Array of Robots Augmenting the Kinematics of Endocavitary Surgery

Minimally invasive surgery (MIS) has been introduced in the last decades with the goal of making scarless surgery feasible. In general, an MIS approach allows concrete benefits in terms of reduced trauma, quicker recovery times, and improved cosmetics. On the other hand, in its current state, MIS introduces more difficulties for surgeons, due to its intrinsic complexity. This issue has inspired the major technological challenge of designing miniaturized robots able to completely enter the body and to perform surgical procedures under intuitive teleoperation. The dream of achieving a completely minimally invasive therapeutic procedure, while offering the typical advantages of traditional open surgery, has brought to the complete elimination of external incisions by gaining access to the peritoneal cavity through a natural orifice. These scarless procedures are known as Natural Orifice Transluminal Endoscopic Surgery (NOTES) interventions. In this paper, novel approaches to NOTES instruments and platforms are presented, in which modular robots measuring 12 mm in diameter with basic functionalities (manipulation, cutting, vision, and retraction) and multiple degrees of freedom are deployed inside a human phantom and anchored on a supporting frame for the stable execution of tasks. This paper illustrates the general concept, novel design guidelines for the modular robots, and two robotic units successfully assembled and tested with ten users, in order to assess the capabilities of the system in pick and place experiments and cutting tasks. Experiments for the assessing force and accuracy are described as well.