Flexible Robotics in Medicine

A Design Journey of Motion Generation Mechanisms and Biorobotic System Development

Hongliang Ren

• Publisher: Academic Press
• Year: 2020
• ISBN:
  9780128165560
• Topic: Technology & Engineering
• Subtopic: Robotics
• Index: Technology & Engineering

Flexible Robotics in Medicine: A Design Journey of Motion Generation Mechanisms and Biorobotic System Development provides a resource of knowledge and successful prototypes regarding flexible robots in medicine. With specialists in the medical field increasingly utilizing robotics in medical procedures, it is vital to improve current knowledge regarding technologies available. This book covers the background, medical requirements, biomedical engineering principles, and new research on soft robots, including general flexible robotic systems, design specifications, design rationale, fabrication, verification experiments, actuators and sensors in flexible medical robotic systems.

Presenting several projects as examples, the authors also discuss the pipeline to develop a medical robotic system, including important milestones such as involved regulations, device classifications and medical standards.

• Covers realistic prototypes, experimental protocols and design procedures for engineering flexible medical robotics
• Covers the full product development pipeline for engineering new flexible robots for medical applications, including design principles and design verifications
• Includes detailed information for application and development of several types of robots, including Handheld Concentric-Tube Flexible Robot for Intraocular Procedures, a Preliminary Robotic Surgery Platform with Multiple Section Tendon-Driven Mechanism, a Flexible Drill for Minimally Invasive Transoral Surgical Robotic System, Four-Tendon-Driven Flexible Manipulators, Slim Single-port Surgical Manipulator with Spring Backbones and Catheter-size Channels, and much more

Chapter 1

Slender snake-like endoscopic robots in surgery

Shumei Yu^{1, 2}, Wenjun Xu^{3, 4} and Hongliang Ren⁵, ¹Suzhou University, P.R. China, ²National University of Singapore, Singapore, ³Department of Biomedical Engineering, National University of Singapore, Singapore, ⁴Peng Cheng Laboratory, Shenzhen, P.R. China, ⁵Department of Biomedical Engineering, National University of Singapore, Singapore

Abstract

For surgery, the targets inside the human body have complicated anatomical structures, which make access to the operating region challenging with high risks of bleeding and infections. Though keyhole surgical robots with articulated arms help surgeons to overcome the access difficulties in part, narrow and curved cavities require robots to be more compact and flexible. Thus snake-like robots are developed to cater to the demand because of their slim body and hyperredundancy in movement. This survey presents state-of-the-art knowledge about snake-like robots for robotic surgeries. We have investigated the commercial products, representative research prototypes, and new mechanical designs of the surgery-oriented snake-like robots. Additionally, for safe and precise human–robot interaction, modeling, sensing, and control of snake-like robots have been summarized.

Keywords

Snake-like robots; surgical robots; kinematic modeling; statics; dynamics; compensation; force sensing; shape sensing; workspace; motion planning; control

For surgery, the targets inside the human body have complicated anatomical structures, which make access to the operating region challenging with high risks of bleeding and infections. Though keyhole surgical robots with articulated arms help surgeons to overcome the access difficulties in part, narrow and curved cavities require robots to be more compact and flexible. Thus snake-like robots are developed to cater to the demand because of their slim body and hyperredundancy in movement. This survey presents state-of-the-art knowledge about snake-like robots for robotic surgeries. We have investigated the commercial products, representative research prototypes, and new mechanical designs of the surgery-oriented snake-like robots. Additionally, for safe and precise humanrobot interaction, modeling, sensing, and control of snake-like robots have been summarized.

1.1 Introduction

As engineering and medical science developed, robotics in the surgical field has made significant progress in the aspects of accuracy, efficiency, and safety. Among the boom of surgical robots market, the successful units in corresponding surgical areas include Da Vinci in laparoscopic surgery, CyberKnife in radiosurgery, MAKOplasty in a knee or hip replacement, Renaissance in spine surgery. These units break through the traditional operations by minimal invasiveness, clearer field of view, accurate targeting, navigation, and manipulation. Nevertheless, for the complex anatomical structures with narrow and curly cavities, such as a paranasal sinus, nasal cavity, antrum auris, pharynx, and larynx, it is difficult to reach and operate by traditional devices. Although endoscopic technology has been developed, surgeons have to deflect their attention partially to manipulations from inspections. The migration of industrial robots is facing challenges with narrow and curly cavity environments. Thus robots with the ability of flexible motion bring about the interests of the researchers and developers.

Snake, which goes through 100 million years of evolution, lives in nature almost around the world with high adaptability, still keeps the long, slim, and limbless body feature. Snake locomotion has attracted the interests of scientists in bionics and robotics for a long time. Since Shigeo Hirose in Tokyo Institute of Technology developed the first snake-like robot in the 1970s, studies on snake-like robots’ locomotion mechanism, mechanical design, gait generation, and motion control have been continuously published. Among the motion generation theories, gaits generated based on the curves are the most popular, exceeding the central pattern generator (CPG) and dynamic model–based methods. Chirikjian developed the backbone curve theory, and Choset studied the discretization of a curve in snake-like robot motion generations. Due to the hyperredundancy in DOF, snake-like robots can be used as a flexible manipulator to inspect spaces that are difficult to reach, for example, products by OC Robotics as inspectors. Inspired by the industrial usages, researchers have been trying to study snake-like robots that can be used for operational purposes.

Traditional snake-like robots have articulated rigid links. Due to their bulky shape, although they are found in certain studies that cater to stomach and intestine biopsy applications [1], they are of low priority in consideration of surgical applications. Continuum robots that take the form of cable-driven, concentric tube, catheter, steering needle fit the operation environment better than the snake-like robots of traditional modality. However, continuum robots in a surgical area have a long and slim shape and move like a snake, so they are often named as snake-like robots likewise. As has been surveyed previously [2], snake-like robots have been developed for applications in neurosurgery, otolaryngology, cardiac surgery, vascular surgery, abdominal surgery, and urological surgery. Take the cable-driven snake-like robot; for example, the actuation mechanism introduces backlash in the movement [3]. Additionally, the friction force is hard to be recognized to get an accurate hysteresis model. Besides, when the robots move inside the human body, it is challenging to build the interaction model. The sensing of the position, configuration, and force are difficult issues due to their downscaled size. Therefore accurate control for this type of robot to reach the target and accomplish the operations such as inspection, biopsy, cutting, and suturing is difficult. This survey discusses snake-like robots in surgical applications and summarizes the recent progress in mechanical design, modeling, sensing, and control. Among the contents, the authors will emphasize the motion compensation techniques, workspace analysis, motion planning, and control of the robots, which have not been surveyed intensively in previous studies.

1.2 Snake-like robots for surgery

Because of the similarity on shapes, endoscopes can be reckoned as the predecessor of the snake-like robot for surgical usage. Equipped with cameras and essential transmission mechanisms, an endoscope can be used to inspect or do biopsy tasks inside cavities of the human body. However, surgeons found the functions of the existing endoscopes challenging to satisfy the need for more complicated manipulations. Furthermore, an endoscope is at high risk of causing perforation, indigitation in clinical usage. To cater to the demand of intra-lumen exploration, researchers have made their efforts on various types of actuation and transmission designs to develop compact snake-like robots in the past decades. Most of them take the form of cable-driven, discrete joints, concentric tubes, continuum joints, and articulated rigid-link structures for surgical applications.

1.2.1 Commercial products

In this subsection, we summarize the commercialized snake-like robots for surgery. Table 1.1 shows the current surgical systems, their developers, and their application areas. Because of the massive success of Da Vinci in minimally invasive surgery (MIS), most of the snake-like surgical robots developers turned their attention on natural orifice transluminal endoscopic surgery (NOTES), for example, ViaCath [6] and Master [7]. For a subclass of NOTES such as colonoscopy and transoral surgery, a specialized product for a specific natural orifice such as NeoGuide [4] and Flex [5] emerged. CardioARM [8] is intended for specific cardiac surgery.

Table 1.1

Commercialized snake-like surgical robots.

Name	Published year	Developer	Product feature	Surgical application
NeoGuide [4]	2007	NeoGuide Systems Inc.	Tip position sensor and insertion depth sensor	Colonoscopy
Flex Robotic System [5]	2013	Medrobotics	Access and visualization without laryngoscopy	Transoral surgery
ViaCath [6]	2007	EndoVia Medical	Contains an endoscope and two articulated instruments	NOTES
Master [7]	2010	EndoMaster Medical	Master-slave manipulation by tendon-sheath actuation	NOTES
CardioARM [8]	2013	Medrobotics	“Follow the leader” control	Cardiac surgery

Most of the commercialized snake-like surgical robots adopted the cable-driven structure as driving mechanisms. The NeoGuide has 16 segments, each of which with the 8 cm length can be controlled in the desired direc...

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright
• List of Contributors
• Preface: A design journey of biorobotic motion generation mechanisms and flexible continuum system development
• Chapter 1. Slender snake-like endoscopic robots in surgery
• Chapter 2. Prototyping soft origami quad-bellows robots from single-bellows characterization
• Chapter 3. Cable-driven flexible endoscope utilizing diamond-shaped perforations: FlexDiamond
• Chapter 4. Flexible steerable manipulator utilizing complementary configuration of multiple routing grooves and ball joints for stable omnidirectional bending
• Chapter 5. Modular origami joint operator to create bendable motions with multiple radii
• Chapter 6. Handheld flexible robot with concentric tubes aiming for intraocular procedures
• Chapter 7. Tendon routing and anchoring for cable-driven single-port surgical manipulators with spring backbones and luminal constraints
• Chapter 8. Compliant bending tubular mechanisms with variable groove patterns for flexible robotic drilling delivery
• Chapter 9. Tendon-driven linkage for steerable guide of flexible bending manipulation
• Chapter 10. Soft-bodied flexible bending mechanism with silent shape memory alloys aiming for robotic endoscopy
• Chapter 11. Comparative mechanical analysis for flexible bending manipulators with quad-tendon antagonistic pairs
• Chapter 12. Flexible robotic platform with multiple-bending tendon-driven mechanism
• Chapter 13. Design evolution of a flexible robotic bending end-effector for transluminal explorations
• Chapter 14. Force sensing in compact concentric tube mechanism with optical fibers
• Chapter 15. Electromechanical characterization of magnetic responsive and conductive soft polymer actuators
• Chapter 16. Robotic transluminal Pan-and-Tilt Scope
• Chapter 17. Single-port multichannel multi-degree-of-freedom robot with variable stiffness for natural orifice transluminal endoscopic surgery
• Chapter 18. EndoGoose: a flexible and steerable endoscopic forceps with actively pose-retaining bendable sections
• Chapter 19. Flexible drill manipulator utilizing different rolling sliding joints for transoral drilling through the tracheal tissue
• Chapter 20. Thermo-responsive hydrogel-based circular valve embedded with shape-memory actuators
• Chapter 21. OmniFlex: omnidirectional flexible hand-held endoscopic manipulator with spheroidal joint
• Index