41 / 2019-06-07 15:13:52

Robot-assisted flexible ureteroscopy

surgical robot,flexible ureteroscopy,master-slave control

全体主题 > Medical diagnosis and surgical robotics

Introduction: Flexible ureteroscopy (FURS) is a method to diagnose and treat the renal and ureteral stones with less bleeding, higher stone-free rate (SFR), shorter hospital time and slim chance for complication. Some obstacles limit the development of FURS such as complex control, uncomfortable operating position and radiation. Some robot systems arose to solve these problems but the results are not satisfactory. A novel robot is proposed in this paper and its performance was tested.
Methods: The basic motion of the flexible ureteroscope was analyzed and 3 degrees of freedom (DOFs) were extracted and named rotation, deflection and translation. A slave manipulator with 3 DOFs was designed and integrated on an adjusting platform with 3 DOFs. Kinematics modeling of the flexible endoscope was analyzed. Master-slave control strategy was utilized and control system was built based on Programmable Multi-Axis Controller (PMAC). Phantom experiments were designed to check the basic function of the robot system including assembling time and comfortability. An animal experiment was arranged to check the overall performance.
Results: In the assembling test, it would take 7 seconds to assemble the endoscope to the robot after several training. In the phantom experiment, all the kidney calices could be checked by the robot system and all the preset stones were found. When compared with conventional model, robot-assisted FURS get lower score (the lower the score, the more comfortable the operators feel). Finally in the animal experiment, all minor renal calices were observed in 3.5 minutes. Time used to evacuate the robot system from operating table was 3 minutes.
Conclusion: The robot system is easy enough to combine with flexible ureteroscope. All the function of the robot is checked and there is no obvious difference with conventional model. However, robot system provides a more comfortable operating position, which is benefit to both the operators and the patients. Animal experiments illustrates that the robot system have the ability to assist the operators to finish FURS.
Discussion: In this research, a robot system is designed for FURS. Its function is checked by phantom experiments and animal experiments. It has the possibility to carry out remote surgery. Next work will be focused on force feedback based on the robot system.