Robotics and telemanipulation technologies for endoscopic surgery - A review of the ARTEMIS project

In endoscopic surgery, the ability Co guide the instrument is significantly decreased compared with open surgery. Rigid laparoscopic instruments offer only four of the six degrees of freedom required for the free handling of objects in space. Robotics technology can be used to restore full mobility of the endoscopic instrument. Therefore, we designed a master-slave manipul ator system (ARTEMIS) for laparoscopic surgery as a prototype. The system c onsists of two robotic arms holding two steerable laparoscopic instruments. These two work units are controlled from a console equipped with two maste r arms operated by the surgeon. The systems and its components were evaluat ed experimentally. Laparoscopic manipulations were feasible with the ARTEMI S system. The placement of ligatures and sutures and the handling of cathet ers were possible in phantom models. The surgical practicability of the sys tem was demonstrated in animal experiments. We conclude that robotic manipu lators are feasible for experimental endoscopic surgery. Their clinical app lication requires further technical development.