Modeling of a 4-DOF Flexible Laparoscopic Instrument for Robot-Assisted Minimally Invasive Surgery

Background: Flexible surgical instruments for Robot-Assisted Minimally Invasive Surgery (RAMIS) face a critical limitation: the inability to rotate the distal head while the instrument is in a bent configuration, which restricts the maneuverability in narrow surgical workspaces. Methods: This paper presents a novel 4-degree-of-freedom (DOF) flexible laparoscopic instrument with a 10 mm diameter, incorporating a 3D-printed flexible element. The design enables independent bending (0–90°), continuous distal head rotation (360°), gripper actuation (0–60°), and rod rotation (180°). A constant-curvature kinematic model was developed. The instrument was manufactured using PolyJet 3D printing technology and integrated with the ATHENA parallel robot for proof-of-concept experimental validation. Results: Experimental tests demonstrated successful independent 360° distal head rotation across the full bending range (0–90°), validated through simulated surgical procedures including stomach retraction. Quantitative characterization using optical motion capture revealed a maximum angular deflection of 79.85° at 670 g applied load, with tip displacements of 74.95 mm (X) and 91.18 mm (Y). The measured grasping force was approximately 2 N, tip position repeatability was ±2.86 mm, and fatigue testing demonstrated no degradation after 500 bending cycles, confirmed by digital microscope inspection. The instrument performed multiple manipulation tasks, including elastic band transfer, wire path navigation, spring manipulation, and tissue grasping. Conclusions: The proposed instrument addresses a significant white spot in surgical robotics by adding an additional functional capability enabling grasper reorientation without repositioning the entire instrument.