Toward lean minimally invasive robotic surgery

Developed minimally invasive surgical (MIS) robots are large multi-arm, multipurpose systems requiring significant investments that limit their availability in hospitals. A larger distribution of MIS robots with benefit for patients might be achieved improving their modularity and scalability so that smaller hospitals or medical centers could decide for a simpler and lower cost setup for a limited number of treatments only, while centers with higher funding could have more systems dedicated to different classes of operations. In line with this statement the paper proposes the paradigm of lean MIS system comprising a scalable set of modular, agile, small size single-instrument robots with limited life cycle cost. Miniaturization of instruments can further reduce invasiveness of procedures and one promising research direction is needle laparoscopic surgery, which can be applied to classes of operations on small regions requiring small force interaction with the patient. In the paper the development of a lean single-instrument manipulator for needlescopic surgery is presented and a new master concept for accurate restitution of surgical force proposed and discussed.