抄録
This article introduces assemblable instruments for laparoscopic surgery and a remote operation device for radiation seed implantation for oral cancer that are presented at the 13th conference.
In laparoscopic surgery, only small incisions are made in the abdominal wall and therefore instruments for laparoscopic surgery are slender so that they can pass through small diameter trocars placed in the incisions. To relax this limitation, we have proposed assemblable surgical instruments whose parts are inserted through trocars and put together inside the abdominal cavity.
As a first example, this article introduces an assemblalbe purse-string suture device. A T-shaped purse-string suture device is used to make purse-string suture on the esophagus in open surgery preparatory to the anastomosis of the esophagus and the small intestine with a circular stapler. Because of its shape, it cannot pass through a trocar, which motivated us to develop the assemblalbe purse-suture suture device for laparoscopic surgery.
As a second example, this article introduces assemblable hands that can grasp and/or retract large internal organs. We have taken two different approaches. One approach is to develop a hand that has a single function but can be inserted and assembled through a single port. A three fingered hand with three degrees of freedom is developed. Its assembly method uses a string to suspend a finger module inserted first in the abdominal cavity, which is connected with another finger inserted from the same trocar.
The other approach is to develop a hand that has multiple functions with more degrees of freedom but requires two ports for its assembly. Using this approach, we developed a three-fingered assemblable hand with nine degrees of freedom. The first finger unit is inserted from a first trocar. Then the second and third finger units are inserted from a second trocar facing to the first trocar. The ends of the finger units are inserted to the first trocar from the inside to outside of the abdominal cavity. They are connected to the end of the first finger unit. This assembly method is safe because it connects mechanical parts outside the abdominal cavity. The hand can grasp and retract internal organs, as validated by in vivo experiments.
The second main topic is a remote operation device for radiation seed implantation for oral cancer. Although brachytherapy is minimum invasive for patients, operators are exposed to radiation, which hinders it from being widely adopted as a treatment for oral cancer. This motivates us to develop the remote operation device for radiation seed implantation. The radiation level at a distance of 1m from the radiation seed is significantly reduced. Therefore the developed device is operated at a distance of 1m away from the radiation seed. Unlike the prostate, oral organs are not fixed on other tissues. A grasper that grasps and fixes oral organs is necessary to implant a radiation seed into it. Therefore the remote operation device consists of three sub-devices: an applicator manipulator that inserts a radiation seed, a grasper, and remote operational parts for them.
In addition, this article briefly introduces a lung positioner for thoracoscopic surgery, a sound based force sensor, and a multi-tube propelling device.
