Natural orifice endoscopic surgery can enable incisionless approaches, but a major challenge is the lack of small and dexterous instrumentation. Surgical robots have the potential to meet this need yet often disrupt the clinical workflow. Hand-held robots that combine thin manipulators and endoscopes have the potential to address this by integrating seamlessly into the clinical workflow and enhancing dexterity. As a case study illustrating the potential of this approach, we describe a hand-held robotic system that passes two concentric tube manipulators through a 5 mm port in a rigid endoscope for transurethral laser prostate surgery. This system is intended to catalyze the use of a clinically superior, yet rarely attempted, procedure for benign prostatic hyperplasia. This paper describes system design and experiments to evaluate the surgeon’s functional workspace and accuracy using the robot. Phantom and cadaver experiments demonstrate successful completion of the target procedure via prostate lobe resection.

中文翻译：

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手持式经内窥镜机器人机械手：经尿道激光前列腺手术案例研究

自然孔口内窥镜手术可以实现无切口入路，但主要挑战是缺乏小巧灵巧的器械。手术机器人有可能满足这一需求，但往往会扰乱临床工作流程。结合了薄型机械手和内窥镜的手持机器人有可能通过无缝集成到临床工作流程中并提高灵活性来解决这个问题。作为说明这种方法潜力的案例研究，我们描述了一个手持机器人系统，该系统将两个同心管机械手通过刚性内窥镜中的 5 毫米端口，用于经尿道激光前列腺手术。该系统旨在促进临床上优越但很少尝试的良性前列腺增生手术的使用。本文描述了系统设计和实验，以使用机器人评估外科医生的功能工作空间和准确性。幻影和尸体实验证明通过前列腺叶切除成功完成了目标手术。