Lomanto Davide, Wijerathne Sujith, Ho Lawrence Khek Yu, Phee Louis Soo Jay
Department of Surgery, Minimally Invasive Surgical Centre (MISC), Khoo Teck Puat Advanced Surgery Training Centre (ASTC), National University Hospital , Singapore.
Minim Invasive Ther Allied Technol. 2015 Feb;24(1):37-44. doi: 10.3109/13645706.2014.996163.
Natural orifice transluminal endoscopic surgery (NOTES) is a novel surgical procedure during which abdominal operations can be performed with an endoscope passed through a natural orifice through an internal incision in the stomach, vagina, bladder or colon. NOTES is still evolving and many barriers stand on its way before it can gain acceptance in modern surgical practice. Effective access to the peritoneal cavity, closure techniques of the natural orifice access sites, development of a multitasking platform to accomplish procedures and support for special orientation are only a handful of its known limitations. Although the endoscope and conventional tools are useful for simple procedures, many important and complicated procedures are currently not possible due to limitation of degree of freedom (DOF) of the end effectors. We have developed a Master and Slave Transluminal Endoscopic Robot (MASTER) with nine degrees of freedom (DOF) in end effectors, which are long and flexible so as to enhance endoscopic procedures and NOTES. Using MASTER we have successfully performed endoscopic sub-mucosal dissections (ESD) to segmental hepatectomies in animal models. Thus, the MASTER robotic system shows great potential to perform new surgical procedures that are otherwise not possible with conventional endoscopic tools.
经自然腔道内镜手术(NOTES)是一种新型手术方法,在此过程中可通过经胃、阴道、膀胱或结肠的内部切口将内窥镜经自然腔道插入来实施腹部手术。NOTES仍在不断发展,在被现代外科实践所接受之前,它面临着许多障碍。有效进入腹腔、自然腔道入口部位的闭合技术、用于完成手术的多任务平台的开发以及对特殊定位的支持只是其已知的部分限制。尽管内窥镜和传统工具对于简单手术很有用,但由于末端执行器的自由度(DOF)有限,目前许多重要且复杂的手术无法进行。我们开发了一种主从式经腔道内镜机器人(MASTER),其末端执行器具有九个自由度,且长而灵活,以增强内镜手术和NOTES。使用MASTER,我们已在动物模型中成功地从内镜黏膜下剥离术(ESD)开展到了肝段切除术。因此,MASTER机器人系统在实施传统内镜工具无法完成的新手术方面显示出巨大潜力。