Mechanical Engineering, University of Nebraska-Lincoln, Omaha, NE, USA.
Surg Endosc. 2012 Mar;26(3):727-31. doi: 10.1007/s00464-011-1943-3. Epub 2011 Nov 1.
This study aimed to demonstrate the effectiveness of using a multifunctional miniature in vivo robotic platform to perform a single-incision colectomy. Standard laparoscopic techniques require multiple ports. A miniature robotic platform to be inserted completely into the peritoneal cavity through a single incision has been designed and built. The robot can be quickly repositioned, thus enabling multiquadrant access to the abdominal cavity.
The miniature in vivo robotic platform used in this study consists of a multifunctional robot and a remote surgeon interface. The robot is composed of two arms with shoulder and elbow joints. Each forearm is equipped with specialized interchangeable end effectors (i.e., graspers and monopolar electrocautery).
Five robotic colectomies were performed in a porcine model. For each procedure, the robot was completely inserted into the peritoneal cavity, and the surgeon manipulated the user interface to control the robot to perform the colectomy. The robot mobilized the colon from its lateral retroperitoneal attachments and assisted in the placement of a standard stapler to transect the sigmoid colon. This objective was completed for all five colectomies without any complications.
The adoption of both laparoscopic and single-incision colectomies currently is constrained by the inadequacies of existing instruments. The described multifunctional robot provides a platform that overcomes existing limitations by operating completely within one incision in the peritoneal cavity and by improving visualization and dexterity. By repositioning the small robot to the area of the colon to be mobilized, the ability of the surgeon to perform complex surgical tasks is improved. Furthermore, the success of the robot in performing a completely in vivo colectomy suggests the feasibility of using this robotic platform to perform other complex surgeries through a single incision.
本研究旨在展示使用多功能微型活体机器人平台进行单切口结直肠切除术的有效性。标准的腹腔镜技术需要多个端口。已经设计并制造了一种可完全通过单个切口插入腹腔的微型机器人平台。该机器人可以快速重新定位，从而实现多象限进入腹腔。
本研究中使用的微型活体机器人平台由多功能机器人和远程外科医生接口组成。机器人由具有肩和肘关节的两个臂组成。每个前臂都配备有专用的可互换末端执行器（即抓握器和单极电灼器）。
在猪模型中进行了五次机器人结直肠切除术。对于每个手术，机器人完全插入腹腔，外科医生操作用户界面来控制机器人完成结直肠切除术。机器人从其侧后方腹膜附着处游离结肠，并协助放置标准吻合器以横断乙状结肠。这一目标在所有五次结直肠切除术中均得以实现，没有任何并发症。
目前，腹腔镜和单切口结直肠切除术的采用受到现有器械不足的限制。所描述的多功能机器人提供了一个平台，通过在腹腔内的一个切口内完全操作，并通过改善可视化和灵巧性，克服了现有局限性。通过将小机器人重新定位到要游离的结肠区域，外科医生执行复杂手术任务的能力得到提高。此外，机器人成功完成完全体内结直肠切除术表明，通过单个切口使用这种机器人平台进行其他复杂手术是可行的。
