A proof-of-principle robot with potential for the development of a hand-held tactile instrument for minimally-invasive artery cross-clamping.

One of the most common diseases of the vascular system is abdominal aortic aneurysm (AAA), for which the most definitive treatment is surgery. Minimally invasive aorta surgery is a novel method of surgery performed through small incisions and offers significant advantages including less pain, shorter hospital stay, faster patient recovery, less possibility of infection, etc. However, lack of sense of touch is the main drawback of this type of aorta surgery that would incapacitate the surgeon to exactly distinguish the aorta from its surrounding tissues which could cause various problems during the aorta cross-clamping process. One of the most important drawbacks is that it makes the aorta cross-clamping process the most time-consuming process of aortic repair surgery. The artificial tactile sensing approach is a novel method that can be used in various fields of medicine and, more specifically, in minimally invasive surgeries, where using the 'tactile sense' is not possible. In this paper, considering the present problems during aortic-repair-laparoscopy and imitating the movement of surgeons' fingers during aorta cross-clamping, a novel tactile-based artery cross-clamping robot is introduced and its function is evaluated experimentally. It is illustrated that this new tactile-based artery cross-clamping robot is well capable of dissecting an artery from its adjacent tissues in a short time with an acceptable accuracy.

Artery cross-clamping during laparoscopic vascular surgeries; a computational tactile sensing approach.

Artificial palpation is one of the most valuable achievements of artificial tactile sensing approach that can be used in various fields of medicine and more specifically in surgery. These techniques cause different surgical maneuvers to be done more precisely and noninvasively. In this study, considering the present problems and limitations of cross-clamping an artery during laparoscopic vascular surgeries, a new tactile sensory system will be introduced.Having imitated surgeon's palpation during open vascular surgeries and modeled it conceptually, the optimal amount of the total angular displacement of each robot joint in order to cross-clamping an artery without damaging to the artery surrounding tissues will be calculated. The elastic governing equation of contact occurred between the tactile sensor placed on the first link of the robot and the surrounding tissues around the artery were developed. A finite element model is coupled with genetic algorithm optimization method so that the normal stress and displacements in contact surface of the robot and artery's surrounding tissues would be minimized. Thus, reliability and accuracy of artificial tactile sensing method in artery cross-clamping will be demonstrated. Finally, the functional principles of the new tactile system capable of cross-clamping an artery during laparoscopic surgeries will be presented.