Miniature surgical robot for laparoendoscopic single-incision colectomy

Abstract

Background: This study aimed to demonstrate the effectiveness of using a multifunctional miniature in vivo robotic platform to perform a single-incision colectomy. Standard laparoscopic techniques require multiple ports. A miniature robotic platform to be inserted completely into the peritoneal cavity through a single incision has been designed and built. The robot can be quickly repositioned, thus enabling multiquadrant access to the abdominal cavity.

Methods: The miniature in vivo robotic platform used in this study consists of a multifunctional robot and a remote surgeon interface. The robot is composed of two arms with shoulder and elbow joints. Each forearm is equipped with specialized interchangeable end effectors (i.e., graspers and monopolar electrocautery).

Results: Five robotic colectomies were performed in a porcine model. For each procedure, the robot was completely inserted into the peritoneal cavity, and the surgeon manipulated the user interface to control the robot to perform the colectomy. The robot mobilized the colon from its lateral retroperitoneal attachments and assisted in the placement of a standard stapler to transect the sigmoid colon. This objective was completed for all five colectomies without any complications.

Conclusions: The adoption of both laparoscopic and single-incision colectomies currently is constrained by the inadequacies of existing instruments. The described multifunctional robot provides a platform that overcomes existing limitations by operating completely within one incision in the peritoneal cavity and by improving visualization and dexterity. By repositioning the small robot to the area of the colon to be mobilized, the ability of the surgeon to perform complex surgical tasks is improved. Furthermore, the success of the robot in performing a completely in vivo colectomy suggests the feasibility of using this robotic platform to perform other complex surgeries through a single incision.