Concept of Solo-Surgery using a Locally Operated Detachable End-effector Manipulator to support endoscopic surgery

Yuji Nishizawa, PhD, Toshikazu Kawai, PhD, Tatsuo Nakamura, PhD, Masao Fujiwara, PhD, Keiichi Okano, PhD, Yasuyuki Suzuki, PhD. Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University.

[Background] Among the recent advances in endoscopic surgery, Solo-Surgery can now be performed with high accuracy because of improvements in surgical techniques. However, to further generalize this surgical method, which can be used when the range of motion of forceps and expansion of the operative field is limited, it is necessary to establish new surgical techniques and further develop the technology. We have developed the Locally Operated Detachable End-effector Manipulator, LODEM, which enables local operation in a surgical field using existing, detachable forceps for endoscopic surgery, and promote the R&D for the use of this robot in Solo-Surgery.

[Objectives/methods] To present the concept of Solo-Surgery with LODEM, we evaluated the operability of LODEM, and its utility for laparoscopic cholecystectomy and low anterior resection in a preclinical test.

[Results] In the experiment to demonstrate the operability of LODEM, in which the tip of the forceps was moved to a target point, there was no significant difference in the duration of the third and subsequent operations performed by 6 surgeons. In the preclinical testing of LODEM for laparoscopic cholecystectomy and low anterior resection, a surgeon successfully completed the surgery using the forceps of the LODEM to resect an organ, and expand the surgical field by operating with the LODEM.

[Conclusion] These findings suggest that LODEM could be useful to support Solo-Surgery in actual clinical treatment because of its high operability. We present the concept of using this low-cost device to successfully perform solo surgery with high accuracy, in addition to our future vision.

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