Minimally Invasive Surgery: Equipment and Troubleshooting

2019 ◽  
Author(s):  
Jacob A. Greenberg ◽  
Laura E. Fischer

The field of minimally invasive surgery has evolved rapidly since the first laparoscopic appendectomies and cholecystectomies were performed nearly 30 years ago.1 Minimally invasive approaches are now widely used for gastrointestinal resection, hernia repair, antireflux surgery, bariatric surgery, and solid-organ surgery, such as hepatic, pancreatic, adrenal, and renal resections. Although the techniques and equipment needed to access, expose, and dissect vary according to the type of operation and surgeon’s preference, a basic set of equipment is essential for any laparoscopic or robotic procedure: endoscope, camera, light source, signal processing unit, video monitor, insufflator and gas supply, trocars, and surgical instruments. Understanding how to use and troubleshoot this equipment is critical for any surgeon who performs minimally invasive surgery. We review the essentials of basic laparoscopic equipment, including the mechanics of normally functioning equipment and the various types of laparoscopic trocars and instruments. We also discuss robotic equipment and the fundamental differences from laparoscopy. Minilaparoscopy and single-site equipment are briefly explained. Additionally, we discuss potential technical difficulties that surgeons may encounter while performing minimally invasive procedures and provide suggestions for troubleshooting these problems. This review 13 figure, 2 tables, and 64 references.Key Words: Laparoscopy, Robotic Surgery, Minimally Invasive Surgery, Laparoscopic Surgery, Trocars, Surgical Energy Devices, Insufflator, Laparoscopic Instrumentation, Ergonomics, Single Site Surgery

2019 ◽  
Author(s):  
Jacob A. Greenberg ◽  
Laura E. Fischer

The field of minimally invasive surgery has evolved rapidly since the first laparoscopic appendectomies and cholecystectomies were performed nearly 30 years ago.1 Minimally invasive approaches are now widely used for gastrointestinal resection, hernia repair, antireflux surgery, bariatric surgery, and solid-organ surgery, such as hepatic, pancreatic, adrenal, and renal resections. Although the techniques and equipment needed to access, expose, and dissect vary according to the type of operation and surgeon’s preference, a basic set of equipment is essential for any laparoscopic or robotic procedure: endoscope, camera, light source, signal processing unit, video monitor, insufflator and gas supply, trocars, and surgical instruments. Understanding how to use and troubleshoot this equipment is critical for any surgeon who performs minimally invasive surgery. We review the essentials of basic laparoscopic equipment, including the mechanics of normally functioning equipment and the various types of laparoscopic trocars and instruments. We also discuss robotic equipment and the fundamental differences from laparoscopy. Minilaparoscopy and single-site equipment are briefly explained. Additionally, we discuss potential technical difficulties that surgeons may encounter while performing minimally invasive procedures and provide suggestions for troubleshooting these problems. This review 13 figure, 2 tables, and 64 references.Key Words: Laparoscopy, Robotic Surgery, Minimally Invasive Surgery, Laparoscopic Surgery, Trocars, Surgical Energy Devices, Insufflator, Laparoscopic Instrumentation, Ergonomics, Single Site Surgery


2019 ◽  
Author(s):  
Jacob A. Greenberg ◽  
Laura E. Fischer

The field of minimally invasive surgery has evolved rapidly since the first laparoscopic appendectomies and cholecystectomies were performed nearly 30 years ago.1 Minimally invasive approaches are now widely used for gastrointestinal resection, hernia repair, antireflux surgery, bariatric surgery, and solid-organ surgery, such as hepatic, pancreatic, adrenal, and renal resections. Although the techniques and equipment needed to access, expose, and dissect vary according to the type of operation and surgeon’s preference, a basic set of equipment is essential for any laparoscopic or robotic procedure: endoscope, camera, light source, signal processing unit, video monitor, insufflator and gas supply, trocars, and surgical instruments. Understanding how to use and troubleshoot this equipment is critical for any surgeon who performs minimally invasive surgery. We review the essentials of basic laparoscopic equipment, including the mechanics of normally functioning equipment and the various types of laparoscopic trocars and instruments. We also discuss robotic equipment and the fundamental differences from laparoscopy. Minilaparoscopy and single-site equipment are briefly explained. Additionally, we discuss potential technical difficulties that surgeons may encounter while performing minimally invasive procedures and provide suggestions for troubleshooting these problems. This review 13 figure, 2 tables, and 64 references.Key Words: Laparoscopy, Robotic Surgery, Minimally Invasive Surgery, Laparoscopic Surgery, Trocars, Surgical Energy Devices, Insufflator, Laparoscopic Instrumentation, Ergonomics, Single Site Surgery


2010 ◽  
Vol 26 (5) ◽  
pp. 451-456 ◽  
Author(s):  
Carissa L. Garey ◽  
Carrie A. Laituri ◽  
Daniel J. Ostlie ◽  
Shawn D. St. Peter

2012 ◽  
Vol 6 (2) ◽  
Author(s):  
Chin-Hsing Kuo ◽  
Jian S. Dai

A crucial design challenge in minimally invasive surgical (MIS) robots is the provision of a fully decoupled four degrees-of-freedom (4-DOF) remote center-of-motion (RCM) for surgical instruments. In this paper, we present a new parallel manipulator that can generate a 4-DOF RCM over its end-effector and these four DOFs are fully decoupled, i.e., each of them can be independently controlled by one corresponding actuated joint. First, we revisit the remote center-of-motion for MIS robots and introduce a projective displacement representation for coping with this special kinematics. Next, we present the proposed new parallel manipulator structure and study its geometry and motion decouplebility. Accordingly, we solve the inverse kinematics problem by taking the advantage of motion decouplebility. Then, via the screw system approach, we carry out the Jacobian analysis for the manipulator, by which the singular configurations are identified. Finally, we analyze the reachable and collision-free workspaces of the proposed manipulator and conclude the feasibility of this manipulator for the application in minimally invasive surgery.


2021 ◽  
Author(s):  
Rene I. Luna

Minimally invasive surgery has changed the landscape of women’s surgical healthcare. Conventional and robotic laparoscopy are the preferred approach for many major minimally invasive gynecological procedures. However, the philosophy of minimally invasive surgery has been pushed to reduce the size and minimize the number of ports placed. Many conventional minimally invasive surgical procedures use 3–5 ports through multiple small incisions. Laparoscopic single site surgery tries to perform on that philosophy but has its limitations. Enters robotic surgery already a major force in minimally invasive surgery and now sets to remove the limitations of single site surgery. However it requires proper understanding of the instruments and the techniques for successful robotic single site surgery. It starts with patient selection. Knowing the instruments needed and the proper set up of those instruments. Then knowing how to use the instruments in operating and suturing and closing. And finish with special considerations.


Robotica ◽  
2021 ◽  
pp. 1-13
Author(s):  
Xingze Jin ◽  
Mei Feng ◽  
Zhiwu Han ◽  
Ji Zhao ◽  
Hankun Cao ◽  
...  

Abstract In minimally invasive surgery, surgical instruments with a wrist joint have better flexibility. However, the bending motion of the wrist joint causes a coupling motion between the end-effector and wrist joint, affecting the accuracy of the movement of the surgical instrument. Aiming at this problem, a new gear train decoupling method is proposed in the paper, which can automatically compensate for the coupled motion in real-time. Based on the performance tests of the instrument prototype, a series of decoupling effects tests are carried out. The test results show that the surgical instrument has excellent decoupling ability and stable performance.


2018 ◽  
Vol 03 (03n04) ◽  
pp. 1841007 ◽  
Author(s):  
Truman Cheng ◽  
Xue Zhang ◽  
Calvin Sze Hang Ng ◽  
Philip Wai Yan Chiu ◽  
Zheng Li

A major challenge of minimally invasive surgery (MIS), particularly in laparoendoscopic single site (LESS) surgery, is trocar crowding. Trocar crowding causes instruments fencing, limited instrument access and limited endoscope views. It also increases the workload of surgeons. One strategy to alleviate the problem is to use magnetic anchored and guided system (MAGS). Existing MAGS endoscopes are assembled by multiple miniature components and actuated by onboard motors. This makes them complex, difficult to manufacture as well as requires additional power consumption. In this work, we present a novel soft-bodied magnetic anchored and guided endoscope, which comprises of a silicon structure, the magnets and a wireless camera module. The developed endoscope incorporates benefits of both MAGS (e.g. wireless steering and translation) and soft-bodied devices (e.g. compactness, lightweight, safety and simple fabrication). We model the moment loads experienced by the silicon structure to optimize the design of the endoscope. Performance and feasibility of the endoscope are validated using both benchtop setting and animal cadaver.


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