Masataka Nakabayashi, PhD1, Yuta Hoshito, Masters Student1, Kazuhiro Endo, MD2, Naohiro Sata, MD2, Satoshi Shimawaki, PhD1. 1Graduate School of Engineering, Utsunomiya University, 2Department of surgery, Jichi Medical University
In the complex laparoscopic surgical procedure, there is a problem such as that the laparoscope and the surgical instruments interfere with each other because multiple instruments is concentrated in one place. This problem is significantly appear in the laparoendoscopic single site surgery.
Therefore we suggested multi degrees of freedom (DOF) manipulator with mantle tube for assisting laparoendoscopic surgery, which manipulator has two flexion and one telescopic mechanisms actuated by wire. It is possible to insert any thin surgical instruments such an endoscope the mantle tube of the multi DOF manipulator, which the manipulator can let those surgical instruments access the operative field from different axis with other instruments. The use of this manipulator has two advantages, one of which is avoidance of fighting between instruments and laparoscope. The other is that become possible to ensure a satisfactory field of vision in the operative field.
In this report, we assumed that this multi-DOF manipulator is used as laparoendscope. In order to evaluate the performance of this manipulator, the operation time of the test in the abdominal cavity simulator (FASOTEC Inc.) was measured. The test is a contact test to multiple-targets, which is a test that bring a forceps contact multiple-targets in the abdominal cavity simulator according to the defined pattern. As a general comparison and evaluation target for this measurement result, it is compared with the case using the same access method as the conventional rigid endoscope. In this test, the number of contacts between forceps and laparoendoscope were recorded by using electrical device.
Subjects (n = 10) are adult men who trained the peg transfer in the above simulator. It was compared of total operating times of the test and the field of vision obtaining each device. From these results, using the suggested manipulator device rather than using rigid laparoscope a satisfactory field of vision is obtained, and it is possible to short the operating time approximately 4 seconds, and to small the number of contacts significantly. Therefore it was shown that the effectiveness using the suggested manipulator device. For this reason, use of this device is expected to facilitate the complex surgical operation.
Additionally, it is performed para ablative operation of swine liver tissue in the abdominal cavity simulator, as previous step of clinical test. The operative field in this test was surveyed, the refinements of this manipulator for improvement performance were described in this report.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86281
Program Number: P821
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster