Functional workspace of a novel single incision surgical robotics platform

Abstract

The enabling potential of robotics continues to increase in abdominal surgery, including gynecology.1 The functionality of a robotics platform is more than just the extent of the workspace that the end effectors can reach, but also the usability (or manipulability) of the end effectors at every reachable point in that workspace. A novel robotics platform has been developed that allows all the articulation to occur inside the abdomen through 2 arms inserted through a small vaginal incision in the rectouterine space. After insertion while extended, the two robotic arms can then retroflex back towards the point of entry to perform procedures such as a hysterectomy with the standard fundus to cervix surgical workflow. This study measured the manipulability of this new robotic platform throughout its entire reachable workspace in the abdomen by first generating a set of 200,000 configurations of the robot arms and secondly calculating the manipulability index according to robotics literature.2 The results show that, due to the shoulder, elbow and wrist joints of the arms that perform all of their articulation after entry, the reachable workspace encompasses the entirety of the average male and female abdomen from the para-aortic nodes to the pelvic floor, across from abdominal sidewall to sidewall and from the abdominal wall to vertebrae. Because the wrist joints have unlimited rotation and the shoulder and elbow joints allow the arms to function as they cross over each either, the manipulability index remains high (high usability) within the abdominal cavity and particularly around anatomy of interest such as the uterus and adnexa, lymph nodes, gall bladder, inguinal canal and appendix. The design of this new robotic technology has the potential to provide surgical treatment to a broad array of abdominal anatomy through a single transvaginal entry point.