Evaluation of long-term stability of monolithic 3D-printed robotic manipulator structures for minimally invasive surgery

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Evaluation of long‑term stability of monolithic 3D‑printed robotic manipulator structures for minimally invasive surgery Yannick S. Krieger1   · Daniel Ostler2 · Korbinian Rzepka1 · Alexander Meining3 · Hubertus Feussner2 · Dirk Wilhelm2 · Tim C. Lueth1 Received: 11 January 2020 / Accepted: 3 August 2020 © The Author(s) 2020

Abstract Purpose  In the era of patient-centered medicine, clinical procedures, tools and instruments should be individually adapted to the patient. In this context, the presented 3D-printed Single-Port Overtube Manipulator System follows the aims to provide patient- and task-specific disposable manipulators for minimally invasive surgery. In a first experiment, the robustness of the monolithic flexure hinge structures in use as robotic manipulators will be investigated. Methods  Customizable monolithic manipulator structures designed by means of an automated design process and manufactured with selective laser sintering were investigated with regard to long-term stability in an endurance test. Therefore, a bare manipulator arm, an arm equipped with a standard instrument and finally loaded with an additional load of 0.5 N were evaluated by continuously following a trajectory within the workspace of the manipulator arms over a period of 90 min. Results  The unloaded manipulator as well as the manipulator arm equipped with a standard instrument showed a sufficient reproducibility (deviation of 1.5 mm and 2.5 mm, respectively, on average) with regard to an application as telemanipulated master–slave surgical robotic system. The 3D-printed manipulators showed no damage and maintained integrity after the experiment. Conclusion  It has been shown that 3D-printed manipulators in principle are suitable for use as disposable surgical manipulator systems and offer a long-term stability over at least 90 min. The developed manipulator design shows great potential for the production of patient-, task- and user-specific robot systems. However, the manipulator geometries as well as the control strategies still show room for improvements. Keywords  Patient-specific · Minimally invasive surgery · Surgical robotics · 3D printing

Introduction Minimally invasive surgery (MIS) has gained an importance over the last decade as it offers significant benefits to the patient, such as less patient trauma and a shorter recovery * Yannick S. Krieger [email protected] 1



Institute of Micro Technology and Medical Device Technology, Technical University of Munich, Munich, Germany

2



MITI Research Group (Minimally Invasive Interdisciplinary Therapeutical Intervention), Department of General and Visceral Surgery, Technical University of Munich, Munich, Germany

3

Medical Clinic and Polyclinic II, University Hospital Würzburg, Würzburg, Germany



time. The increased application of MIS has led to the development of specific tools to improve the limited vision and access to the surgical site. Furthermore, the principle of MIS has further been improved toward less invasive procedures, e.g., sin