Timo J. C. Oude Vrielink

T. J. C. Oude Vrielink, Y. W. Pang, M. Zhao et al.

The CYCLOPS is a cable-driven parallel mechanism used for minimally invasive applications, with the ability to be customised to different surgical needs; allowing it to be made procedure- and patient-specific. For adequate optimisation, however, appropriate data on clinical constraints and task-space is required. Whereas the former can be provided through preoperative planning and imaging, the latter remains a problem, primarily for highly dexterous MIS systems. The current work focuses on the development of a task-space optimisation method for the CYCLOPS system and the development of a data collection method in a simulation environment for minimally invasive task-spaces. The same data collection method can be used for the development of other minimally invasive platforms. A case-study is used to illustrate the developed method for Endoscopic Submucosal Dissection (ESD). This paper shows that using this method, the system can be succesfully optimised for this application.

Timo J. C. Oude Vrielink, Ming Zhao, Ara Darzi et al.

Gastrointestinal (GI) cancers account for 1.5 million deaths worldwide. Endoscopic Submucosal Dissection (ESD) is an advanced therapeutic endoscopy technique with superior clinical outcome due to the minimally invasive and en bloc removal of tumours. In the western world, ESD is seldom carried out, due to its complex and challenging nature. Various surgical systems are being developed to make this therapy accessible, however, these solutions have shown limited operational workspace, dexterity, or low force exertion capabilities. The current paper shows the ESD CYCLOPS system, a bimanual surgical robotic attachment that can be mounted at the end of any flexible endoscope. The system is able to achieve forces of up to 46N, and showed a mean error of 0.217mm during an elliptical tracing task. The workspace and instrument dexterity is shown by pre-clinical ex vivo trials, in which ESD is succesfully performed by a GI surgeon. The system is currently undergoing pre-clinical in vivo validation.

Kiyoteru Miyashita, Timo Oude Vrielink, George Mylonas

This paper introduces a new surgical end-effector probe, which allows to accurately apply a contact force on a tissue, while at the same time allowing for high resolution and highly repeatable probe movement. These are achieved by implementing a cable-driven parallel manipulator arrangement, which is deployed at the distal-end of a robotic instrument. The combination of the offered qualities can be advantageous in several ways, with possible applications including: large area endomicroscopy and multi-spectral imaging, micro-surgery, tissue palpation, safe energy-based and conventional tissue resection. To demonstrate the concept and its adaptability, the probe is integrated with a modified da Vinci robot instrument.