Abstract
Purpose
In minimally invasive surgery, instruments are inserted from the exterior of the patient’s body into the surgical field inside the body through the minimum incision, resulting in limited visibility, accessibility, and dexterity. To address this problem, surgical instruments with articulated joints and multiple degrees of freedom have been developed. The articulations in currently available surgical instruments use mainly wire or link mechanisms. These mechanisms are generally robust and reliable, but the miniaturization of the mechanical parts required often results in problems with size, weight, durability, mechanical play, sterilization, and assembly costs.
Methods
We thus introduced a compliant mechanism to a laparoscopic surgical instrument with multiple degrees of freedom at the tip. To show the feasibility of the concept, we developed a prototype with two degrees of freedom articulated surgical instruments that can perform the grasping and bending movements. The developed prototype is roughly the same size of the conventional laparoscopic instrument, within the diameter of 4 mm. The elastic parts were fabricated by Ni-Ti alloy and SK-85M, rigid parts ware fabricated by stainless steel, covered by 3D- printed ABS resin. The prototype was designed using iterative finite element method analysis, and has a minimal number of mechanical parts.
Results
The prototype showed hysteresis in grasping movement presumably due to the friction; however, the prototype showed promising mechanical characteristics and was fully functional in two degrees of freedom. In addition, the prototype was capable to exert over 15 N grasping that is sufficient for the general laparoscopic procedure. The evaluation tests thus positively showed the concept of the proposed mechanism.
Conclusion
The prototype showed promising characteristics in the given mechanical evaluation experiments. Use of a compliant mechanism such as in our prototype may contribute to the advancement of surgical instruments in terms of simplicity, size, weight, dexterity, and affordability.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
http://www.kymerax.com (2014)
Miniati R, Dori F, Cecconi G, Frosini F, Sacca F, Gentili BG, Petrucci F, Franchi S, Gusinu R (2014) Hospital based economic assessment of robotic surgery. IFMBE Proc 41:1144–1146
http://www.dexteritesurgical.com/dexteritesurgical-en/dex-robot (2014)
Romanelli JR, Earle DB (2009) Single-port laparoscopic surgery: an overview. Surg Endosc 23:1419–1427
Tacchino R, Greco F, Matera D (2009) Single-incision laparoscopic cholecystectomy: surgery without a visible scar. Surg Endosc 23:896–899
http://surgical.covidien.com/products/single-incision-laparoscopic-surgery/sils-stitch (2014)
Stammberger H, Posawetz W (1990) Functional endoscopic sinus surgery. Eur Arch Otohinolaryngol 247:63–76
Jho HD (1999) Endoscopic pituitary surgery. Pituitary 2:139–154
http://www.mizuho.co.jp/pnet/neurosurgery/neurosurgery-other/fcf/index.html (2014)
http://www.entriguesurgical.com/home/outside_US_products/serpent (2014)
Lim JJB, Erdman AG (2003) A review of mechanism used in laparoscopic surgical instruments. Mech Mach Theory 38:1133–1147
Howell LL (2001) Compliant mechanisms. Wiley-Interscience. ISBN 978-0-471-38478-6
Smith ST (2000) Flexures elements of elastic mechanisms. CRC Press. ISBN 90-5699-261-9
Lobontiu N (2002) Compliant mechanisms. CRC Press. ISBN 978-0-8493-1367-7
Lange D, Langelaar MN, Herder JL (2008) Towards the design of a statically balanced compliant laparoscopic grasper using topology optimization. In: Proceedings of ASME 2008 international design engineering technical conferences and computers and information in engineering conference (IDETC/CIE2008), pp 293–305
Sato R, Nokata M (2011) Development of one part grasping forceps for vascular catheter. J JSCAS 13(3):300–301 (in Japanese)
Arata J, Saito Y, Fujimoto H (2010) Outer shell type 2 DOF bending manipulator using spring-link mechanism for medical applications. In: Proceedings of international conference robotics and automation, pp 1041–1046
Arata J, Kogiso S (2013) Monolithically designed minimally invasive surgical tool using compliant mechanism. Int J CARS Suppl 1:S369–371
Arata J, Kogiso S, Sakaguchi M, Nakadate R, Oguri S, Uemura M, Cho B, Akahoshi T, Ikeda T, Hashizume M (2014) Articulated minimally invasive surgical tool for laparoscopy based on compliant mechanism. Int J CARS 9(Suppl 1):S183–184
Tolou N, Herder JL (2008) Towards the design of a statically balanced compliant laparoscopic grasper using topology optimization. In: International design engineering technical conference and computers and information in engineering conference, pp 1–13
Kozuka H, Arata J, Okuda K, Onaga A, Ohno M, Sano A, Fujimoto H (2012) Compliant-parallel mechanism for high precision machine with a wide range of working area. In: Proceedings of international conference on intelligent robots and systems, pp 2519–2524
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Arata, J., Kogiso, S., Sakaguchi, M. et al. Articulated minimally invasive surgical instrument based on compliant mechanism. Int J CARS 10, 1837–1843 (2015). https://doi.org/10.1007/s11548-015-1159-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11548-015-1159-4