Microsurgical robotic system for the deep surgical field: development of a prototype and feasibility studies in animal and cadaveric models.
OBJECTIVE
To enhance the surgeon's dexterity and maneuverability in the deep surgical field, the authors developed a master-slave microsurgical robotic system. This concept and the results of preliminary experiments are reported in this paper.


METHODS
The system has a master control unit, which conveys motion commands in six degrees of freedom (X, Y, and Z directions; rotation; tip flexion; and grasping) to two arms. The slave manipulator has a hanging base with an additional six degrees of freedom; it holds a motorized operating unit with two manipulators (5 mm in diameter, 18 cm in length). The accuracy of the prototype in both shallow and deep surgical fields was compared with routine freehand microsurgery. Closure of a partial arteriotomy and complete end-to-end anastomosis of the carotid artery (CA) in the deep operative field were performed in 20 Wistar rats. Three routine surgical procedures were also performed in cadavers. The accuracy of pointing with the nondominant hand in the deep surgical field was significantly improved through the use of robotics. The authors successfully closed the partial arteriotomy and completely anastomosed the rat CAs in the deep surgical field. The time needed for stitching was significantly shortened over the course of the first 10 rat experiments. The robotic instruments also moved satisfactorily in cadavers, but the manipulators still need to be smaller to fit into the narrow intracranial space.


CONCLUSIONS
Computer-controlled surgical manipulation will be an important tool for neurosurgery, and preliminary experiments involving this robotic system demonstrate its promising maneuverability.
Morita
Akio
A
Department of Neurosurgery, Faculty of Medicine, School of Engineering, University of Tokyo, Japan. amort-ky@umin.ac.jp
Sora
Shigeo
S
Mitsuishi
Mamoru
M
Warisawa
Shinichi
S
Suruman
Katopo
K
Asai
Daisuke
D
Arata
Junpei
J
Baba
Shoichi
S
Takahashi
Hidechika
H
Mochizuki
Ryo
R
Kirino
Takaaki
T
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D002102:Cadaver; D002339:Carotid Arteries / Q000601:surgery*; D003198:Computer Simulation; D006801:Humans; D008866:Microsurgery / Q000379:methods*; D019635:Neurosurgical Procedures / Q000295:instrumentation* / Q000379:methods*; D051381:Rats; D017208:Rats, Wistar; D012371:Robotics