Department of Biomedical Engineering, National University of Singapore, EA-05-30, 9 Engineering Drive 1, Singapore, 117575, Singapore.
National University of Singapore (Suzhou) Research Institute, Suzhou, China.
Ann Biomed Eng. 2019 Jun;47(6):1329-1344. doi: 10.1007/s10439-019-02241-0. Epub 2019 Mar 12.
Transoral robotic surgery (TORS) allows for access to oropharyngeal regions in an effective and minimally invasive manner. However, safe TORS access to deep pharyngeal (such as hypopharynx) sites remains a great challenge for current surgical robotic systems. In this work, we introduce a novel continuum robot with an optimized flexible parallel mechanism, to meet stringent requirements imposed by TORS on size, workspace, flexibility, and compliance. The system is comprised of two parts, a guidance part and an execution part, and achieves 11 controllable degrees of freedom. The execution part of the robot, based on the optimized flexible parallel mechanism, is able to reach deep sites in the oropharynx and larynx with the assistance of the continuum guidance part. In addition to the mechanical design, extensive analysis and experiments were carried out. Kinematic models were derived and the reachable workspace of the robot was verified to cover the entire target surgical area. Experimental results indicate that the robot achieves significantly enhanced compliance. Additionally, the designed robot can withstand a load of 1.5 N within the allowable range of the deflection. The positioning errors caused by the interference between different mechanisms can be effectively eliminated using the proposed compensation method. The maximum displacement error of this system under various conditions is less than 2 mm and the maximum bending error is less than 7.5°, which are satisfied for TORS. Cadaver trials were conducted to further demonstrate the feasibility. The reduced setup time and the reduced time to access the target site indicate that the developed surgical robotic system can achieve better operative efficiency in TORS when compared with current systems.
经口机器人手术（TORS）允许以有效且微创的方式进入口咽区域。然而，当前的手术机器人系统对于深部咽（如下咽）部位的安全 TORS 进入仍然是一个巨大的挑战。在这项工作中，我们引入了一种具有优化的柔性并联机构的新型连续体机器人，以满足 TORS 对尺寸、工作空间、灵活性和顺应性的严格要求。该系统由两部分组成，一部分是导向部分，一部分是执行部分，实现了 11 个可控自由度。机器人的执行部分基于优化的柔性并联机构，在连续体导向部分的辅助下，能够到达口咽和喉深部的部位。除了机械设计，还进行了广泛的分析和实验。推导了运动学模型，并验证了机器人的可达工作空间覆盖整个目标手术区域。实验结果表明，机器人具有显著增强的顺应性。此外，设计的机器人可以在允许的挠度范围内承受 1.5N 的负载。使用提出的补偿方法可以有效消除不同机构之间干扰引起的定位误差。在各种条件下，该系统的最大位移误差小于 2mm，最大弯曲误差小于 7.5°，满足 TORS 的要求。进行了尸体试验以进一步证明其可行性。与当前系统相比，开发的手术机器人系统在 TORS 中可以实现更好的手术效率，减少了设置时间和到达目标部位的时间。
