of Medicine, 3Faculty of Science and Technology, Keio University
Objective of the technology or device: The development of a novel surgical device, Robot-assisted Rigid Endoscopic Surgical System has widen the use of minimally invasive procedures, enhancing precision by giving higher dexterity for surgeons hands and a 3D HD vision. However, the currently available system lacks haptic feedback and thus requires surgeons to rely solely on visual clues. The deficiency of haptic feedback has been widely cited as a disadvantage of the current system potentially associated with lower safety and accuracy compared with open and conventional laparoscopic approaches. The objective of this device is to provide surgeons with real haptic sensation in a slave-master robotic surgery.
Description of the technology and method of its use or application: We have developed a flexible grasping forceps robot system having real haptic feedback. Force sensation is transmitted implementing four-channel bilateral control. The master controller is consist of a linear motor, a linear encoder and handles. At the head of the flexible tube, is mounted the slave robot composed of an encoder, a motor, a gear head, a torque transmitter and a gripper. The diameter and the length of the slave robot is 7 mm and 64 mm, respectively. Under laparoscopic view, two surgeons grasped porcine intestine with or without haptic feedback 5 times each following the given sequence: grasp for 3 seconds, move the intestine 2 cm, grasp for 3 seconds, release.
Preliminary results: All the tasks were successfully performed in this model. The grasping force of the intestine was 2 to 3 N and 5 N (upper limit of the device) with and without haptic sensation, respectively. According to endoscopic observations, intestinal deformity was stronger without haptics. Histological evaluation revealed that more subserosal dissection was observed for the non-haptic grasping.
Conclusions / future directions: In this model, the grasping force was limited to 5 N in the non-haptic trial. Therefore, the tissue damage was comparatively mild. However, clinically used robots have more power in grasping and have higher risk to cause damage to organs. Haptic forceps system can provide necessary and sufficient grasping force which would reduce the damage to vital organs. We are planning to implement this technology on the Flexible Endoscopic Surgery System to ensure patient safety.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 84477
Program Number: ETP712
Presentation Session: Emerging Technology Poster
Presentation Type: Poster