title: Design and performance evaluation of a minimally invasive telerobotic platform for transurethral surveillance and intervention.
abstract: Bladder cancer, a significant cause of morbidity and mortality worldwide, presents a unique opportunity for aggressive treatment due to the ease of transurethral accessibility. While the location affords advantages, transurethral resection of bladder tumors can pose a difficult challenge for surgeons encumbered by current instrumentation or difficult anatomic tumor locations. This paper presents the design and evaluation of a telerobotic system for transurethral surveillance and surgical intervention. The implementation seeks to improve current procedures and enable development of new surgical techniques by providing a platform for intravesicular dexterity and integration of novel imaging and interventional instrumentation. The system includes a dexterous continuum robot with access channels for the parallel deployment of multiple visualization and surgical instruments. This paper first presents the clinical conditions imposed by transurethral access and the limitations of the current state-of-the-art instrumentation. Motivated by the clinical requirements, the design considerations for this system are discussed and the prototype system is presented. Telemanipulation evaluation demonstrates submillimetric RMS positioning accuracy and intravesicular dexterity suitable for improving transurethral surveillance and intervention.
authors.affiliation: College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA. reg2117@columbia.edu
authors.forename: Roger E
authors.initials: RE
authors.lastname: Goldman
authors.forename: Andrea
authors.initials: A
authors.lastname: Bajo
authors.forename: Lara S
authors.initials: LS
authors.lastname: MacLachlan
authors.forename: Ryan
authors.initials: R
authors.lastname: Pickens
authors.forename: S Duke
authors.initials: SD
authors.lastname: Herrell
authors.forename: Nabil
authors.initials: N
authors.lastname: Simaan
mesh_terms: D000818:Animals; D002417:Cattle; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D008954:Models, Biological; D012371:Robotics / Q000295:instrumentation*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D014521:Urethra / Q000601:surgery; D001743:Urinary Bladder / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000601:surgery