Soft robots inside the human body
From the article “Soft Robotics in Minimally Invasive Surgery” by Mark Runciman, Ara Darzi and George P. Mylonas
Soft Robotics Vol. 6, No. 4
Minimally invasive surgery (MIS) involves the use of long rigid or flexible surgical instruments that are inserted into the body through small incisions or natural orifices, in contrast to open surgery where large incisions are used to access the target anatomy directly. The goal of MIS is to complete a surgical procedure as safely and quickly as possible, while minimizing damage to peripheral tissue. MIS is being used with increasing frequency as an alternative to open surgery because of the improvements it can bring to patient safety, cosmesis, recovery time, shorter hospital stay, fewer postoperative complications, and pain. This review details a literature search targeted at articles describing novel soft robotic devices for MIS.
Central to MIS is the field of endoscopy; the process of viewing the inside of the body by directly inserting an optical device into the area of interest. The optical device is called an endoscope and several different types exist. Today, an endoscope commonly refers to a long flexible tube approximately 1.5–2 m in length equipped with a high-resolution camera and a light source at its tip.
The tip can be actively steered by means of two thumb-controlled dials at its proximal end. Typically, there are working channels along the endoscope's length to supply air and water, and through which small, flexible instruments can be introduced for performing basic therapeutic procedures. Flexible endoscopes of this description are used for visualization of the upper gastrointestinal (GI) tract (gastroscope) and lower GI tract (colonoscope).
However, rigid endoscopes of varying length and diameter are also used in many applications, for example, to visualize the abdomen (laparoscope), brain, (neuroendoscope), joints (arthroscope), and esophagus (esophagoscope). There are a wide range of endoscopic procedures involving either diagnosis or therapy on many parts of the body. Flexible and rigid endoscopes can vary in diameter and length depending on the application and the patient.
Surgical tools allow surgeons to grasp, dissect, remove, and suture tissue inside the body. A common example of MIS is endoscopic surgery for abdominal procedures, where a laparoscope and two or three long, rigid surgical tools of typical diameter around 5 mm are introduced into the abdomen through multiple individual small incisions.
Several approaches have been developed to make MIS even less invasive and to enable new procedures that are impossible with traditional open surgery. One of these improved approaches is single-incision laparoscopic surgery, which involves inserting not only a laparoscope but also two rigid instruments through a single larger incision in the abdomen, preferably at the umbilicus, therefore reducing the number of incisions, but increasing the difficulty of the procedure.
Natural orifice transluminal endoscopic surgery (NOTES) is a technique in which the abdomen is accessed using a long, flexible endoscope inserted through the mouth, anus, or vagina, and offers the benefit of avoiding abdominal incisions entirely. Instead, NOTES is performed through internal incisions that allow the endoscope to cross between tubular structures within the body, known as lumen, to adjacent cavities.
MIS can also be performed on the brain by removing part of the skull and placing a port, through which a neuroendoscope and surgical instruments are passed to gain access to target tissue deep in the brain....
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