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Telescopes for Inner Space: Fiber Optics and Endoscopes
Published in Suzanne Amador Kane, Boris A. Gelman, Introduction to Physics in Modern Medicine, 2020
Suzanne Amador Kane, Boris A. Gelman
More speculative uses of endoscopy are being explored by the medical profession, including a new method for abdominal surgery that avoids external incisions altogether. Called Natural Orifice Translumenal Endoscopic Surgery, or NOTES, these procedures instead involve surgery performed by endoscopes inserted through the mouth or anus and incisions made through the stomach or colon wall. The surgical procedure then is performed with the endoscope being threaded internally to the site of surgery, for example, for gallbladder removals. Why might this be advantageous? Cutting the skin and the walls of the abdomen in open or laparoscopic surgery excites a vigorous emergency response, including triggering nerves, the immune system, and chemical messengers that promote the body's defenses – but the same is less true for internal incisions. Thus, NOTES holds out the prospect of surgery with minimal pain, no need for general anesthesia, no external scarring, and reduced recovery time.
Intervention: Nanotechnology in Reconstructive Intervention and Surgery
Published in Harry F. Tibbals, Medical Nanotechnology and Nanomedicine, 2017
NOTES is a new approach to endoscopic surgery in which natural orifices are used as entry points for incisions, thus avoiding damage to the skin and/ or wall of the abdomen or thorax, and eliminating external surgical scars. NOTES can be performed through internal incisions in the stomach, bladder, vagina, navel, as well as transnasal endoscopic surgery [64,65].
Modeling of a joint-type flexible endoscope based on elastic deformation and internal friction
Published in Advanced Robotics, 2019
Yuanyuan Zhou, Guohao Jiang, Cheng Zhang, Zhidong Wang, Zhongtao Zhang, Hao Liu
Endoscopy is an important tool for surgeons [1,2]. Since it is used in confined, often tortuous spaces within complex anatomy, the endoscope must be capable of active bending. Some newly developed surgeries, such as single port laparoscopic surgery (SPLS) and natural orifice transluminal endoscopic surgery (NOTES), require endoscopy with even higher flexibility [3–5].
A Panoramic Survey on Grasping Research Trends and Topics
Published in Cybernetics and Systems, 2019
Manuel Graña, Marcos Alonso, Alberto Izaguirre
Automation is entering the surgical theater from several fronts, all of them are essentially ways to improve grasping and manipulating teleoperation, i.e. the surgeon controls the operation of tools and access to body tissues by a robot actuator through an ad hoc designed user interface. Surgical robots, such as the daVinci surgical system, require an exhaustive training that may be reduced with enhanced sensors and actuators. Reliable and atraumatic grasping and manipulation of biological tissue are crucial processes during Robot-Assisted Surgery (RAS). A specific challenge is the detection of the slippage of grasped tissue, often out of the surgeon field of attention. Current approaches to slippage detection include thermal-based sensors, whose integration with the da Vinci standard tools has been reported (Burkhard, Cutkosky, and Steger 2018), and force sensing in forceps instruments allowing precise control of the grasp force avoiding tissue damage (Kim et al. 2018; Yu et al. 2018). A challenge in RAS user interface design is to provide some haptic feedback about the handled tissue elastic properties in order to help the user to discriminate among tissues. Direct force sensing may provide useful haptic feedback. For standard surgical system tools lacking direct force sensors, indirect force sensing has been demonstrated using surrogate signals (O’Neill, Stephens, and Kowalewski 2018). The heterogeneous compliant tissues that are manipulated by RAS instruments may behave in unexpected ways under pressure and manipulation. Modeling and prediction of the tissue behavior is a challenging unsolved problem. Alambeigi et al. (2018) have followed a data driven approach, trying to produce an online dynamical model estimation of the tissue responses to grasping and manipulation. Currently, they have demonstrated the approach with specific phantoms for experimentation in the da Vinci Research Kit. In another kind of minimally invasive surgery, the Natural Orifice Transluminal Endoscopic Surgery, the challenge is to reach the target operation using natural area body conducts, hence there is a need of manipulators that can bend and adapt to their natural tortuous paths. Thermoplastic materials such as Polyethylene Terephthalate have been recently proposed to build such tools (Le et al. 2018).