Laparoscopic Surgery has been revolutionized by the world of Surgical Robotics. Robot-Assisted Surgeries have been proven to have many advantages over the fundamental, traditional "by-hand" procedures previously conducted, and still currently being done for certain operations. Robot-assisted surgery may offer benefits to patients through the use of minimally invasive techniques, which may result in reduced blood loss, reduced blood transfusion, fewer complications, reduced postoperative pain, shorter hospital stays, and reduced recovery times (Ho et al., 2011). Studies have proven that robotic surgery may lead to patients recovering faster depending on the timeframe and the type of procedure (Tang et al., 2018). These benefits provide the highest quality care for the patient that can be provided. Robotic-assisted surgical platforms may overcome many of the shortcomings of laparoscopy while preserving the patient benefits (Boggess, 2007). Laparoscopic Surgery provides many benefits over open surgery as well and including the Robotic Surgical Assist allows for further/amplified benefits for the parties involved. The idea is to minimize the need for lengthy patient recovery time, discomfort, and complications caused by the procedure itself. The pain, discomfort, and disability, or other morbidities as a result of surgery is more frequently due to trauma involved in gaining access to the area to perform the intended procedure rather than from the procedure itself (Mack, 2001). Regulating certain areas of the procedure, such as required incision size, allows the patient a smoother recovery.
With laparoscopic surgery, it limits risks and complications as a minimally invasive approach but, with robot-assisted laparoscopic surgery, it is even more as such. Currently, there seems to be a struggle in the field of medicine between how best to improve the surgical robots in comparison to how to better optimize, or create, smaller surgical devices to assist in surgeries. A factor that was found to be lacking in the field of medicine was the definition of actions done during surgical procedures. While used widely from a medical standpoint, from an operational standpoint it is not common practice to question the mathematical symbolization of the movements and actions done during surgery. The goal of this research is to determine, analyze, evaluate, and simplify the parameters that are present during Laparoscopic Surgery. These parameters will be compared between traditional surgery and robot-assisted surgery. The robot-assisted condition will be established using the Semi-Robotic Laparoscopic Surgery Support System developed by a University of Central Florida Senior Design Team finalized in the academic semester of Spring 2020. This system utilizes the aspects and features of a surgical robot while maintaining a small form factor and cheap production and purchasing price. Ultimately, this will allow for further evaluation of technologies exploiting the developed surgical robot for research in semi-autonomous control, and safety mechanisms in the context of robotic surgery. It is important to note that this technology is developed as a kinematic guide for laparoscopic surgery. This guiding assist is similar to the features incorporated in robot-assisted laparoscopic surgery which is what allows us to use this surgical assist device to represent the robot-assisted condition.
This technology optimizes the condition of conventional laparoscopic surgery by introducing a braking mechanism into the standard procedure without requiring the major application of the full surgical systems. Through the utilization of this guiding system, this research has established and compared the kinematic and workspace parameters for robot-assisted laparoscopic surgery when the system is equipped vs. when it is equipped and activated; creating two different conditions of Workspace Controlled Laparoscopic Surgery and Kinematically Constrained Laparoscopic Surgery. It was deemed necessary to accomplish an understanding of both domains as well as in comparison to traditional laparoscopic surgical practices in order to engage the argument from a holistic point of view.
Throughout this research, it was determined that, when evaluating traditional Laparoscopic Surgery, there are a series of parameters that are present when discussing the workspace of the human abdomen and the kinematics of the trocar, surgical tool, and camera placed into that workspace. Between these parameters, a variety of similarities was discovered using geometric rules and algebraic functional relationships within the kinematics. Upon equipping the Semi-Robotic Laparoscopic Surgery Support System to the procedure, certain parameters get "zeroed out" due to the fixed nature of the device from one abdominal insertion point to the next. While most parameters may maintain the same behaviors upon the installation of the technology, the majority of these same parameters get "zeroed out" when the technology is activated.
The overall purpose and intent of this research is to define, evaluate, and compare various surgical parameters associated with the practice of laparoscopic surgery while running a comparison between the effectiveness of traditional surgery against robot-assisted surgery that can be made from a new perspective by evaluating the differences in their respective parameters. Results which will be discussed include: specific parameter definitions and labeling, how these parameters benefit the medical field, direct parameter comparison between the evaluated conditions of traditional surgery and robot-assisted surgery (represented by kinematic guiding technology and comparing when the device is applied, Workspace Controlled condition, versus when the braking system is activated, Kinematically Constrained condition), and how these different surgical techniques modify the conditions of surgery for the surgeon and the patient.
Bachelor of Science in Mechanical Engineering (B.S.M.E.)
College of Engineering and Computer Science
Mechanical and Aerospace Engineering
Girgis, Immanuel E., "Workspace and Kinematic Modeling and Analysis of Semi-Robotic Laparoscopic Surgery" (2021). Honors Undergraduate Theses. 916.