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Design Innovation Paper

Novel Miniature Tip Design for Enhancing Dexterity in Minimally Invasive Surgery

[+] Author and Article Information
Aimee Sakes

Department BioMechanical Engineering, Faculty Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, the Netherlands
a.sakes@tudelft.nl

Awaz Ali

Department BioMechanical Engineering, Faculty Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, the Netherlands
a.ali@tudelft.nl

Jovana Janjic

Department Biomedical Engineering, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands
j.janjic@erasmusmc.nl

Paul Breedveld

Department BioMechanical Engineering, Faculty Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, the Netherlands
p.breedveld@tudelft.nl

1Corresponding author.

ASME doi:10.1115/1.4040636 History: Received August 04, 2017; Revised June 04, 2018

Abstract

Even though technological advances have increased the application area of Minimally Invasive Surgery (MIS), there are still hurdles to allow for widespread adoption for more complex procedures. The development of steerable instruments, in which the surgeon can alter the tip orientation, has increased the application area of MIS, but they are bulky, which limits their ability to navigate through narrow environments, and complex, which complicates miniaturization. Furthermore, they do not allow for navigating through complex anatomies. In an effort to improve the dexterity of the MIS instruments, while minimizing the outer dimensions, the previously developed cable-ring mechanism was redesigned, resulting in the thinnest, Ø2 mm (Ø1 mm lumen), 8 Degrees Of Freedom (DOF) multisteerable tip for MIS to date. The multisteerable tip consists of 4 steerable segments of 2-DOF stackable elements allowing for ±90° articulation, as well the construction of complex shapes, actuated by 16 Ø0.2 mm stainless steel cables. In a proof-of-principle experiment, an ultrasound transducer and optical shape sensing fiber were inserted in the lumen and the multisteerable tip was used to perform scanning motions in order to reconstruct a wire frame in 3D. This configuration could in future be used to safely navigate through delicate environments and allow for tissue characterization. Therefore, the multisteerable tip has the potential to increase the application area of MIS in future, as it allows for improved dexterity, the ability to guide several tip tools towards the operation area, and the ability to navigate through tight anatomies.

Copyright (c) 2018 by ASME
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