Abstract
Background
The concept of single-access procedures has gained greater attention from general surgeons during the past 5 years. Despite this wide momentum, these procedures pose several changes for the surgeon, such as impaired eye-hand coordination and restricted manipulation. In this context, robotic-assisted surgery represents a promising technology to enhance the dexterity of laparoscopic surgeons.
Methods
A novel teleoperated robotic system for minimally invasive surgery (MIS) called SPRINT (Single-Port lapaRoscopy bImaNual roboT) has been developed. SPRINT is a master-slave robotic platform designed for bimanual interventions through a single-access port. The system is basically composed by two main arms having a maximum diameter of 18 mm and a stereoscopic-camera (Karl-Storz, Tuttlingen, Germany). The arms may be inserted into a cylindrical introducer that has a maximum diameter of 30 mm. The surgeon console is composed of two master manipulators, a foot-switch, and a 3D full-HD display.
Results
In an animal study, a small-bowel enteroenterostomy and the ligation of a mesenteric vessel bundle have been performed. As preliminary experience, the system has been placed within the peritoneal cavity through an incision of approximately 10 cm: the robot has been suspended in an open fashion, due to some mechanical constraints of the current prototype. The procedures have been performed in an authorized laboratory on a female pig of approximately 50 Kg.
Conclusions
Two typical surgical maneuvers have been performed successfully with the SPRINT surgical platform: an intestinal anastomosis and a vessel ligation. Moreover, the speed, precision, and force with which the SPRINT robot executed the commands by the surgeon controlling the master console have been subjectively described as adequate to the tasks. Based on this preliminary demonstration, bimanual robot solutions, such as the SPRINT robot, may offer more dexterity and precision to single-port techniques in the next future.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ahmed K, Wang TT, Patel VM, Nagpal K, Clark J, Ali M, Deeba S, Ashrafian H, Darzi A, Athanasiou T, Paraskeva P (2011) The role of single-incision laparoscopic surgery in abdominal and pelvic surgery: a systematic review. Surg Endosc 25:378–396
Antoniou SA, Pointner R, Granderath FA (2011) Single-incision laparoscopic cholecystectomy: a systematic review. Surg Endosc 25:367–377
Saber AA, Elgamal MH, Itawi EA, Rao AJ (2008) Single incision laparoscopic sleeve gastrectomy (SILS): a novel technique. Obes Surg 18:1338–1342
Boni L, Dionigi G, Cassinotti E, Di Giuseppe M, Diurni M, Rausei S, Cantore F, Dionigi R (2010) Single-incision laparoscopic right colectomy. Surge Endosc 24:3233–3236
Lirici MM (2012) Single site laparoscopic surgery: an intermediate step toward no (visible) scar surgery or the next gold standard in minimally invasive surgery? Minim Invasive Ther Allied Technol 21:1–7
Romanelli J, Earle D (2009) Single-port laparoscopic surgery: an overview. Surg Endosc 23:1419–1427
Tang B, Hou S, Cuschieri A (2012) Ergonomics of and technologies for single-port laparoscopic surgery. Minim Invasive Ther Allied Technol 21:46–54
Dapri G (2012) Specially designed curved reusable instruments for single-access laparoscopy: 2.5-year experience in 265 patients. Minim Invasive Ther Allied Technol 21:31–39
Galvao Neto M, Ramos A, Campos J (2009) Single-port laparoscopic access surgery. Tech Gastrointest Endosc 11:84–93
Pearl J, Ponsky J (2008) Natural orifice translumenal surgery: a critical review. J Gastrointest Surg 12:1293–1300
Pryor AD, Tushar JR, DiBernardo LR (2010) Single-port cholecystectomy with the TransEnterix SPIDER: simple and safe. Surg Endosc 24:917–923
Horgan S, Thompson K, Talamini M, Ferreres A, Jacobsen G, Spaun G, Cullen J, Swanstrom L (2011) Clinical experience with a multifunctional, flexible surgery system for endolumenal, single-port and NOTES procedures. Surg Endosc 25:586–592
Haber GP, White MA, Autorino R, Escobar PF, Kroh MD, Chalikonda S, Khanna R, Forest S, Yang B, Altunrende F, Stein RJ, Kaouk JH (2010) Novel robotic daVinci instruments for laparoendoscopic single-site surgery. Urology 76:1279–1282
Ding J, Xu K, Goldman R, Allen P, Fowler D, Simaan N (2010) Design, simulation and evaluation of kinematic alternatives for insertable robotic effectors platforms in single port access surgery. In: Proceedings of the IEEE International Conference on Robotics and Automation (ICRA), May 2010, pp 1053–1058
Noonan SD, Payne C, Clark J, Sodergren M, Darzi A, Yang GZ (2011) An articulated universal joint based flexible access robot for minimally invasive surgery. In: Proceedings of the IEEE International Conference on Robotics and Automation (ICRA), May 2011, pp 1147–1152
Kobayashi Y, Tomono Y, Sekiguchi Y, Watanabe H, Toyoda K, Konishi K, Tomikawa M, Ieiri S, Tanoue K, Hashizume M, Fujie MG (2010) A surgical robot with vision field control for single port endoscopic surgery. Int J Med Robotics Comput Assist Surg 6:454–464
Phee S, Ho K, Lomanto D, Low S, Huynh V, Kencana A, Yang K, Sun Z, Chung S (2010) Natural orifice transgastric endoscopic wedge hepatic resection in an experimental model using an intuitively controlled master and slave transluminal endoscopic robot (MASTER). Surg Endosc 24:2293–2298
Wortman TD, Meyer A, Dolghi O, Lehman AC, McCornick RL, Farritor SM, Oleynikov D (2012) Miniature surgical robot for laparoendoscopic single-incision colectomy. Surg Endosc 26:727–731
Lehman AC, Wood NA, Farritor S, Goede MR, Oleynikov D (2011) Dexterous miniature robot for advanced minimally invasive surgery. Surg Endosc 25:119–123
Piccigallo M, Scarfogliero U, Quaglia C, Petroni G, Valdastri P, Menciassi A, Dario P (2010) Design of a novel bimanual robotic system for single port laparoscopy. IEEE/ASME Trans Mechatronics. doi:10.1109/TMECH.2010.2078512 December 13, 2010
Petroni G, Niccolini M, Menciassi A, Dario P, Cuschieri A (2012) A novel intracorporeal assembling robotic system for single-port laparoscopic surgery. Surg Endosc. doi:10.1007/s00464-012-2453-7
Niccolini M, Petroni G, Menciassi A, Dario P (2012) Real-time control architecture of a novel Single-Port lapaRoscopy bimaNual roboT (SPRINT). In: Proceedings of the IEEE International Conference on Robotics and Automation (ICRA), May 2012
Pini G, Rassweiler J (2012) Minilaparoscopy and laparoendoscopic single-site surgery: mini and single scar in urology. Minim Invasive Ther Allied Technol 21:8–25
Acknowledgments
The authors thank N. Funaro, A. Melani, G. Favati, C. Filippeschi, and R. Di Leonardo for prototype manufacturing, and the members of Novineon Healthcare Technology Partners GmbH for their support during the in vivo test sessions. The authors also are grateful to S. Tognarelli and M. Salerno for their technical support. Financial support for this study was provided by the European Commission in the framework of ARAKNES FP7 European Project 224565 (www.araknes.org).
Disclosures
G. Petroni, M. Niccolini, S. Caccavaro, C. Quaglia, A. Menciassi, S. Schostek, G. Basili, O. Goletti, M. O. Schurr, and P. Dario have no conflicts of interest or financial ties to disclose.
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
Supplementary material 1 (MOV 35492 kb)
Rights and permissions
About this article
Cite this article
Petroni, G., Niccolini, M., Caccavaro, S. et al. A novel robotic system for single-port laparoscopic surgery: preliminary experience. Surg Endosc 27, 1932–1937 (2013). https://doi.org/10.1007/s00464-012-2690-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-012-2690-9