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A Compliant Transoral Surgical Robotic System Based on a Parallel Flexible Mechanism

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Abstract

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.

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Acknowledgments

This work is supported by the Singapore NMRC Bedside and Bench under Grant R-397-000-245-511 and National Key Research and Development Program, The Ministry of Science and Technology (MOST) of China (No. 2018YFB1307703), both awarded to Dr. Hongliang Ren.

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Authors and Affiliations

  1. Department of Biomedical Engineering, National University of Singapore, EA-05-30, 9 Engineering Drive 1, Singapore, 117575, Singapore

    Xiaoyi Gu, Changsheng Li, Xiao Xiao & Hongliang Ren

  2. Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Singapore, Singapore

    Chwee Ming Lim

  3. National University of Singapore (Suzhou) Research Institute, Suzhou, China

    Xiaoyi Gu & Hongliang Ren

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  1. Xiaoyi Gu
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  2. Changsheng Li
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  3. Xiao Xiao
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  4. Chwee Ming Lim
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  5. Hongliang Ren
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Correspondence to Hongliang Ren.

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Associate Editor Ka-Wai Kwok oversaw the review of this article.

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Gu, X., Li, C., Xiao, X. et al. A Compliant Transoral Surgical Robotic System Based on a Parallel Flexible Mechanism. Ann Biomed Eng 47, 1329–1344 (2019). https://doi.org/10.1007/s10439-019-02241-0

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  • DOI: https://doi.org/10.1007/s10439-019-02241-0

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