Department of Mechanical Engineering, Faculty of Engineering, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka, 819-0395, Japan.
Center for Advanced Medical Open Innovation, Kyushu University, Fukuoka, 812-8582, Japan.
Int J Comput Assist Radiol Surg. 2023 Jan;18(1):1-8. doi: 10.1007/s11548-022-02726-9. Epub 2022 Aug 3.
Gastrointestinal cancer can be treated using a flexible endoscope through a natural orifice. However, treatment instruments with limited degrees of freedom (DOFs) require a highly skilled operator. Articulated devices useful for endoluminal procedures, such as endoscopic submucosal dissection and biopsy, have been developed. These devices enable dexterous operation in a narrow lumen; however, they suffer from limitations such as large size and high cost. To overcome these limitations, we developed a 2.5-mm articulated forceps that can be inserted into a standard endoscope channel based on a compliant mechanism.
The compliant mechanism allows the device to be compact and affordable, which is possible due to its monolithic structure. The proposed mechanism consists of two segments, 1-DOF grasping and 2-DOF bending, that are actuated by tendon-sheath mechanisms. A prototype was designed based on finite element analysis results.
To confirm the effectiveness of the proposed mechanism, we fabricated the prototype using a 3D printer. A series of mechanical performance tests on the prototype revealed that it achieved the following specifications: (1) DOF: 1-DOF grasping + 2-DOF bending, (2) outer diameter: 2.5 mm, (3) length of the bending segment: 30 mm, and (4) range of motion: [Formula: see text] to [Formula: see text] (grasping) and [Formula: see text] to [Formula: see text] (bending). Finally, we performed a tissue manipulation test on an excised porcine colon and found that a piece of mucous membrane tissue was successfully resected using an electric knife while being lifted with the developed forceps.
The results of the evaluation experiment demonstrated a positive feasibility of the proposed mechanism, which has a simpler structure compared to those of other conventional mechanisms; furthermore, it is potentially more cost-effective and is disposable. The mechanical design, prototype implementation, and evaluations are reported in this paper.
通过自然腔道利用柔性内镜对胃肠道癌症进行治疗。然而,自由度(DOF)有限的治疗器械需要高度熟练的操作人员。已经开发出了一些用于内镜下黏膜下剥离术和活检等腔内手术的铰接式器械。这些器械可使在狭窄的腔道中实现灵巧操作;然而,它们存在尺寸大、成本高等局限性。为了克服这些局限性,我们开发了一种基于柔顺机构的 2.5mm 铰接式活检钳,可插入标准内镜通道。
柔顺机构使器械变得紧凑且经济实惠,这得益于其整体式结构。所提出的机构由两个部分组成,1-DOF 抓取和 2-DOF 弯曲,由肌腱护套机构驱动。根据有限元分析结果设计了原型。
为了验证所提出的机构的有效性,我们使用 3D 打印机制造了原型。对原型进行了一系列机械性能测试,结果表明其达到了以下规格:(1)自由度:1-DOF 抓取+2-DOF 弯曲,(2)外径:2.5mm,(3)弯曲段长度:30mm,(4)运动范围:[公式:见文本]至[公式:见文本](抓取)和[公式:见文本]至[公式:见文本](弯曲)。最后,我们在切除的猪结肠上进行了组织操作测试,发现使用开发的活检钳成功地切除了一块粘膜组织,同时用电动刀提起。
评估实验的结果表明,所提出的机构具有较好的可行性,与其他传统机构相比,其结构更为简单;此外,它具有更高的成本效益,且为一次性使用。本文报告了机械设计、原型实现和评估。