Ohdaira Takeshi, Prof, Atsuo Takenishi, Prof. Center for Advanced Medical Initiatives, Kyushu University.
PURPOSE: The robot developed for clinical use such as da Vinci Surgical System allowed solo surgery, for example, prostatectomy within a restricted operative field. However, concerning gastrectomy or colectomy, which needs widely dynamic action such as overturning organs, it is difficult to operate at the same position. For its reason, surgeons frequently have to move the whole body of heavy robot. We successfully performed minimally invasive endoscopic surgery by using humanoid. The following four points are benefits of humanoid in compare with conventional commercialized surgical robots: 1) easy adaptation to conventional equipment of operation room as same as human surgeon; 2) prevention of instability caused by fatigue in robot hands; 3) quick transportation without help of commander surgeon; 4) possibility of storage in compact space.
METHODS: We carried out humanoid-assisted solo surgery by NOTES-assisted Needlescopic Surgery, what is defined as Multi Piercing Surgery (MPS). Partial gastrectomy and cholecystectomy were performed in two pigs. The utility of a humanoid was evaluated about 1) accuracy and 2) stability of posture. At first, instability and stability of endoscopic view were evaluated with the naked eye by observing the video recorded by the 3D camera in glassless 3D monitor. Furthermore, we clarified the instability of endoscope by the sensor coil of electromagnetic navigation system inserted through the channel of the endoscope. And then the time that required for move from storage position to surgery position for humanoid, was counted.
RESULTS: It turned out that flexible endoscope operation by humanoid did not cause any instability except for minor deviation that originated in the physical property of flexible endoscope. Center point of endoscopic view did not tremble in evaluation of both grassless 3D monitor and tracks of electromagnetic navigation system at all. Furthermore, unlike conventional robots, humanoid as same as surgeon of human-being was able to be quickly set at the surgery position.
CONCLUSION: Humanoid in MPS possibly works as a useful tool to ensure safety and certainty without changing conventional equipment of operation room.