title: Development and evaluation of a master-slave robot system for single-incision laparoscopic surgery.
abstract: PURPOSE                         :                          Single-incision laparoscopic surgery (SILS) brings cosmetic benefits for patients, but this procedure is more difficult than laparoscopic surgery. In order to reduce surgeons' burden, we have developed a master-slave robot system which can provide robot-assisted SILS as if it were performing conventional laparoscopic surgery and confirmed the feasibility of our proposed system.                                                                           METHODS                         :                          The proposed system is composed of an input device (master side), a surgical robot system (slave side), and a control PC. To perform SILS in the same style as regular laparoscopic surgery, input instruments are inserted into multiple incisions, and the tip position and pose of the left-sided (right-sided) robotic instrument on the slave side follow those of the right-sided (left-sided) input instruments on the master side by means of a control command from the PC. To validate the proposed system, we defined four operating conditions and conducted simulation experiments and physical experiments with surgeons under these conditions, then compared the results.                                                                           RESULTS                         :                          In the simulation experiments, we found learning effects between trials (P = 0.00013 < 0.05). Our proposed system had no significant difference from a condition simulating classical laparoscopic surgery (P = 0.23 > 0.1), and the task time of our system was significantly shorter than the simulated SILS (P = 0.011 < 0.05). In the physical experiments, our system performed SILS more easily, efficiently, and intuitively than the other operating conditions.                                                                           CONCLUSION                         :                          Our proposed system enabled the surgeons to perform SILS as if they were operating conventionally with laparoscopic techniques.
authors.affiliation: Department of Mechanical Science and Bioengineering, Graduate School of Engineering Science, Osaka University, Toyonaka, Japan. horise@robotics.me.es.osaka-u.ac.jp
authors.forename: Yuki
authors.initials: Y
authors.lastname: Horise
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nishikawa
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Sekimoto
authors.forename: Yu
authors.initials: Y
authors.lastname: Kitanaka
authors.forename: Norikatsu
authors.initials: N
authors.lastname: Miyoshi
authors.forename: Shuji
authors.initials: S
authors.lastname: Takiguchi
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
authors.forename: Fumio
authors.initials: F
authors.lastname: Miyazaki
mesh_terms: D002921:Cicatrix / Q000517:prevention & control; D003198:Computer Simulation; D004867:Equipment Design; D004869:Equipment Safety; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D012371:Robotics / Q000295:instrumentation / Q000379:methods*; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013647:Task Performance and Analysis; D014945:Wound Healing / Q000502:physiology