title: An anthropomorphic design for a minimally invasive surgical system based on a survey of surgical technologies, techniques and training.
abstract: BACKGROUND
  Over the past century, abdominal surgery has seen a rapid transition from open procedures to less invasive methods, such as robot-assisted minimally invasive surgery (MIS). This study aimed to investigate and discuss the needs of MIS in terms of instrumentation and to inform the design of a novel instrument.
  
  
  METHODS
  A survey was conducted among surgeons regarding their opinions on surgical training, surgical systems, how satisfied they were with them and how easy they were to use. A concept for MIS robotic instrumentation was then developed and a series of focus groups with surgeons were run to discuss it. The initial prototype of the robotic instruments, herein demonstrated, comprises modular rigid links with soft joints actuated by shape memory alloy helix actuators; these instruments are controlled using a sensory hand exoskeleton.
  
  
  RESULTS
  The results of the survey, as well as those of the focus groups, are presented here. A first prototype of the system was built and initial laboratory tests have been conducted in order to evaluate this approach.
  
  
  CONCLUSIONS
  The analysed data from both the survey and the focus groups justify the chosen concept of an anthropomorphic MIS robotic system which imitates the natural motion of the hands.
authors.affiliation: Bristol Robotics Laboratory, Bristol, UK; Department of Engineering Design and Mathematics, University of the West of England, Bristol, UK.
authors.forename: Antonia
authors.initials: A
authors.lastname: Tzemanaki
authors.forename: Peter
authors.initials: P
authors.lastname: Walters
authors.forename: Anthony Graham
authors.initials: AG
authors.lastname: Pipe
authors.forename: Chris
authors.initials: C
authors.lastname: Melhuish
authors.forename: Sanja
authors.initials: S
authors.lastname: Dogramadzi
mesh_terms: D000497:Alloys / Q000737:chemistry; D000886:Anthropometry; D004867:Equipment Design; D017144:Focus Groups; D013502:General Surgery / Q000295:instrumentation*; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation* / Q000379:methods; D007858:Learning; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D065287:Robotic Surgical Procedures / Q000379:methods*; D012371:Robotics / Q000379:methods; D025321:Surgery, Computer-Assisted / Q000379:methods; D011795:Surveys and Questionnaires
chemical_list: D000497:Alloys
keywords: focus groups; hand exoskeleton; minimally invasive surgery; multi-fingered instruments; robot-assisted surgery; shape memory alloy actuators; survey