Towards Autonomous Robot-Assisted Natural Orifice Translumenal Endoscopic Surgery

Abstract

Natural Orifice Translumenal Endoscopic Surgery (NOTES) promises to reduce the invasiveness of surgical procedures by accessing the peritoneal cavity through a natural orifice. Current tools for performing NOTES are based on the flexible endoscopy platform, and are significantly limited in imaging and manipulation by the size and geometry of the natural lumen. For NOTES to revolutionize minimally invasive surgery, new approaches are necessary that enable the surgeon to perform procedures with vision and dexterity equivalent to laparoscopic procedures. An image-guided, two-armed, dexterous miniature NOTES robot has been developed that can be placed into the peritoneal cavity through a transgastric incision. Using this robot, the surgeon has effectively demonstrated tissue dissection in non-survivable animal model procedures. A next step in the development of miniature in vivo robots is the automation of routinely performed, low level surgical tasks. This paper details work towards autonomous tissue dissection using the NOTES robot. As a first step, visual tracking and robot control methods are being developed.