Frontiers of robotic endoscopic capsules: a review.

Digestive diseases are a major burden for society and healthcare systems, and with an aging population, the importance of their effective management will become critical. Healthcare systems worldwide already struggle to insure quality and affordability of healthcare delivery and this will be a significant challenge in the midterm future. Wireless capsule endoscopy (WCE), introduced in 2000 by Given Imaging Ltd., is an example of disruptive technology and represents an attractive alternative to traditional diagnostic techniques. WCE overcomes conventional endoscopy enabling inspection of the digestive system without discomfort or the need for sedation. Thus, it has the advantage of encouraging patients to undergo gastrointestinal (GI) tract examinations and of facilitating mass screening programmes. With the integration of further capabilities based on microrobotics, e.g. active locomotion and embedded therapeutic modules, WCE could become the key-technology for GI diagnosis and treatment. This review presents a research update on WCE and describes the state-of-the-art of current endoscopic devices with a focus on research-oriented robotic capsule endoscopes enabled by microsystem technologies. The article also presents a visionary perspective on WCE potential for screening, diagnostic and therapeutic endoscopic procedures.

A novel robotic system for single-port laparoscopic surgery: preliminary experience.

BACKGROUND: The concept of single-access procedures has gained greater attention from general surgeons during the past 5 years. Despite this wide momentum, these procedures pose several changes for the surgeon, such as impaired eye-hand coordination and restricted manipulation. In this context, robotic-assisted surgery represents a promising technology to enhance the dexterity of laparoscopic surgeons. METHODS: A novel teleoperated robotic system for minimally invasive surgery (MIS) called SPRINT (Single-Port lapaRoscopy bImaNual roboT) has been developed. SPRINT is a master-slave robotic platform designed for bimanual interventions through a single-access port. The system is basically composed by two main arms having a maximum diameter of 18 mm and a stereoscopic-camera (Karl-Storz, Tuttlingen, Germany). The arms may be inserted into a cylindrical introducer that has a maximum diameter of 30 mm. The surgeon console is composed of two master manipulators, a foot-switch, and a 3D full-HD display. RESULTS: In an animal study, a small-bowel enteroenterostomy and the ligation of a mesenteric vessel bundle have been performed. As preliminary experience, the system has been placed within the peritoneal cavity through an incision of approximately 10 cm: the robot has been suspended in an open fashion, due to some mechanical constraints of the current prototype. The procedures have been performed in an authorized laboratory on a female pig of approximately 50 Kg. CONCLUSIONS: Two typical surgical maneuvers have been performed successfully with the SPRINT surgical platform: an intestinal anastomosis and a vessel ligation. Moreover, the speed, precision, and force with which the SPRINT robot executed the commands by the surgeon controlling the master console have been subjectively described as adequate to the tasks. Based on this preliminary demonstration, bimanual robot solutions, such as the SPRINT robot, may offer more dexterity and precision to single-port techniques in the next future.

Microsystems in medicine - results of an international survey.

The utilization of microsystems technology (MST) in medical applications is instrumental in opening up new market segments, in the creation of novel, more effective diagnosis and therapy options in medicine, as well as in the further development of MST. However, the players in the healthcare industry are faced with technical and non-technical difficulties. The present study analyzes this emerging field from the viewpoint of medicine, market, and MST. It identifies applications of medical devices with microsystems components and analyzes their potentials in great detail. Thus, especially the creation of new market segments is expected from a broad use of MST in medicine. Furthermore, problems and conditions during the entry of microsystems into medical products are illuminated, in particular considering the specific market features of the healthcare industry. The high expenditure necessary for establishing this technology in healthcare industry is the most significant obstacle, since this market is dominated by small and medium-sized enterprises (SMEs). But there are non-technical difficulties as well. This article presents selected results of the study, which was carried out in the scope of the EU project netMED (virtual institute on micromechatronics for biomedical industry).

[Actuator design and control exemplified by a urologic implant]. / Aktorik und Steuerung Am Beispiel eines Urologischen Implantats.

The state of the art concerning the use of actuators and sensors and the intelligent microprocessor-based control will be discussed on the basis of a novel urological implant, a fine tuned, sensor controlled artificial sphincter. A set of powerful actuators with a reaction time lower than 10 ms have been realised due to an appropriate design of components. This has been achieved at a supply voltage of 4.2 V and a power input lower than 0.1 mW. An optimal reliability as well as the comfort in operating the implant by the physician and the patient was gained by the use of different data technologies being adapted to the implanted system.