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Конспект
Current trends in abdominal surgery are towards elimination of external incisions. Natural Orifice Transluminal Endoscopic Surgery (NOTES), a surgical technique free of external incisions, performed through a natural orifice access (e. g., esophagus, anus or vagina) and an internal tissue incision, has gained in popularity. Compared with open surgeries and traditional minimally invasive surgeries, this type of surgery has certain advantages, including no visible scarring, shortened hospitalization, less post-operative pain and a lower anesthesia requirement.
However, although NOTES has gained worldwide attention, it is still not widely used in practical clinical human application. There are several challenges to address, such as lack of flexible and powerful actuation, lack of tool dexterity, poor depth perception, and lack of multitasking tools. Current research mainly focuses on design of instruments or robots to improve the actuation or dexterity, while just a few studies have addressed the multitasking tool issue. As it is impossible to use only one tool to complete a NOTES procedure, and changing tool tips manually during surgery is extremely difficult due to the surgical environment constraints, surgical instruments with automatic tool changing function are urgently needed. To address the aforementioned problems, this dissertation presents a bimanual robot with a tool-changing manipulator. An articulated drive mechanism containing two independent curvature sections, which can articulate into complicated “S” shapes, is proposed to assist robot access through the natural orifice. Details of the design, analysis, control and further improvements to the robot are introduced. Three clinical validation experiments of the robot are conducted to demonstrate its functionality and capability.
