Abstract
Background
Minimally invasive surgery attracts more and more attention because of the advantages of minimal trauma, less bleeding and pain and low complication rate. However, minimally invasive surgery for beating hearts is still a challenge. Our goal is to develop a soft robot surgical system for single-port minimally invasive surgery on a beating heart.
Materials and methods
The soft robot described in this paper is inspired by the octopus arm. Although the octopus arm is soft and has more degrees of freedom (DOFs), it can be controlled flexibly. The soft robot is driven by cables that are embedded into the soft robot manipulator and can control the direction of the end and middle of the soft robot manipulator. The forward, backward and rotation movement of the soft robot is driven by a propulsion plant. The soft robot can move freely by properly controlling the cables and the propulsion plant. The soft surgical robot system can perform different thoracic operations by changing surgical instruments. To evaluate the flexibility, controllability and reachability of the designed soft robot surgical system, some testing experiments have been conducted in vivo on a swine.
Results
Through the subxiphoid, the soft robot manipulator could enter into the thoracic cavity and pericardial cavity smoothly and perform some operations such as biopsy, ligation and ablation. The operations were performed successfully and did not cause any damage to the surrounding soft tissues. From the experiments, the flexibility, controllability and reachability of the soft robot surgical system have been verified. Also, it has been shown that this system can be used in the thoracic and pericardial cavity for different operations.
Conclusions
Compared with other endoscopy robots, the soft robot surgical system is safer, has more DOFs and is more flexible for control. When performing operations in a beating heart, this system maybe more suitable than traditional endoscopy robots.
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Acknowledgements
This work was supported in part by Natural Science Foundation of China under Grant 61473191 and in part by State Key Laboratory of Robotics and System (HIT).
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Hesheng Wang, Runxi Zhang, Weidong Chen, Xiaozhou Wang and Rolf Pfeifer have no conflicts of interest or financial ties to disclose.
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Wang, H., Zhang, R., Chen, W. et al. A cable-driven soft robot surgical system for cardiothoracic endoscopic surgery: preclinical tests in animals. Surg Endosc 31, 3152–3158 (2017). https://doi.org/10.1007/s00464-016-5340-9
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DOI: https://doi.org/10.1007/s00464-016-5340-9