Skip to main content
Top
Published in: Surgical Endoscopy 6/2007

Open Access 01-06-2007 | Technique

The mechanical master–slave manipulator: an instrument improving the performance in standardized tasks for endoscopic surgery

Authors: J. Diks, J. E. N. Jaspers, W. Wisselink, B. A. M. J. de Mol, C. A. Grimbergen

Published in: Surgical Endoscopy | Issue 6/2007

Login to get access

Abstract

Background

This study aimed to evaluate the feasibility and efficacy of a mechanical minimally invasive manipulator for endoscopic surgery. In contrast to currently available motorized master–slave manipulators, this mechanical manipulator consists of two purely mechanical, hand-controlled endoscopic arms with joints that allow seven degrees of freedom (DOF).

Methods

For the study, 30 medical students performed four different tasks in a pelvic trainer box using either two conventional endoscopic needleholders or a set of mechanical manipulators. The exercise consisted of four different tasks: repositioning of coins, rope passing, passing of a suture through rings, and tying of a surgical knot. All experiments were recorded on videotape (S-VHS), and the data were analyzed afterwards by an independent observer using a quantitative time-action analysis.

Results

A significant difference in the number of total actions (including failures) favoring the mechanical manipulator group was shown in most exercises. A significant difference in failures per task was shown in favor of the mechanical manipulator group as well. There was no significant difference shown in the total time per exercise.

Conclusions

The tasks clearly demonstrated the efficacy of the mechanical manipulator, although some technical flaws emerged during the experiments. Considering the fact that a first prototype of the mechanical manipulator was tested, modifications are to be expected in a next model. These experiments show the potential of the mechanical manipulator, and it is expected to be a competitive and economical instrument for endoscopic surgery in the near future.
Literature
1.
go back to reference Agresta F, Michelet I, Coluci G, Bedin N (2000) Emergency laparoscopy: a community hospital experience. Surg Endosc 14: 484–487PubMedCrossRef Agresta F, Michelet I, Coluci G, Bedin N (2000) Emergency laparoscopy: a community hospital experience. Surg Endosc 14: 484–487PubMedCrossRef
2.
go back to reference Ballantyne GH (2002) Robotic surgery, telerobotic surgery, telepresence, and telementoring: review of early clinical results. Surg Endosc 16: 1389–1402PubMedCrossRef Ballantyne GH (2002) Robotic surgery, telerobotic surgery, telepresence, and telementoring: review of early clinical results. Surg Endosc 16: 1389–1402PubMedCrossRef
3.
go back to reference Berguer R, Forkey DL, Smith WD (1999) Ergonomic problems associated with laparoscopic surgery. Surg Endosc Ultras 13: 466–468CrossRef Berguer R, Forkey DL, Smith WD (1999) Ergonomic problems associated with laparoscopic surgery. Surg Endosc Ultras 13: 466–468CrossRef
4.
go back to reference Bodner J, Wykypiel H, Wetscher G, Schmid T (2004) First experiences with the da Vinci operating robot in thoracic surgery. Eur J Cardiothorac Surg 25: 844–851PubMedCrossRef Bodner J, Wykypiel H, Wetscher G, Schmid T (2004) First experiences with the da Vinci operating robot in thoracic surgery. Eur J Cardiothorac Surg 25: 844–851PubMedCrossRef
5.
go back to reference Breedveld P, Wentink M (2000) Eye-hand coordination in laparoscopy: overview of experiments and supporting aids. Minim Invasive Ther Allied Technol 10: 155–162 Breedveld P, Wentink M (2000) Eye-hand coordination in laparoscopy: overview of experiments and supporting aids. Minim Invasive Ther Allied Technol 10: 155–162
6.
go back to reference Cadiere GB, Himpens J, Germay O, Izizaw R, Degueldre M, Vandromme J, Capelluto E, Bruyns J (2001) Feasibility of robotic laparoscopic surgery: 146 cases. World J Surg 25: 1467–1477PubMed Cadiere GB, Himpens J, Germay O, Izizaw R, Degueldre M, Vandromme J, Capelluto E, Bruyns J (2001) Feasibility of robotic laparoscopic surgery: 146 cases. World J Surg 25: 1467–1477PubMed
7.
go back to reference Hubens G, Coveliers H, Balliu L, Ruppert M, Vaneerdeweg W (2003) A performance study comparing manual and robotically assisted laparoscopic surgery using the da Vinci system. Surg Endosc 17: 1595–1599PubMedCrossRef Hubens G, Coveliers H, Balliu L, Ruppert M, Vaneerdeweg W (2003) A performance study comparing manual and robotically assisted laparoscopic surgery using the da Vinci system. Surg Endosc 17: 1595–1599PubMedCrossRef
8.
go back to reference Jaspers JE, Den Boer KT, Sjoerdsma W, Bruijn M, Grimbergen CA (2000) Design and feasibility of PASSIST, a passive instrument positioner. J Laparoendosc Adv Surg Tech A 10: 331–335PubMedCrossRef Jaspers JE, Den Boer KT, Sjoerdsma W, Bruijn M, Grimbergen CA (2000) Design and feasibility of PASSIST, a passive instrument positioner. J Laparoendosc Adv Surg Tech A 10: 331–335PubMedCrossRef
9.
go back to reference Jaspers JEN, Shehata M, Wijkhuizen F, Herder JL, Grimbergen CA (2004) Mechanical manipulator for intuitive control of endoscopic instruments with seven degrees of freedom. Minim Invasive Ther 13: 191–198CrossRef Jaspers JEN, Shehata M, Wijkhuizen F, Herder JL, Grimbergen CA (2004) Mechanical manipulator for intuitive control of endoscopic instruments with seven degrees of freedom. Minim Invasive Ther 13: 191–198CrossRef
10.
go back to reference Loulmet D, Carpentier A, d’Attellis N, Berrebi A, Cardon C, Ponzio O, Aupecle B, Relland JY (1999) Endoscopic coronary artery bypass grafting with the aid of robotic assisted instruments. J Thorac Cardiovasc Surg 118: 4–10PubMedCrossRef Loulmet D, Carpentier A, d’Attellis N, Berrebi A, Cardon C, Ponzio O, Aupecle B, Relland JY (1999) Endoscopic coronary artery bypass grafting with the aid of robotic assisted instruments. J Thorac Cardiovasc Surg 118: 4–10PubMedCrossRef
11.
go back to reference Martin RC II, Kehdy FJ, Allen JW (2005) Formal training in advanced surgical technologies enhances the surgical residency. Am J Surg Aug 190: 244–248CrossRef Martin RC II, Kehdy FJ, Allen JW (2005) Formal training in advanced surgical technologies enhances the surgical residency. Am J Surg Aug 190: 244–248CrossRef
12.
go back to reference Mohr FW, Falk V, Diegeler A, Autschback R (1999) Computer enhanced coronary artery bypass surgery. J Thorac Cardiovasc Surg 117: 1212–1213PubMedCrossRef Mohr FW, Falk V, Diegeler A, Autschback R (1999) Computer enhanced coronary artery bypass surgery. J Thorac Cardiovasc Surg 117: 1212–1213PubMedCrossRef
13.
go back to reference Nio D, Bemelman WA, Boer KT, Dunker MS, Gouma DJ, Gulik TM (2002) Efficiency of manual versus robotical (Zeus) assisted laparoscopic surgery in the performance of standardized tasks. Surg Endosc 16: 412–415, Epub 16 November 2001PubMedCrossRef Nio D, Bemelman WA, Boer KT, Dunker MS, Gouma DJ, Gulik TM (2002) Efficiency of manual versus robotical (Zeus) assisted laparoscopic surgery in the performance of standardized tasks. Surg Endosc 16: 412–415, Epub 16 November 2001PubMedCrossRef
14.
go back to reference Nio D, Diks J, Linsen MA, Cuesta MA, Gracia C, Rauwerda JA, Wisselink W (2005) Robot-assisted laparoscopic aortobifemoral bypass for aortoiliac occlusive disease: early clinical experience. Eur J Vasc Endovasc Surg 29: 586–590PubMedCrossRef Nio D, Diks J, Linsen MA, Cuesta MA, Gracia C, Rauwerda JA, Wisselink W (2005) Robot-assisted laparoscopic aortobifemoral bypass for aortoiliac occlusive disease: early clinical experience. Eur J Vasc Endovasc Surg 29: 586–590PubMedCrossRef
15.
go back to reference Perez A, Zinner MJ, Ashley SW, Brooks DC, Whang EE (2003) What is the value of telerobotic technology in gastrointestinal surgery? Surg Endosc 17: 811–813PubMedCrossRef Perez A, Zinner MJ, Ashley SW, Brooks DC, Whang EE (2003) What is the value of telerobotic technology in gastrointestinal surgery? Surg Endosc 17: 811–813PubMedCrossRef
16.
go back to reference Prasad SM, Maniar HS, Soper NJ, Damiano RJ Jr, Klingensmith ME (2002) The effect of robotic assistance on learning curves for basic laparoscopic skills. Am J Surg 183: 702–707PubMedCrossRef Prasad SM, Maniar HS, Soper NJ, Damiano RJ Jr, Klingensmith ME (2002) The effect of robotic assistance on learning curves for basic laparoscopic skills. Am J Surg 183: 702–707PubMedCrossRef
17.
go back to reference Richards KF, Fisher KS, Flores JH, Christensen BJ (1996) Laparoscopic appendectomy: comparison with open appendectomy in 720 patients. Surg Laparosc Endosc 6: 205–209PubMedCrossRef Richards KF, Fisher KS, Flores JH, Christensen BJ (1996) Laparoscopic appendectomy: comparison with open appendectomy in 720 patients. Surg Laparosc Endosc 6: 205–209PubMedCrossRef
18.
go back to reference Ruurda JP, Broeders IA, Simmermacher RP, Borel Rinkes IH, Van Vroonhoven TJ (2002) Feasibility of robot-assisted laparoscopic surgery: an evaluation of 35 robot-assisted laparoscopic cholecystectomies. Surg Laparosc Endosc Percutan Tech 12: 41–45PubMedCrossRef Ruurda JP, Broeders IA, Simmermacher RP, Borel Rinkes IH, Van Vroonhoven TJ (2002) Feasibility of robot-assisted laparoscopic surgery: an evaluation of 35 robot-assisted laparoscopic cholecystectomies. Surg Laparosc Endosc Percutan Tech 12: 41–45PubMedCrossRef
19.
go back to reference Shah PR, Joseph A, Haray PN (2005) Laparoscopic colorectal surgery: learning curve and training implications. Postgrad Med J 81: 537–540PubMedCrossRef Shah PR, Joseph A, Haray PN (2005) Laparoscopic colorectal surgery: learning curve and training implications. Postgrad Med J 81: 537–540PubMedCrossRef
20.
go back to reference Van Veelen MA (2001) New ergonomic guidelines for laparoscopic instruments. Minim Invasive Ther Allied Technol 10: 163–167CrossRef Van Veelen MA (2001) New ergonomic guidelines for laparoscopic instruments. Minim Invasive Ther Allied Technol 10: 163–167CrossRef
21.
go back to reference Wentink M, Wieringa PA, Jackimowicz JJ, Stultiëns GNM (2000) Quantifying hand–eye coordination problems during minimally invasive surgery: is the surgeon misoriented? Minim Invasive Ther 9: 352–353 Wentink M, Wieringa PA, Jackimowicz JJ, Stultiëns GNM (2000) Quantifying hand–eye coordination problems during minimally invasive surgery: is the surgeon misoriented? Minim Invasive Ther 9: 352–353
22.
go back to reference Wisselink W, Cuesta MA, Gracia C, Rauwerda JA (2002) Robot-assisted laparoscopic aortobifemoral bypass for aortoiliac occlusive disease: a report of two cases. J Vasc Surg 36: 1079–1082PubMedCrossRef Wisselink W, Cuesta MA, Gracia C, Rauwerda JA (2002) Robot-assisted laparoscopic aortobifemoral bypass for aortoiliac occlusive disease: a report of two cases. J Vasc Surg 36: 1079–1082PubMedCrossRef
Metadata
Title
The mechanical master–slave manipulator: an instrument improving the performance in standardized tasks for endoscopic surgery
Authors
J. Diks
J. E. N. Jaspers
W. Wisselink
B. A. M. J. de Mol
C. A. Grimbergen
Publication date
01-06-2007
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 6/2007
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-006-9038-2

Other articles of this Issue 6/2007

Surgical Endoscopy 6/2007 Go to the issue