title: Conceptual design of a novel multi-DoF manual instrument for laparoscopic surgery.
abstract: BACKGROUND
  Laparoscopic surgery is becoming increasingly popular throughout the world. But the conventional instruments used in many surgeries are not flexible enough to be operated. Challenging tasks, such as suturing and knot-tying tasks are difficult to complete using conventional instruments with limited degrees of freedom (DoFs). In the paper, a novel cable-driven multi-DoF manual instrument is presented with a simple structure but strong functionality.
  
  
  METHODS
  The proposed instrument has been developed with a wristlike operation end (OE), a wristlike end effector (EE), and the transmission system. It can be operated intuitively. The orientation and the position of the EE are directly controlled by surgeons due to the one-to-one motion mapping structure. The clamp structure and tension device are reasonably designed. The pitch, yaw, and the open and close motion are actuated by cables. Based on the optimization index Global Condition Index (GCI), four cables are used to actuate the pitch and yaw motions, while other two are used for the open and close motion. The layout of the cables is also determined by the GCI.
  
  
  RESULTS
  Experiments carried out with a prototype show that tasks such as suturing and knot-tying can be completed comfortably. Due to the intuitive control and multi-DoFs, surgeons can use the prototype to finish the tasks with ease.
  
  
  CONCLUSIONS
  The instrument developed herein with intuitive control and dexterity can be used alone or together with a robotic system to accomplish some challenging tasks that are difficult for conventional instruments.
authors.affiliation: Key Lab for Mechanism Theory and Equipment Design of Ministry of Education, School of Mechanical Engineering, Tianjin University, People’s Republic of China. wangfifi@msn.com
authors.forename: Xiaofei
authors.initials: X
authors.lastname: Wang
authors.forename: Shuxin
authors.initials: S
authors.lastname: Wang
authors.forename: Jianmin
authors.initials: J
authors.lastname: Li
authors.forename: Guokai
authors.initials: G
authors.lastname: Zhang
authors.forename: Zhiliang
authors.initials: Z
authors.lastname: Wu
mesh_terms: D003198:Computer Simulation; D017076:Computer-Aided Design; D004867:Equipment Design; D019544:Equipment Failure Analysis; D020706:Laparoscopes; D008962:Models, Theoretical; D012371:Robotics / Q000295:instrumentation*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*