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Published Online: 19 June 2014

Soft Robotics Technologies to Address Shortcomings in Today's Minimally Invasive Surgery: The STIFF-FLOP Approach

Publication: Soft Robotics
Volume 1, Issue Number 2

Abstract

Most devices for single-site or natural orifice transluminal surgery are very application specific and, hence, capable of effectively carrying out specific surgical tasks only. However, most of these instruments are rigid, lack a sufficient number of degrees of freedom (DOFs), and/or are incapable of modifying their mechanical properties based on the tasks to be performed. The current philosophy in commercial instrument design is mainly focused on creating minimally invasive surgical systems using rigid tools equipped with dexterous tips. Only few research efforts are aimed at developing flexible surgical systems, with many DOFs or even continuum kinematics. The authors propose a radical change in surgical instrument design: away from rigid tools toward a new concept of soft and stiffness-controllable instruments. Inspired by biology, we envision creating such soft and stiffness-controllable medical devices using the octopus as a model. The octopus presents all the capabilities requested and can be viewed as a precious source of inspiration. Several soft technologies are suitable for meeting the aforementioned capabilities, and in this article a brief review of the most promising ones is presented. Then we illustrate how specific technologies can be applied in the design of a novel manipulator for flexible surgery by discussing its potential and by presenting feasibility tests of a prototype responding to this new design philosophy. Our aim is to investigate the feasibility of applying these technologies in the field of minimally invasive surgery and at the same time to stimulate the creativeness of others who could take the proposed concepts further to achieve novel solutions and generate specific application scenarios for the devised technologies.

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References

1.
Ponsky TA, Khosla A, Ponsky JL. Minimally Invasive Surgery. Textbook of Clinical Gastroenterology and Hepatology, 2nd ed. Oxford: Wiley-Blackwell, 2012.
2.
Ding J, Xu K, Goldman R, Allen P, Fowler D, Simaan N. Design, simulation and evaluation of kinematic alternatives for insertable robotic effectors platforms in single port access surgery. IEEE International Conference on Robotics and Automation (ICRA), 2010, pp. 1053–1058.
3.
Degani A, Choset H, Zubiate B, Ota T, Zenati M. Highly articulated robotic probe for minimally invasive surgery. IEEE International Conference on Medicine and Biology (EMBS), 2008, pp. 3273–3276.
4.
Shang J, Noonan DP, Payne C, Clark J, Sodergren MH, Darzi A, Yang GZ. An articulated universal joint based flexible access robot for minimally invasive surgery. IEEE International Conference on Robotics and Automation (ICRA), 2011, pp. 1147–1152.
5.
Breedveld P, Sheltes JS, Blom EM, Verheij JEI. A new, easily miniaturized steerable endoscope. IEEE Eng Med Biol Mag 2005;24:40–47.
6.
Petroni G, Niccolini M, Menciassi A, Dario P, Cuschieri A. A novel intracorporeal assembling robotic system for single-port laparoscopic surgery. Surg Endosc 2013;27:665–670.
7.
Zahraee AH, Jérome S, Paik KJ, Guillaume M. Robotic Hand-Held Surgical Device: Evaluation of End-Effector's Kinematics and Development of Proof-of-Concept Prototypes. Medical Image Computing and Computer-Assisted Intervention at MICCAI 2010. Berlin: Springer, 2010, pp. 432–439.
8.
Gonenc B, Handa J, Gehlbach P, Taylor RH, Iordachita I. A comparative study for robot assisted vitreoretinal surgery: Micron vs. the Steady-Hand Robot. IEEE International Conference on Robotics and Automation (ICRA), 2013, pp. 4832–4837.
9.
Loeve A, Breedveld P, Dankelman J. Scopes too flexible…and too stiff. IEEE Pulse 2010;1:26–41.
10.
Slatkin A, Burdick J, Grundfest W, Khatib O, Salisbury J, eds. The Development of a Robotic Endoscope Experimental Robotics IV. Berlin: Springer, 1997, pp. 161–169.
11.
Phee L, Accoto D, Menciassi A, Stefanini C, Carrozza MC, Dario P. Analysis and development of locomotion devices for the gastrointestinal tract. IEEE Trans Biomed Eng 2002;49:613–616.
12.
Development of a multi-module STIFF-FLOP manipulator. Available at http://www.stiff-flop.eu (accessed April 29, 2014).
13.
Trivedi D, Rahn C, Kier W, Walker I. Soft robotics: biological inspiration, state of the art, and future research. Appl Bionics Biomech 2008;5:99–117.
14.
Walker ID. Continuous backbone “continuum” robot manipulators. ISRN Robot 2013;2013:726506.
15.
Laschi C, Mazzolai B, Cianchetti M, Margheri L, Follador M, Dario P. A soft robot arm inspired by the octopus. Adv Robot 2012;26:709–727.
16.
Grzesiak A, Becker R, Verl A. The Bionic handling assistant: a success story of additive manufacturing. Assembly Automat 2011;31:329–333.
17.
Vitiello V, Lee SL, Cundy TP, Yang GZ. Emerging robotic platforms for minimally invasive surgery. IEEE Rev Biomed Eng 2013;6:111–126.
18.
Tortora G, Ranzani T, De Falco I, Dario P, Menciassi A. A miniature robot for retraction tasks under vision assistance in minimally invasive surgery. Robotics 2014;3:70–82.
19.
Vyas L, Aquino D, Kuo CH, Dai JS, Dasgupta P. Flexible robotics. BJUI Int 2011;107:187–189.
20.
Wallace GG, Teasdale PR, Spinks GM, Kane-Maguire LAP. Conductive Electroactive Polymers: Intelligent Polymer Systems. Boca Raton, FL: CRC Press, 2008.
21.
Mirfakhrai T, Madden JDW, Baughman RH. Polymer artificial muscles. Mater Today 2007;10:30–38.
22.
Funakubo H. Shape Memory Alloys. New York: Gordon and Breach Science Publishers, 1987.
23.
Cianchetti M. Fundamentals on the use of shape memory alloys in soft robotics. In: Habib MK, Davim JP, eds. Interdisciplinary Mechatronics: Engineering Science and Research Development. New York: Wiley-ISTE, 2013, pp. 227–254.
24.
Sun L, Huang WM, Ding Z, Zhao Y, Wang CC, Purnawali H, Tang C. Stimulus-responsive shape memory materials: a review. Mater Des 2012;33:577–640.
25.
Yi S, Song YS, Paik J. Characterization of silicone rubber based soft pneumatic actuators. 2013 IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS), 2013.
26.
Martinez VR, Branch LJ, Fish RC, Jin L, Shepherd FR, Nunes MDR, Suo Z, Whitesides MG. Robotic tentacles with three-dimensional mobility based on flexible elastomers. Adv Mater 2013;25:205–212.
27.
De Greef A, Lambert P, Delchambre A. Towards flexible medical instruments: review of flexible fluidic actuators. Precision Eng 2009;33:311–321.
28.
Gravagne I, Walker I. Manipulability, force, and compliance analysis for planar continuum manipulators. IEEE Trans Robot Automat 2002;18:263–273.
29.
Kim YJ, Cheng S, Kim S, Iagnemma K. A stiffness-adjustable hyperredundant manipulator using a variable neutral-line mechanism for minimally invasive surgery. IEEE Trans Robot 2013;30:1–14.
30.
Webster RJ, Romano JM, Cowan NJ. Mechanics of precurved-tube continuum robots. IEEE Trans Robot 2009;25:67–78.
31.
Dupont PE, Lock J, Itkowitz B, Butler E. Design and control of concentric-tube robots. IEEE Trans Robot 2010;26:209–225.
32.
Mahvash M, Dupont P. Stiffness control of surgical continuum manipulators. IEEE Trans Robot 2011;27:334–345.
33.
Guidanean K, Lichodziejewski D. An inflatable rigidizable truss structure based on new sub-TgPolyurethane composites. Proceedings of the AIAA/ASME/ASCE/AHS/ASC Structures, Structural Dynamics, and Materials Conference, Denver, 2002.
34.
Redell FH, Lichodziejewski D, Kleber J, Greschi kG. Testing of an inflation-deployed sub-Tg rigidized support structure for a planar membrane waveguide antenna. Proceedings of the Collection of Technical Papers—AIAA/ASME/ASCE/AHS/ASC Structures, Structural Dynamics and Materials Conference, 2005, pp. 920–927.
35.
Cheng N, Ishigami G, Hawthorne S, Hao C, Hansen M, Telleria M, Playter R, Iagnemma K. Design and analysis of a soft mobile robot composed of multiple thermally activated joints driven by a single actuator. IEEE International Conference on Robotics and Automation (ICRA), 2010, pp. 5207–5212.
36.
Telleria MJ, Hansen M, Campbell D, Servi A, Culpepper M. Modeling and implementation of solder-activated joints for single-actuator, centimeter-scale robotic mechanisms. IEEE International Conference on Robotics and Automation (ICRA), 2010, pp. 1681–1686.
37.
Loeve AJ, Bosma JH, Breedveld P, Dodou D, Dankelman J. Polymer rigidity control for endoscopic shaft-guide “Plastolock” a feasibility study. J Med Devices 2010;4:1–6.
38.
Dong H, Walker GM. Adjustable stiffness tubes via thermal modulation of a low melting point polymer. Smart Mater Struct 2012;21(4).
39.
Wanliang S, Lu T, Majidi C. Soft-matter composites with electrically tunable elastic rigidity. Smart Mater Struct 2013;22(8).
40.
Park G, Bement MT, Hartman DA, Smith RE, Farrar CR. The use of active materials for machining processes: a review. Int J Mach Tools Manuf 2007;47:2189–2206.
41.
Yalcintas M, Dai H. Magnetorheological and electrorheological materials in adaptive structures and their performance comparison. Smart Mater Struct 1999;8:560–573.
42.
Sturges RHJR, Laowattana S. A flexible, tendon-controlled device for endoscopy. Int J Robot Res 1993;12:121–131.
43.
Moses MS, Kutzer MDM, Ma H, Mehran A. A continuum manipulator made of interlocking fibers. 2013 IEEE International Conference on Robotics and Automation (ICRA), 2013, pp. 4008–4015.
44.
Yagi A, Matsumiya K, Masamune K, Liao H, Dohi T. Rigid-flexible outer sheath model using slider linkage locking mechanism and air pressure for endoscopic surgery. Proceedings of the Medical Image Computing and Computer-Assisted Intervention (MICCAI’06), 2006, pp. 503–510.
45.
Kim Y-J, Cheng S, Kim S, Iagnemma K. A novel layer jamming mechanism with tunable stiffness capability for minimally invasive surgery. IEEE Trans Robot 2013;29:1031–1042.
46.
Liu AJ, Nagel SR. Jamming is not just cool anymore. Nature 1998;396:21–22.
47.
Brown E, Rodenberg N, Amend J, Mozeika A, Steltz E, Zakin MR, Lipson H, Jaeger HM. Universal robotic gripper based on the jamming of granular material. Proc Natl Acad Sci USA 2010;107:18809–18814.
48.
Cheng NG, Lobovsky MB, Keating SJ, Setapen AM, Gero KI, Hosoi AE, Lagnemma KD. Design and analysis of a robust, low-cost, highly articulated manipulator enabled by jamming of granular media. 2012 IEEE International Conference on Robotics and Automation (ICRA), 2012, pp. 4328–4333.
49.
Steltz E, Mozeika A, Rembisz J, Corson N, Jaeger H. Jamming as an enabling technology for soft robotics. SPIE 2010;7642:63.
50.
Loeve A, van de Ven OS, Vogel JG, Breedveld P, Dankelman J. Vacuum packed particles as flexible endoscope guides with controllable rigidity. Granular Matter 2010;12:543–554.
51.
Letts R, Hobson D. The vacuum splint: an aid in emergency splinting of fractures. Can Med Assoc J 1973;109:599.
52.
Jiang A, Ataollahi A, Althoefer K, Dasgupta P, Nanayakkara T. A variable stiffness joint by granular jamming. Proceedings of the ASME 2012 International Design Engineering Technical Conferences & Computers and Information in Engineering Conference IDETC/CIE, 2012.
53.
Cianchetti M, Ranzani T, Gerboni G, De Falco I, Laschi C, Menciassi A. STIFF-FLOP surgical manipulator: mechanical design and experimental characterization of the single module. Proceedings of the 2013 IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS), 2013.
54.
Webster III RJ, Jones BA. Design and kinematic modeling of constant curvature continuum robots: a review. Int J Robot Res 2010;29:1661–1683.
55.
Suzumori K, Iikura S, Tanaka H. Flexible microactuator for miniature robots. Micro Electro Mechanical Systems, 1991, MEMS ’91, Proceedings. An Investigation of Micro Structures, Sensors, Actuators, Machines and Robots. IEEE, 1991, pp. 204–209.
56.
Hashmonai M, Kopelman D. Sling retraction of the falciform ligament to ameliorate exposure in laparoscopic upper abdominal surgery. Surg Laparosc Endosc 1996;6:71–72.
57.
Lim SK, Shin TY, Kim KH, Han WK, Chung BH, Hong SJ, Choi YD, Rha KH. LESS robot-assisted nephroureterectomy: comparison with conventional multiport technique in the management of upper urinary tract urothelial carcinoma. BJU Int 2013. [Epub ahead of print]
58.
Polygerinos P, Seneviratne LD, Althoefer K. Modeling of light intensity-modulated fiber-optic displacement sensors. IEEE Trans Instrum Meas 2011;60:1408–1415.
59.
Searle TC, Althoefer K, Seneviratne L, Liu H. An optical curvature sensor for flexible manipulators. 2013 IEEE International Conference on Robotics and Automation (ICRA), 2013, pp. 4415–4420.

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Published In

cover image Soft Robotics
Soft Robotics
Volume 1Issue Number 2June 2014
Pages: 122 - 131

History

Published online: 19 June 2014
Published in print: June 2014

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Matteo Cianchetti*
The BioRobotics Institute, Polo Sant'Anna Valdera, Scuola Superiore Sant'Anna, Pontedera, Pisa, Italy.
Tommaso Ranzani*
The BioRobotics Institute, Polo Sant'Anna Valdera, Scuola Superiore Sant'Anna, Pontedera, Pisa, Italy.
Giada Gerboni
The BioRobotics Institute, Polo Sant'Anna Valdera, Scuola Superiore Sant'Anna, Pontedera, Pisa, Italy.
Thrishantha Nanayakkara
Department of Informatics, Centre for Robotics Research, NIHR Biomedical Research Centre, King's College London, London, United Kingdom.
Kaspar Althoefer
Department of Informatics, Centre for Robotics Research, NIHR Biomedical Research Centre, King's College London, London, United Kingdom.
Prokar Dasgupta
Department of Urology, King's College London, Guy's Hospital, London, United Kingdom.
MRC Centre for Transplantation, NIHR Biomedical Research Centre, King's College London, London, United Kingdom.
Arianna Menciassi
The BioRobotics Institute, Polo Sant'Anna Valdera, Scuola Superiore Sant'Anna, Pontedera, Pisa, Italy.

Notes

*
These two authors contributed equally to this work.
Address correspondence to:Tommaso RanzaniThe BioRobotics InstitutePolo Sant'Anna ValderaScuola Superiore Sant'AnnaViale Rinaldo Piaggio 34Pontedera (PI)Pisa 56025Italy
E-mail: [email protected]

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No competing financial interests exist.

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