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Surgical Endoscopy

Erschienen in:

01.06.2015 | Review

A state of the art review and categorization of multi-branched instruments for NOTES and SILS

verfasst von: Ewout A. Arkenbout, Paul W. J. Henselmans, Filip Jelínek, Paul Breedveld

Erschienen in: Surgical Endoscopy | Ausgabe 6/2015

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Abstract

Background

Since the advent of Natural Orifice Translumenal Endoscopic Surgery (NOTES) and single incision laparoscopic surgery (SILS), a variety of multitasking platforms have been under development with the objective to allow for bimanual surgical tasks to be performed. These instruments show large differences in construction, enabled degrees of freedom (DOF), and control aspects.

Methods

Through a literature review, the absence of an in-depth analysis and structural comparison of these instruments in the literature is addressed. All the designed and prototyped multitasking platforms are identified and categorized with respect to their actively controlled DOF in their shafts and branches. Additionally, a graphical overview of patents, bench test experiments, and animal and/or human trials performed with each instrument is provided.

Results

The large range of instruments, various actuation strategies, and different direct and indirect control methods implemented in the instruments show that an optimal instrument configuration has not been found yet. Moreover, several questions remain unanswered with respect to which DOF are essential for bimanual tasks and which control methods are best suited for the control of these DOF.

Conclusions

Considering the complexity of the currently prototyped and tested instruments, future NOTES and SILS instrument development will potentially necessitate a reduction of the available DOF to minimize the control complexity, thereby allowing for single surgeon bimanual task execution.

Synonyms to SILS are Single-Port Access (SPA) surgery, Single-Site Laparoscopy (SSL), Single-Port Laparoscopic Surgery (SPLS), Single-Port Laparoscopy (SPL), and Laparo Endoscopic Single-Site (LESS) surgery.

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Titel: A state of the art review and categorization of multi-branched instruments for NOTES and SILS
verfasst von: Ewout A. Arkenbout
Paul W. J. Henselmans
Filip Jelínek
Paul Breedveld
Publikationsdatum: 01.06.2015
Verlag: Springer US
Erschienen in: Surgical Endoscopy / Ausgabe 6/2015
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-014-3816-z

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