Preclinical evaluation of a surgical assistant robot for use in minimally invasive abdominal surgeries.

Abstract

In recent years, robotic assistance has become increasingly used and applied in minimally invasive surgeries. A new cooperative surgical robot system that includes a joystick-guided robotic scope holder was developed in this study, and its feasibility for use in minimally invasive abdominal surgery was evaluated in a preclinical setting. The cooperative surgical robot consists of a six-degree-of-freedom collaborative robot arm and a one-degree-of-freedom bidirectional telescopic end-effector specializing in surgical assistance. The robot holds the endoscopic camera and performs remote center of motion based on the port into which the trocar is inserted. Surgeons can operate the robot with joysticks or hand-guided control. Cadaveric sessions were conducted in a male human cadaver to evaluate the system's potential to provide adequate surgical access and the reach required to complete a range of general abdominal surgeries. The results indicated that minimally invasive abdominal surgeries (low anterior resection, appendectomy, and cholecystectomy) were technically feasible with the new cooperative surgical robot, with docking times of 43, 26, and 32 s, respectively. The operative times were 15, 55, and 35 min for appendectomy, total mesorectal excision, and cholecystectomy, respectively. A National Aeronautics and Space Administration Task Load Index cognitive workload assessment by six surgeons who participated in the cadaveric study, resulted in an acceptable global score of 42.2. This preclinical study demonstrated that the new cooperative robotic surgery is usable in minimally invasive abdominal surgeries. Further simulations are necessary to confirm this promising product.