The Virtuoso Surgical System: First Live Animal Experience

Abstract

The purpose of this paper is to describe initial animal experiences with the Virtuoso Surgical System, which is shown in Fig. 1. The Virtuoso System is a teleoperated system that delivers two concentric tube manipulators through a rigid endoscope. The manipulators are actuated by 10 motors (5 per manipulator) in a Motor Pack that is supported by a lightweight robot Holding Arm (Kuka, LBR MED 7). The surgeon operates the system from a Surgeon Workstation with custom five degree-of-freedom user interfaces. The Motor Pack accepts insertable and ex- changeable Instrument Cartridges. The system can deliver tools for retraction (blunt retractors, snares, forceps) and energy delivery (laser, electrosurgery). The endoscope is a a conventional setup for cystoscopy/hysteroscopy; it is 26 Fr at its largest diameter (8.67 mm) and contains an Inner Sheath and Outer Sheath for continuous flow irrigation (i.e. an endoscope and concentric tubes as in [1]). The en- doscope can be inserted into the patient without the Motor Pack using conventional endoscopic tools (e.g. obturators). Fig. 1: The Virtuoso System is made of three main subsystems: the Surgeon Workstation, the Motor Pack, and the Patient Cart. The Holding Arm can be manipulated by hand, so that the endoscope can be re-oriented during the procedure. The robot arm operates in impedance mode to provide gravity compensation so that interaction feels weightless, from the surgeon’s perspective. The surgeon also has the capability to remotely translate the endoscope along its axis via a foot pedal at the Surgeon Workstation. For more information on various versions of and applications for the Virtuoso System, see [2], [1], [3]. For a review on concentric tube manipulators themselves, see [4].