title: Natural orifice transluminal endoscopic surgery with a snake-mechanism using a movable pulley.
abstract: BACKGROUND
  Natural orifice transluminal endoscopic surgery is an emerging technique. We aimed to develop an advanced surgical robot mechanism for natural orifice surgery.
  
  
  METHODS
  We propose the active-controlled overtube-type platform with multiple channels for an endoscopic camera and surgical tools. To make such a platform, we suggest an advanced snake mechanism comprising movable pulleys to make a snake mechanism with multiple degrees of freedom and high operating force.
  
  
  RESULTS
  The stiffness and maneuverability of the active-controlled platform appeared satisfactory. Using prototypes and ex vivo experiments, we confirmed that the mechanism was suitable for a snake-like robotic platform for natural orifice surgery.
  
  
  CONCLUSIONS
  The suggested snake mechanism using movable pulleys has the advantages of stiffness and maneuverability. This new mechanism can be an alternative platform for natural orifice surgery.
authors.affiliation: Biomedical Engineering Branch, Research Institute and Hospital, National Cancer Center, Republic of Korea.|Biomedical Engineering Research Center, Asan Medical Center, Republic of Korea.
authors.forename: Hoyul
authors.initials: H
authors.lastname: Lee
authors.affiliation: Biomedical Engineering Branch, Research Institute and Hospital, National Cancer Center, Republic of Korea.
authors.forename: Kwang Gi
authors.identifier: http://orcid.org/0000-0001-9714-6038
authors.initials: KG
authors.lastname: Kim
authors.affiliation: Biomedical Engineering Branch, Research Institute and Hospital, National Cancer Center, Republic of Korea.
authors.forename: Jong Hyun
authors.initials: JH
authors.lastname: Seo
authors.affiliation: Biomedical Engineering Branch, Research Institute and Hospital, National Cancer Center, Republic of Korea.
authors.forename: Dae Kyung
authors.identifier: http://orcid.org/0000-0003-3296-6646
authors.initials: DK
authors.lastname: Sohn
mesh_terms: D004867:Equipment Design; D006801:Humans; D009038:Motion; D057605:Natural Orifice Endoscopic Surgery / Q000295:instrumentation* / Q000379:methods; D065287:Robotic Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D012371:Robotics / Q000295:instrumentation* / Q000379:methods; D013314:Stress, Mechanical
keywords: TME; natural orifce surgery; rectum; robot design