Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Surgical Endoscopy
Published in: Surgical Endoscopy 12/2015

01-12-2015

A miniaturized robotic platform for natural orifice transluminal endoscopic surgery: in vivo validation

Authors: Selene Tognarelli, Marco Salerno, Giuseppe Tortora, Claudio Quaglia, Paolo Dario, Marc Oliver Schurr, Arianna Menciassi

Published in: Surgical Endoscopy | Issue 12/2015

Login to get access

Abstract

Background

Natural orifice transluminal endoscopic surgery (NOTES) involves accessing the abdominal cavity via one of the body natural orifices for enabling minimally invasive surgical procedures. However, the constraints imposed by the access modality and the limited available technology make NOTES very challenging for surgeons. Tools redesign and introduction of novel surgical instruments are imperative in order to make NOTES operative in a real surgical scenario, reproducible and reliable. Robotic technology has major potential to overcome current limitations.

Methods

The robotic platform described here consists of a magnetic anchoring frame equipped with dedicated docking/undocking mechanisms to house up to three modular robots for surgical interventions. The magnetic anchoring frame guarantees the required stability for surgical tasks execution, whilst dedicated modular robots provide the platform with adequate vision, stability and manipulation capabilities.

Results

Platform potentialities were demonstrated in a porcine model. Assessment was organized into two consecutive experimental steps, with a hybrid testing modality. First, platform deployment, anchoring and assembly through transoral–transgastric access were demonstrated in order to assess protocol feasibility and guarantee the safe achievement of the following experimental session. Second, transabdominal deployment, anchoring, assembly and robotic module actuation were carried out.

Conclusions

This study has demonstrated the feasibility of inserting an endoluminal robotic platform composed of an anchoring frame and modular robotic units into a porcine model through a natural orifice. Once inserted into the peritoneal cavity, the platform provides proper visualization from multiple orientations. For the first time, a platform with interchangeable modules has been deployed and its components have been connected, demonstrating in vivo the feasibility of intra-abdominal assembly. Furthermore, increased dexterity employing different robotic units will enhance future system capabilities.
Appendix
Available only for authorised users
Literature
1.
Kantsevoy SV, Hu B, Jagannath SB, Vaughn CA, Beitler DM, Chung SS, Cotton PB, Gostout CJ, Hawes RH, Pasricha PJ, Magee CA, Pipitone LJ, Talamini MA, Kalloo AN (2006) Transgastric endoscopic splenectomy: is it possible? Surg Endosc 20(3):522–525CrossRefPubMed
2.
Wang X, Meng MQH (2012) Robotics for Natural Orifice Transluminal Endoscopic Surgery: a review. J Robot 2012:1–9CrossRef
3.
Swanstrom LL, Kozarek R, Pasricha PJ, Gross S, Birkett D, Park PO, Saadat V, Ewers R, Swain P (2005) Development of a new access device for transgastric surgery. J Gastrointest Surg 9(8):1129–1136CrossRefPubMed
4.
Yonezawa J, Kaise M, Sumiyama K, Goda K, Arakawa H, Tajiri H (2006) A novel double-channel therapeutic endoscope (“R-scope”) facilitates endoscopic submucosal dissection of superficial gastric neoplasms. Endoscopy 38(10):1011–1015CrossRefPubMed
5.
Eickhoff A, Van Dam J, Jakobs R, Kudis V, Hartmann D, Damian U, Weickert U, Schilling D, Riemann JF (2007) Computer-assisted colonoscopy (The NeoGuide Endoscopy System): results of the first human clinical trial (“PACE Study”). Am J Gastroenterol 102:261–266CrossRefPubMed
6.
Dallemagne B, Marescaux J (2010) The ANUBISTM project. Minim Invasive Ther Allied Technol 19:257–261CrossRefPubMed
7.
Yeung BPM, Gourlay T (2012) A technical review of flexible endoscopic multitasking platforms. Int J Surgery 10:345–354CrossRef
8.
Spaun G, Zheng B, Swanström L (2009) A multitasking platform for natural orifice translumenal endoscopic surgery (NOTES): a benchtop comparison of a new device for flexible endoscopic surgery and a standard dual-channel endoscope. Surg Endosc 23:2720–2727CrossRefPubMed
9.
Abbott DJ, Becke C, Rothstein RI, Peine WJ (2007) Design of an endoluminal NOTES robotic system. IEEE/RSJ international conference on intelligent robots and systems. San Diego, USA, pp 410–416
10.
Phee SJ, Kencana AP, Huynh VA, Sun ZL, Low SC, Yang K, Lomanto D, Ho KY (2010) Design of a master and slave transluminal endoscopic robot for natural orifice transluminal endoscopic surgery. Inst Mech Eng Part C J Mech Eng Sci 224:1495–1503CrossRef
11.
Vitiello V, Lee SL, Cundy TP, Yang GZ (2013) Emerging robotic platforms for minimally invasive surgery. IEEE Rev Biomed Eng 6:111–126CrossRefPubMed
12.
Cahill RA (2010) Natural orifice transluminal endoscopic surgery—here and now. The Surgeon 8(1):44–50CrossRefPubMed
13.
Karimyan V, Sodergren M, Clark J, Yang GZ, Darzi A (2009) Navigation systems and platforms in natural orifice translumenal endoscopic surgery (NOTES). Int J Surg 7:297–304CrossRefPubMed
14.
Harada K, Susilo E, Menciassi A, Dario P (2009) Wireless reconfigurable modules for robotic endoluminal surgery. IEEE international conference on robotics and automation. Kobe, Japan, pp 2699–2704
15.
Diller E, Pawashe C, Floyd S, Sitti M (2011) Assembly and disassembly of magnetic mobile micro-robots towards deterministic 2-D reconfigurable micro-systems. Int J Robot Res 30(14):1667–1680CrossRef
16.
Canes D, Lehman AC, Farritor SM, Oleynikov D, Desai MM (2009) The future of notes instrumentation: flexible robotics and in vivo minirobots. J Endourol 23:787–792CrossRefPubMed
17.
Raman JD, Scott DJ, Cadeddu JA (2009) Role of magnetic anchors during laparoendoscopic single site surgery and notes. J Endourol 23:781–786CrossRefPubMed
18.
Best SL, Kabbani W, Scott DJ, Bergs R, Beardsley H, Fernandez R, Mashaud LB, Cadeddu JA (2010) Magnetic anchoring and guidance system instrumentation for laparo-endoscopic single-site surgery/natural orifice transluminal endoscopic surgery: lack of histologic damage after prolonged magnetic coupling across the abdominal wall. Urology 77(1):243–247CrossRefPubMed
19.
Scott DJ, Tang SJ, Fernandez R, Bergs R, Goova MT, Zeltser I, Kehdy FJ, Cadeddu JA (2007) Completely transvaginal NOTES cholecystectomy using magnetically anchored instruments. Surg Endosc 21(12):2308–2316CrossRefPubMed
20.
Tiwari MM, Reynoso JF, Lehman AC, Tsang AW, Farritor SM, Oleynikov D (2010) In vivo miniature robots for natural orifice surgery: state of the art and future perspectives. World J Gastrointest Surg 2(6):217–223PubMedCentralCrossRefPubMed
21.
Tortora G, Salerno M, Ranzani T, Tognarelli S, Dario P, Menciassi A (2013) A modular magnetic platform for natural orifice transluminal endoscopic surgery. IEEE international conference of the engineering in medicine and biology society. Osaka, Japan, pp 6265–6268
22.
Salerno M, Tognarelli S, Quaglia C, Dario P, Menciassi A (2013) Anchoring frame for intra-abdominal surgery. Int J Robot Res 32(3):360–370CrossRef
23.
Tognarelli S, Salerno M, Tortora G, Quaglia C, Dario P, Menciassi A (2012) An endoluminal robotic platform for minimally invasive surgery. IEEE RAS/EMBS biorob conference. Italy, Rome, pp 7–12
24.
Tortora G, Dario P, Menciassi A (2014) Array of robots augmenting the kinematics of endocavitary surgery. IEEE/ASME Trans Mechatron 99:1–9
Metadata
Title
A miniaturized robotic platform for natural orifice transluminal endoscopic surgery: in vivo validation
Authors
Selene Tognarelli
Marco Salerno
Giuseppe Tortora
Claudio Quaglia
Paolo Dario
Marc Oliver Schurr
Arianna Menciassi
Publication date
01-12-2015
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 12/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-015-4097-x

Other articles of this Issue 12/2015

Surgical Endoscopy 12/2015 Go to the issue

OriginalPaper

Do we need antibiotic prophylaxis in endoscopic inguinal hernia repair? Results of the Herniamed Registry

OriginalPaper

Factors associated with endoscopic full-thickness resection of gastric submucosal tumors

OriginalPaper

Clinical impact of submucosal tunneling endoscopic resection for the treatment of gastric submucosal tumors originating from the muscularis propria layer (with video)

Dynamic Manuscript

Endoluminal perforation of a magnetic antireflux device

OriginalPaper

Safety and feasibility of simultaneous endoscopic submucosal dissection for multiple gastric neoplasias

OriginalPaper

Clinicopathological factors of multiple lateral margin involvement after endoscopic submucosal dissection for early gastric cancer