Review of surgical robotic systems for keyhole and endoscopic procedures: state of the art and perspectives
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REVIEW
Review of surgical robotic systems for keyhole and endoscopic procedures: state of the art and perspectives Yuyang Chen2, Shu’an Zhang2, Zhonghao Wu2, Bo Yang3, Qingquan Luo4, Kai Xu (
✉)1
1
State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China; 2RII Lab (Lab of Robotics Innovation and Intervention), UM-SJTU Joint Institute, Shanghai Jiao Tong University, Shanghai 200240, China; 3Department of Urology, Shanghai Changhai Hospital, the Second Military Medical University, Shanghai 200433, China; 4 Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China
© Higher Education Press 2020
Abstract Minimally invasive surgery, including laparoscopic and thoracoscopic procedures, benefits patients in terms of improved postoperative outcomes and short recovery time. The challenges in hand–eye coordination and manipulation dexterity during the aforementioned procedures have inspired an enormous wave of developments on surgical robotic systems to assist keyhole and endoscopic procedures in the past decades. This paper presents a systematic review of the state-of-the-art systems, picturing a detailed landscape of the system configurations, actuation schemes, and control approaches of the existing surgical robotic systems for keyhole and endoscopic procedures. The development challenges and future perspectives are discussed in depth to point out the need for new enabling technologies and inspire future researches. Keywords
surgical robots; keyhole surgery; endoscopic surgery
Introduction Keyhole surgery (e.g., laparoscopic and thoracoscopic procedures) has been widely adopted due to its advantages, such as low postoperative complication rates, less pain, short recovery time, and excellent cosmesis [1,2]. Manipulation challenges in these procedures, including limited visual perception, reduced distal dexterity, reversed hand–eye coordination, and hindered haptic sensing, have inspired a vast wave of developments on surgical robotic systems to improve their assistance and obtain superhuman capabilities [3–5]. Robotic systems for keyhole and endoscopic procedures usually consist of a patient-side cart and a surgeon console (Fig. 1). As presented in the “Configuration and actuation of the patient-side cart” section, the patient-side cart often involves a few surgical manipulators that maneuver a laparoscope (or a thoracoscope) and two to three surgical instruments. A laparoscope and thoracoscope are the same in their composition. During a procedure, a laparoscope is inserted into the abdomen, whereas a thoracoscope is inserted into the thorax. Surgical manipulators can have
Received July 29, 2019; accepted March 5, 2020 Correspondence: Kai Xu, [email protected]
various forms and actuation schemes. Given that the control scheme of surgical robotic systems is mainly teleoperation, the surgeon console primarily consists of a 2D/3D display, a pair of master devices, and a touchscreen/ ke
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