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Design and control of a robotic assistant for laparoscopic surgery   
摘  要:   This paper presents a robotic assistant for helping surgeons in minimally invasive surgery. The system pro- vides the direct control of the camera positioning inside the abdominal cavity, by both surgeon voice commands and remote teleoperation. This work is based on a previous experience with a system designed around an industrial robot arm. The new system keeps all the capabilities of the previous one, but incorporates a specially designed arm for this application. This prototype does not require any modification of a standard operation theatre (furniture or surgery tools) for its installation and its putting into operation. The system has been tested by using patient simulators, and in vitro tissues. During last years, a new field has gained the interest of robotic researchers. Minimally invasive techniques, such as laparoscopy, have grown as a very suitable domain for robotic systems. In these procedures, the sur- geon only uses the visual feedback information provided by a camera attached to the endoscope. Thus, the surgeon manoeuvres the laparoscope and video camera within the abdominal cavity to explore the anatom- ical structures and their pathologies. Since these procedures can last up to two (or even more) hours, the camera image can suffer a significant loss of stability. The centring on the point of interest can be worse, as well. In this scenery, a robotic aid, able of moving the laparoscopic camera according to surgeon's voice commands (allowing him or her to use both hands in the surgical procedure itself), would become a very helpful tool in the operating room. 1. Problem Statement. Laparoscopic techniques involve the use of long stem instruments through small incisions in the abdominal wall of the patient. A special camera, whose optic penetrates as well into the abdomen, helps the surgeon to manoeuvre the instruments in order to complete the procedure (Satava, 1998). Thus, we have two possibil- ities to develop a robotic aid: moving the instruments or moving the camera. Every one of these options follow a different target: robotized instruments can help us to achieve telesurgery, moving the surgeon from the operating room to a distant site; a robotic camera, however, can improve coordination and efficiency, and free a second surgeon (the one who moves the camera) to help the main surgeon, or to carry out another procedure in a different operating room. A review of the literature can show diverse ways of facing the development of a laparoscopic assistant. In 1995 Taylor and others proposed a complete system, including a manipulator, a special end-effector to carry the laparoscopic camera and a new control strategy. The manipulator had 7 degrees-of-freedom (dof) divid- ed into three components: a translation component (3 dof), a remote centre-of-motion component (2 dof) and a distal component (2 dof) that completed the 4 dof that an insertion point offers (roll, pitch, yaw and penetration). Thus the orientation of the camera through the incision was decoupled of its positioning. An interface based on an instrument-mounted joystick, for voice-recognition system were not very capable at that moment. Green, at SRI International (1995), developed a different concept. The target of this system was to explore the possibility of a telesurgery scheme, appropriate not only for minimally invasive surgery but to open sur- gery as well. Thus, two manipulators (5 dof) was included in the local subsystem -though the inclusion of 7 dof manipulators was yet planned-, and a complete remote workstation was developed, including stereo vid- eo and audio, and two master manipulators with force reflection capabilities. A view of the surgical field was provided by a camera mounted on a third arm. This telesurgery concept was later enhanced and taken to a commercial stage by Intuitive Surgical's Da Vinci system (Guthart, 2000). The HISAR system (Funda, 1995) presented a new configuration of the manipulator. The proposed one was a 7 dof robot mounted on the ceiling, with 3 dof to position the camera and 4 dof to get the right orientation. Two of these orientation axes were passive to grant free compliance with the port of entry. Since this point acts as a fulcrum, it is necessary to have an accurate knowledge of its position to move the camera with pre- cision. In order to achieve this, a re-estimation procedure of the pivoting point is proposed.

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