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Pursuing minimal invasiveness is a trend in the development of modern surgeries as smaller size of incision reduces blood loss and postoperative hospitalization stay. This poses high requirement on surgical devices including endoscopes and instruments because the surgeon is difficult to see the full view of the surgical site via a small port. In addition, slenderness and steerability are also critical to access and perform manipulation in complex anatomies. Therefore, we proposed a handheld steerable surgical device to address the problems, with which the incision could be minimized to 3.2 mm in diameter. It consists of a steerable endoscope formed by cable-driven riveted continuum structure and two dexterous slender instruments using concentric push–pull robot (CPPR) mechanism. In design, analysis on the steerability and stiffness about the endoscope was conducted, and we also modeled the tip tool pose with respect to actuation configuration. Specific pattern of CPPR structure benefits designing slender instruments (1.1 mm in outer diameter), and two CPPR-based dexterous instruments pass through the hollow space of the endoscope to reach the narrow constrained surgical sites. Experiments show the potential of the portable device, and ex vivo tests on a porcine lung and heart demonstrate the overall clinic advantages.
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Chen et al. (2025) studied this question.
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