title: Fetus support manipulator with flexible balloon-based stabilizer for endoscopic intrauterine surgery.
abstract: A novel manipulator is described for stabilizing fetus and preventing it from free-floating during the endoscopic intrauterine surgery. Minimally invasive endoscopic fetal surgery enables intrauterine intervention with reduced risk to the mother and fetus. We designed and fabricated a prototype of a fetus supporting manipulator equipped with a flexible bending/curving mechanisms and a soft balloon-based stabilizer. The flexible bending and curving mechanisms enable the stabilizer to reach the target sites within the uterus under an ultrasound-guidance. The balloon-based stabilizer could be inserted into the uterus with a small incision for entry. The accuracy evaluation showed that the maximum error of the curving mechanism was as small as 7 mm and the standard deviation of the bending mechanism was just 1.6 degrees. In the experiments using a fetus model, the manipulator could be well controlled under ultrasound guidance and its curving mechanism with the balloon-based stabilizer could be clearly visualized during the implementation of fetus model supporting. The manipulator has the potential to be used in minimally invasive intrauterine surgery, though further improvements and experiments remain to be carried out.
authors.affiliation: Graduate School of Engineering, the University of Tokyo, Japan. liao@miki.pe.u-tokyo.ac.jp
authors.forename: Hongen
authors.initials: H
authors.lastname: Liao
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Suzuki
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Matsumiya
authors.forename: Ken
authors.initials: K
authors.lastname: Masamune
authors.forename: Takeyoshi
authors.initials: T
authors.lastname: Dohi
authors.forename: Toshio
authors.initials: T
authors.lastname: Chiba
mesh_terms: D004867:Equipment Design; D019544:Equipment Failure Analysis; D020669:Fetoscopes; D005332:Fetoscopy / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000295:instrumentation* / Q000379:methods; D007103:Immobilization / Q000295:instrumentation* / Q000379:methods; D008846:Micromanipulation / Q000295:instrumentation* / Q000379:methods; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D011312:Pressure; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods