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Research Papers

Design and Modeling of a Three-Degree-of-Freedom Articulating Robotic Microsurgical Forceps for Trans-Oral Laser Microsurgery

[+] Author and Article Information
Manish Chauhan

Storm Lab, School of Electronics and
Electrical Engineering,
University of Leeds,
Leeds LS2 9JT, UK
e-mail: m.chauhan@leeds.ac.uk

Nikhil Deshpande

Advanced Robotics Department,
Istituto Italiano di Tecnologia,
Via Morego, 30,
Genova 16163, Italy
e-mail: nikhil.deshpande@iit.it

Darwin G. Caldwell

Advanced Robotics Department,
Istituto Italiano di Tecnologia,
Via Morego, 30,
Genova 16163, Italy
e-mail: darwin.caldwell@iit.it

Leonardo S. Mattos

Advanced Robotics Department,
Istituto Italiano di Tecnologia,
Via Morego, 30,
Genova 16163, Italy
e-mail: leonardo.mattos@iit.it

1Corresponding author.

Manuscript received September 18, 2018; final manuscript received February 25, 2019; published online April 4, 2019. Assoc. Editor: Venketesh Dubey.

J. Med. Devices 13(2), 021006 (Apr 04, 2019) (9 pages) Paper No: MED-18-1170; doi: 10.1115/1.4043017 History: Received September 18, 2018; Revised February 25, 2019

Trans-oral laser microsurgery (TLM) is a surgical procedure for removing malignancies (e.g., cysts, polyps, tumors) of the laryngeal region through laser ablation. Intraoperative microsurgical forceps (i.e., microforceps) are used for tissue manipulation. The microforceps are rigid, single degree-of-freedom (DOF) devices (open–close) with precurved jaws to access different parts of the curved cylindrical laryngeal region. These microforceps are manually handled and are subject to hand tremors, poor reachability, and nonergonomic use, resulting in poor efficacy and efficiency in the surgery. A novel 3DOF motorized microforceps device is presented here, integrated with a 6DOF serial robotic manipulator. The device, referred to as RMF-3, offers three motorized DOFs: (i) open–close forceps jaw; (ii) tool rotation; and (iii) tool-tip articulation. It is designed to be compliant with TLM spatial constraints. The manual handling is replaced by tele-operation device, the omega.7. The design of the RMF-3 is characterized through theoretical and experimental analysis. The device shows a maximum articulation of 38 deg and tool rotation of 100 deg. Its performance is further evaluated through user trials using the ring-in-loop setup. The user trials demonstrate benefits of the 3DOF workspace of the device along with its teleoperation control. RMF-3 offers an improved workspace and reachability within the laryngeal region. Surgeons, in their preliminary evaluation of the device, appreciated the ability to articulate the tip, along with rotation, for hard-to-reach parts of the surgical site. RMF-3 offers an ergonomic robotic teleoperation control interface which overcomes hand tremors and extreme wrist excursion which leads to surgeon pain and discomfort.

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Figures

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Fig. 1

Trans-oral laser microsurgery surgical dimensional overview: (a) traditional access of vocal region, (b) vocal anatomy, and (c) expected access

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Fig. 2

Dimensional requirements of microsurgical forceps in TLM

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Fig. 3

The tool shaft (a) traditional tool dimensions, (b) exploded view of proposed tool, and (c) proposed tool dimensions

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Fig. 4

The tool shaft holder

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Fig. 5

Tool jaw open/close DOF

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Fig. 6

Rotational DOF: (a) subcomponent overview, (b) miter gear, (c) spur gear, and (d) modification in link 5

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Fig. 7

Tool shaft articulation

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Fig. 8

Force measurement experimental setup

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Fig. 9

Force required versus articulation angle

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Fig. 10

Tool shaft rotation characterization (a) without tendon wire and (b) with tendon wire

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Fig. 11

User evaluation setup

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Fig. 12

Number of error over trials

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Fig. 14

Workspace achieved with RMF-3

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Fig. 15

Trials this with surgeons

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