Abstract
Flexible ureteroscopy (FURS) has been developed and has become a preferred routine procedure for both diagnosis and treatment of kidney stones and other renal diseases inside the urinary tract. The traditional manual FURS procedure is highly skill-demanding and easily brings about physical fatigue and burnout for surgeons. The improper operational ergonomics and fragile instruments also hinder its further development and patient safety enhancement. A robotic system is presented in this paper to assist the FURS procedure. The system with a master-slave configuration is designed based on the requirement analysis in manual operation. A joint-to-joint mapping strategy and several control strategies are built to realize intuitive and safe operations. Both phantom and animal experiments validate that the robot has significant advantages over manual operations, including the easy-to-use manner, reduced intraoperative time, and improved surgical ergonomics. The proposed robotic system can solve the major drawbacks of manual FURS. The test results demonstrate that the robot has great potential for clinical applications.
Highlights
Flexible ureteroscopy (FURS) has been introduced and gradually grown as a routine and effective minimally invasive surgery (MIS) procedure for both diagnosis and therapeutic operations to treat ureteral and kidney stones, strictures, and tumors [1, 2]
Compared with other treatments, such as percutaneous nephrolithotomy (PCNL) and shock wave lithotripsy (SWL), FURS can provide the advantages of a higher stone-free rate, less blood loss, shorter hospitalization, and fewer complications [3,4,5,6,7,8]
We developed a master-slave robotic system to target FURS and carried out both phantom and animal experiments [31]
Summary
Flexible ureteroscopy (FURS) has been introduced and gradually grown as a routine and effective minimally invasive surgery (MIS) procedure for both diagnosis and therapeutic operations to treat ureteral and kidney stones, strictures, and tumors [1, 2]. The long-time standing pose, the heavy load, and the indisposed operation postures during operation lead to causing physical fatigue and burnout for surgeons, lowering treatment quality and decreasing patient safety [12, 13], as illustrated in To tackle these challenges, the robot-assisted natural orifice transluminal endoscopic surgery (NOTES) techniques have been extensively studied to perform both diagnostic and therapeutic procedures through natural orifices to further reduce incisions and trauma and shorten the learning curve in surgical practice and skill training with accurate and intuitive operation [15,16,17,18,19,20,21,22,23].
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