Telerobotic Simulator in Minimally Invasive Surgery

Abstract

Minimally Invasive Surgery (MIS) is a technique which was established in the 1980s. The advantages for patient treated by the MIS compared to open (classic) surgery are the following: small incisions reduce pain and trauma, shorter residence at hospital and shorter rehabilitation time, cosmetical advantage due to small incisions. At the same time the Minimally Invasive Surgery has several disadvantages for the surgeons: reduced sight, reverse motion (chop-stick effect), restricted motion because of pivot point (trocar kinematic), reduce tactile and force-feedback because of long instruments, amplification of the tremor due to long instruments. The above mentioned disadvantages are the main reasons why MIS is restricted to a small number of applications. In Minimally Invasive Surgery, the surgeon views the anatomy from inside. The camera is controlled by a surgical assistant. The laparoscope itself consists of a chain of lens optics to transmit the image of the operation site to the CCD camera connected to its outer end, and optical fibers to carry light to illuminate inside. An image of the operation site is displayed on a high resolution CRT screen. The laparoscope and instruments used for the operation are inserted through trocars placed at the incisions of the abdomen. Consequently, the surgeon has no direct control over his/her viewing direction, and the laparoscopic image often is unstable because of tremor and sudden movements of the surgical assistant. To overcome those drawbacks robot surgery plays an important part, because Minimally Invasive Surgery is dedicated to telepresence.