Endoscopic operations, or keyhole surgery, are much less stressful for the patient and give a better cosmetic result than ‘open’ surgery. But on the other hand, it is very difficult for the surgeon to carry out keyhole surgery. This is due to the disruption of hand-eye coordination, as the surgeon has to operate via a 2D image on a monitor. Moreover, the video camera has to be operated by an assistant and the work must be done using long and rigid instruments that provide little freedom of movement. The existing robot systems that have been developed to solve the aforementioned problems are complex, expensive and do not provide the required feedback to the surgeon.

The aim of Joris Jaspers’ research project at the Academic Medical Centre in Amsterdam was to develop simple mechanical alternatives to these complex robotic systems, and also to test them.

The first instrument is a camera and instrument holder. Using this mechanical arm the surgeon can operate the camera himself, thus allowing him to conduct the operation by himself without an assistant. A test showed that this enabled ‘solo surgery’ and that it even brought advantages in comparison to surgery using an assistant.

The second instrument is a mechanical manipulator for operating the various instruments used in keyhole surgery. Two mechanical arms, provided with artificial ‘wrist joints’ for extra freedom of movement, transmit the surgeon’s hand movements exactly onto the instruments.

This mechanical manipulator thus fulfils a similar function to the surgical robot systems, but in a simpler and cheaper manner. In a test carried out with experienced medical students, the manipulator was compared to the existing instruments. This study showed that far fewer actions were needed when using the manipulator and that fewer mistakes were made than with the existing instruments.

MEDICA.de; Source: Delft University of Technology