Versatile end effector for laparoscopic robotic scrub nurse

Abstract

Purpose: Integrating robotic scrub nurses in the operating room has the potential to help overcome staff shortages and limited use of available operating capacities in hospitals. Existing approaches of robotic scrub nurses are mainly focused on open surgical procedures, neglecting laparoscopic procedures. Laparoscopic interventions offer great potential for the context-sensitive integration of robotic systems due to possible standardization. However, the first step is to ensure the safe manipulation of laparoscopic instruments.

Methods: A robotic platform with a universal gripper system was designed to pick up and place laparoscopic as well as da Vinci[Formula: see text] instruments in an efficient workflow. The robustness of the gripper system was studied using a test protocol, which included a force absorption test to determine the operational safety limits of the design and a grip test to determine the system performance.

Results: The test protocol shows results regarding force and torque absorption capabilities of the end effector, which are essential when transferring an instrument to the surgeon to enable a robust handover. The grip tests show that the laparoscopic instruments can be safely picked up, manipulated and returned independent of unexpected positional deviations. The gripper system also enables the manipulation of da Vinci[Formula: see text] instruments, opening the door for robot-robot interaction.

Conclusion: Our evaluation tests have shown that our robotic scrub nurse with the universal gripper system can safely and robustly manipulate laparoscopic and da Vinci[Formula: see text] instruments. The system design will continue with the integration of context-sensitive capabilities.

Keywords: Laparoscopic instruments; Robotic end effector; Robotic scrub nurse; Surgical robotics.

Fig. 1

SASHA-OR system consisting of drop zone (red), instrument rack (yellow), 3D camera (green), end effector (blue)

Fig. 2

Schematic setups of sterile operating areas for interventions with the SASHA-OR system, a laparoscopic surgery, b robotic surgery

Fig. 3

End effector (blue) consisting of two subsystems (shaft gripping subsystem and release button subsystem); a shaft gripping subsystem manipulating instruments with lower gripping area (LGA), b shaft gripping subsystem manipulating instruments with upper gripping area (UGA), c shaft gripping subsystem manipulating da Vinci${}^{\circledR }$ instrument with lower gripping area (LGA) and release button subsystem stabilizing da Vinci${}^{\circledR }$ instrument head while pressing the release buttons

Fig. 4

a End effector under sterile conditions, b Exploded view of the end effector indicating the position of the sterile cover, thus dividing the end effector into a sterile and a non-sterile region

Fig. 5

Force application modeling for payload translation and rotation (black arrows indicate applied force direction), a force absorption in x direction, b force absorption in z direction, c Torque absorption in the xz plane

Fig. 6

a Laparoscopic instruments (ID: A - G) and da Vinci${}^{\circledR }$ instrument (ID: H), b laparoscopic instruments stored in a prototypical instrument rack with flexible brackets

Fig. 7

Depiction of axial translation s, transversal translation t, and transversal rotation $\alpha$

Fig. 8

a Load absorption tests for lower gripping area (LGA), b Load absorption tests for upper gripping area (UGA)

Fig. 9

a Robustness against axial translation s, b Robustness against transversal translation t, c Robustness against transversal rotation $\alpha$