Krieger Axel, Opfermann Justin, Kim Peter C W
Mem. ASME Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, 111 Michigan Avenue, NW, Washington, DC 20010.
Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, 111 Michigan Avenue, NW, Washington, DC 20010 e-mail:
J Med Device. 2018 Mar;12(1):0110051-110056. doi: 10.1115/1.4038335. Epub 2017 Nov 22.
This paper reports the design, development, and initial evaluation of a robotic laparoscopic clipping tool for single manipulator wound closure and anastomosis (tubular reconnection). The tool deploys biodegradable clips and clasps with the goal of (i) integrating grasping and suturing into a single device for single hand or manipulator use, (ii) applying the equivalent of interrupted sutures without the need of managing suture thread, and (iii) allowing for full six degrees-of-freedom (DOFs) laparoscopic control when mounted on a robot arm. The specifications, workflow, and detailed design of the robotic laparoscopic tool and injection molded bio-absorbable T shaped clip and locking clasp are reported. The clipping tool integrates forceps to grab and stabilize tissue and a clip and clasp applier to approximate and fixate the tissue. A curved needle is advanced on a circular needle path and picks up and drags clips through tissue. The clip is then tightened through the tissue and a clasp is clamped around the clip, before the clip is released from the needle. Results of several bench test runs of the tool show: (a) repeatable circular needle drive, (b) successful pick-up and deployment of clips, (c) successful shear of the clip to release the clip from the needle, and (d) closure of clasp on clip with an average of 2.0 N holding force. These data indicate that the robotic laparoscopic clipping tool could be used for laparoscopic wound closure and anastomosis.
本文报告了一种用于单机械手伤口闭合和吻合术（管状重新连接）的机器人腹腔镜夹钳工具的设计、开发和初步评估。该工具部署可生物降解的夹子和扣环，目标是：（i）将抓取和缝合集成到单个设备中，供单手或机械手使用；（ii）应用相当于间断缝合的方法，而无需处理缝线；（iii）安装在机器人手臂上时，允许进行全六自由度（DOF）腹腔镜控制。报告了机器人腹腔镜工具以及注塑生物可吸收T形夹和锁定扣环的规格、工作流程和详细设计。夹钳工具集成了镊子以抓取和稳定组织，以及夹扣施加器以靠近并固定组织。一根弯曲的针在圆形针道上前进，拾取并拖动夹子穿过组织。然后将夹子收紧穿过组织，并在夹子从针上释放之前，在夹子周围夹紧一个扣环。该工具几次台架测试运行的结果表明：（a）针驱动可重复；（b）成功拾取和部署夹子；（c）成功剪断夹子以将其从针上释放；（d）扣环在夹子上闭合，平均保持力为2.0N。这些数据表明，机器人腹腔镜夹钳工具可用于腹腔镜伤口闭合和吻合术。
