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research-article

Development and Feasibility of a Robotic Laparoscopic Clipping Tool for Wound Closure and Anastomosis

[+] Author and Article Information
Axel Krieger

Children’s National Health System, Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, 111 Michigan Ave, NW, Washington, DC, 20010; University of Maryland, ASME Member, Department of Mechanical Engineering, 2181 Glenn L. Martin Hall, Building 088, University of Maryland, College Park, MD 20742
axel@umd.edu

Justin Opfermann

Children’s National Health System, Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, 111 Michigan Ave, NW, Washington, DC, 20010
jopferma@childrensnational.org

Peter C.W. Kim

Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, 111 Michigan Ave, NW, Washington, DC, 20010
pkim@childrensnational.org

1Corresponding author.

ASME doi:10.1115/1.4038335 History: Received May 12, 2017; Revised October 17, 2017

Abstract

This paper reports the design, development, and initial evaluation of a robotic laparoscopic clipping tool for single manipulator wound closure and anastomosis (tubular reconnection). The tool deploys biodegradable clips and clasps with the goal of (i) integrating grasping and suturing into a single device for single hand or manipulator use, (ii) applying the equivalent of interrupted sutures without the need of managing suture thread, and (iii) allowing for full 6 degrees of freedom (DOF) laparoscopic control when mounted on a robot arm. The specifications, workflow, and detailed design of the robotic laparoscopic tool and injection molded bio-absorbable T shaped clip and locking clasp are reported. The clipping tool integrates forceps to grab and stabilize tissue and a clip and clasp applier to approximate and fixate the tissue. A curved needle is advanced on a circular needle path and picks up and drags clips through tissue. The clip is then tightened through the tissue and a clasp is clamped around the clip, before the clip is released from the needle. Results of several bench test-runs of the tool show: a) repeatable circular needle drive, b) successful pick-up and deployment of clips, c) successful shear of the clip to release the clip from the needle, d) and closure of clasp on clip with an average of 2.0 N holding force. This data indicates the robotic laparoscopic clipping tool could be used for laparoscopic wound closure and anastomosis.

Copyright (c) 2017 by ASME
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