Minimally Invasive Surgery Small incision Low risk of infection - - PDF document

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Minimally Invasive Surgery Small incision Low risk of infection - - PDF document

Elec 331 - Minimally Invasive Surgery Minimally Invasive Surgery Small incision Low risk of infection Short recovery time CO 2 Injected by needle Integrated into instrument Uses Exploratory surgery


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SLIDE 1

Elec 331 - Minimally Invasive Surgery 1

Minimally Invasive Surgery

  • Small incision

– Low risk of infection – Short recovery time

  • CO2

– Injected by needle – Integrated into instrument

  • Uses

– Exploratory surgery – Laparoscopic surgery – Arthroscopic surgery

Appendectomy

  • Appendix

– Attached to colon / large intestine – No known function – Inflamed

  • Surgery

– Removal

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SLIDE 2

Elec 331 - Minimally Invasive Surgery 2

Hernia

  • Hernia

– Weakened abdominal wall (muscle) – Intestine protrudes through abdomen – Visible bulge

  • Surgery

– Retract intestine – Sew abdominal wall

Gallbladder

Pre-Operative Post-Operative Stores bile produced by liver Releases bile into digestive tract to emulsify fat Reduced tolerance to high-fat foods after removal

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SLIDE 3

Elec 331 - Minimally Invasive Surgery 3

Colon Resection

  • Colon

– Infected / inflamed

  • Surgery

– Affected section removed – Colon reconnected

Gastric Bypass

  • Pouch made from

top of stomach

  • Small intestine

sewn to pouch

  • Most of stomach

bypassed

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SLIDE 4

Elec 331 - Minimally Invasive Surgery 4

Arthroscopic Knee Surgery

  • Menisectomy

– Remove or repair torn cartilage

  • ACL Reconstruction (video)

Instruments

Laparoscope / Arthroscope Trocar Forceps / Scissors Elevator / Retractor Stapler

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SLIDE 5

Elec 331 - Minimally Invasive Surgery 5

Instrument Types

  • Trocar

– Apertures – Lengths

  • Staplers

– Straight – Helical – Circular

  • Retractors

– Expanding – Extending – Articulating

Optical Fibres Lens

Laparascope

Camera Light Source

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SLIDE 6

Elec 331 - Minimally Invasive Surgery 6

Forceps / Scissors

  • Transmissions

– Rod – Cable / Cable – Cable / Spring

Cable Drives

d

Reduction ratio d 

Navigate Corners

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SLIDE 7

Elec 331 - Minimally Invasive Surgery 7

Dextrous Tips

Steerable (dextrous) sleeve Steering cable Spring loaded sleeve Stiff housing Drive cable Rotate to Change direction Retract to change angle

Articulating MIS Tools

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SLIDE 8

Elec 331 - Minimally Invasive Surgery 8

4-DOF Motion Range

(2 in reverse direction)

Trocar (pivot point)

2-D Transformed Image

  • Exercise

– Start up Paint – Draw an “S” – Change the pen colour – Re-trace the “S”

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SLIDE 9

Elec 331 - Minimally Invasive Surgery 9

Difficulties with MIS

Physical Constraints

  • Motion

– Restricted – Reversed – Scaled by distance to incision – Fixed approach angle – Far from hands

  • Instrument

– Backlash – Flexibility – Size – 1 per incision

Human Experience

  • Lost

– Depth perception – Tactile perception – Proprioception – Visual navigation control – Peripheral vision

  • Altered

– Visual transformation – Head position

  • Communication