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Cadaveric feasibility study of a teleoperated parallel continuum robot with variable stiffness for transoral surgery

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Abstract

Robot-assisted technologies are overcoming the limitations of the current approaches for transoral surgeries, which are suffering from limited vision and workspace. As a result, we develop a novel teleoperated parallel continuum robot with variable stiffness for collision avoidance. This paper focuses on the feasibility study on a cadaveric model for the robotic system as a first trial. We introduce the configuration of the robotic system, the description of the processes of the trial, including the setting of the robotic system, the test of stiffness, and the action of the manipulation. The contact force between the manipulators with different stiffness and the surrounding tissues and a series of surgical operations of the manipulator, including grasping, cutting, pushing, and pulling tissues under the master-slave control mode, were recorded and analyzed. Experimental results suggest that the typical surgical procedure on a cadaveric model was successfully performed. Moreover, the efficacy and feasibility of the developed robotic system are verified to satisfy the requirements of transoral robotic surgery (TORS).

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References

  1. Chan JYW, Chan RCL, Chow VLY, Tsang RKY, Wong STS, Wei WI (2017) Transoral robotic total laryngopharyngectomy and free jejunal flap reconstruction for hypopharyngeal cancer. Oral Oncol 72:194–196

    Article  Google Scholar 

  2. Degani A, Choset H, Wolf A, Zenati MA (2006) Highly articulated robotic probe for minimally invasive surgery. In: Robotics and Automation. ICRA 2006. Proceedings 2006 IEEE International Conference on, 2006. IEEE, pp 4167–4172

  3. Dupont P, Gosline A, Vasilyev N, Lock J, Butler E, Folk C, Cohen A, Chen R, Schmitz G, Ren H 2012 Concentric tube robots for minimally invasive surgery. In: Hamlyn Symposium on Medical Robotics. p 8

  4. Garg A, Dwivedi RC, Sayed S, Katna R, Komorowski A, Pathak K, Rhys-Evans P, Kazi R (2010) Robotic surgery in head and neck cancer: a review. Oral Oncol 46:571–576

    Article  Google Scholar 

  5. Groothuis SS, Stramigioli S, Carloni R (2017) Modeling robotic manipulators powered by variable stiffness actuators: a graph-theoretic and port-Hamiltonian formalism. IEEE Trans Robot 33:807–818

    Article  Google Scholar 

  6. Gu X, Li C, Xiao X, Lim CM, Ren H (2019) A compliant transoral surgical robotic system based on a parallel flexible mechanism. Ann Biomed Eng 47:1329–1344

    Article  Google Scholar 

  7. Hockstein NG, O’Malley BW Jr, Weinstein GS (2006) Assessment of intraoperative safety in transoral robotic surgery. Laryngoscope 116:165–168

    Article  Google Scholar 

  8. Hockstein NG, Weinstein GS, O’Malley BW Jr (2005) Maintenance of hemostasis in transoral robotic surgery. ORL J Oto Rhino Laryngol Head Neck Surg 67:220–224

    Google Scholar 

  9. Hoff PT, D’Agostino MA, Thaler ER (2015) Transoral robotic surgery in benign diseases including obstructive sleep apnea: safety and feasibility. Laryngoscope 125:1249–1253

    Article  Google Scholar 

  10. Lang S, Mattheis S, Hasskamp P, Lawson G, Güldner C, Mandapathil M, Schuler P, Hoffmann T, Scheithauer M, Remacle M (2017) A European multicenter study evaluating the flex robotic system in transoral robotic surgery. Laryngoscope 127:391–395

    Article  Google Scholar 

  11. Li C, Gu X, Xiao X, Lim CM, Ren H (2018) A robotic system with multi-channel flexible parallel manipulators for single port access surgery. IEEE Trans Ind Inform 15(3):1678–1687

    Article  Google Scholar 

  12. Li C, Gu X, Xiao X, Lim CM, Ren H (2019) Flexible robot with variable stiffness in transoral surgery. IEEE Trans Mechatron 25(1):1–10

    Article  Google Scholar 

  13. Li C, King NKK, Ren H (2018) A skull-mounted robot with a compact and lightweight parallel mechanism for positioning in minimally invasive neurosurgery. Ann Biomed Eng 46(10):1465–1478

    Article  Google Scholar 

  14. Li C, Wang T, Hu L, Zhang L, Du H, Zhao L, Wang L, Tang P (2015) A visual servo-based teleoperation robot system for closed diaphyseal fracture reduction. Proc Inst Mech Eng H J Eng Med 229:629–637

    Article  Google Scholar 

  15. Mattheis S, Hasskamp P, Holtmann L, Schäfer C, Geisthoff U, Dominas N, Lang S (2017) Flex robotic system in transoral robotic surgery: the first 40 patients. Head Neck 39:471–475

    Article  Google Scholar 

  16. Moore EJ, Janus J, Kasperbauer J (2012) Transoral robotic surgery of the oropharynx: clinical and anatomic considerations. Clin Anat 25:135–141

    Article  Google Scholar 

  17. O’Malley BW Jr, Weinstein GS, Snyder W, Hockstein NG (2006) Transoral robotic surgery (TORS) for base of tongue neoplasms. Laryngoscope 116:1465–1472

    Article  Google Scholar 

  18. Okamura AM (2004) Methods for haptic feedback in teleoperated robot-assisted surgery. Ind Robot 31(6):499–508

    Article  CAS  Google Scholar 

  19. Park YM, Kim WS, Byeon HK, De Virgilio A, Jung JS, Kim S-H (2010) Feasiblity of transoral robotic hypopharyngectomy for early-stage hypopharyngeal carcinoma. Oral Oncol 46:597–602

    Article  Google Scholar 

  20. Poon H, Li C, Gao W, Ren H, Lim CM (2018) Evolution of robotic systems for transoral head and neck surgery. Oral Oncol 87:82–88

    Article  Google Scholar 

  21. Rahbar R, Ferrari LR, Borer JG, Peters CA (2007) Robotic surgery in the pediatric airway: application and safety. Arch Otolaryngol Head Neck Surg 133:46–50

    Article  Google Scholar 

  22. Reiley CE, Akinbiyi T, Burschka D, Chang DC, Okamura AM, Yuh DD (2008) Effects of visual force feedback on robot-assisted surgical task performance. J Thorac Cardiovasc Surg 135:196–202

    Article  Google Scholar 

  23. Remacle M, Prasad V, Lawson G, Plisson L, Bachy V, Van der Vorst S (2015) Transoral robotic surgery (TORS) with the Medrobotics Flex™ System: first surgical application on humans. Eur Arch Otorhinolaryngol 272:1451–1455

    Article  CAS  Google Scholar 

  24. Ren H, Dupont PE (2012) Tubular enhanced geodesic active contours for continuum robot detection using 3D ultrasound. In: Robotics and Automation (ICRA), 2012 IEEE International Conference on, IEEE, pp 2907–2912

  25. Ren H, Lim CM, Wang J, Liu W, Song S, Li Z, Herbert G, Tse ZTH, Tan Z (2013) Computer-assisted transoral surgery with flexible robotics and navigation technologies: a review of recent progress and research challenges. Crit Rev Biomed Eng 41(4–5):365–391

    Article  Google Scholar 

  26. Tan Z, Ren H (2014) Design and actuation of a snake-like robot for minimally invasive surgeries. In: The 15th International Conference on Biomedical Engineering. Springer, Berlin, pp 28–31

  27. Tateya I, Koh YW, Tsang RK, Hong SS, Uozumi R, Kishimoto Y, Sugimoto T, Holsinger FC (2018) Flexible next-generation robotic surgical system for transoral endoscopic hypopharyngectomy: a comparative preclinical study. Head Neck 40:16–23

    Article  Google Scholar 

  28. Wu L, Song S, Wu K, Lim CM, Ren H (2017) Development of a compact continuum tubular robotic system for nasopharyngeal biopsy. Med Biol Eng Comput 55:403–417

    Article  Google Scholar 

  29. Yu H, Wu L, Wu K, Ren H (2016) Development of a multi-channel concentric tube robotic system with active vision for transnasal nasopharyngeal carcinoma procedures. IEEE Robot Autom Lett 1:1172–1178

    Article  Google Scholar 

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Funding

This work is supported by the National Key Research and Development Program, the Ministry of Science and Technology (MOST) of China (No. 2018YFB1307703), and Singapore NMRC Bedside & Bench under grant R-397-000-245-511 awarded to Dr. Hongliang Ren.

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Correspondence to Hongliang Ren.

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Li, C., Gu, X., Xiao, X. et al. Cadaveric feasibility study of a teleoperated parallel continuum robot with variable stiffness for transoral surgery. Med Biol Eng Comput 58, 2063–2069 (2020). https://doi.org/10.1007/s11517-020-02217-6

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  • DOI: https://doi.org/10.1007/s11517-020-02217-6

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