Robotic system with programmable motion constraint for transurethral resection

Purpose: We propose a tele-operated transurethral robotic system with programmable motion constraint for tissue resection. Methods: The system consists of a surgeon console with an interaction device, a 7-degree-of-freedom manipulator, and a surgical end-effector. The surgical end-effector holds a resectoscope with a motor driven mechanism to perform electrocautery. Instrumental motion with remote center-of-motion (RCM) constraint is important for transurethral procedures since the damage to the healthy structures can be minimized. A screw theory-based programmable RCM generator is proposed to map the inputs of the interaction device to the RCM manifold in the manipulator space. To achieve smooth real-time manipulator following control with RCM constraint, an online trajectory planner is presented. Results: Experiments were performed to evaluate the motion precision and accuracy. The results show that both the RCM precision and accuracy were less than 1 mm. Ex-vivo experiments of robotic resection of soft tissue were also carried out. The results show that our robotic system could achieve instrumental manipulation and delicate cutting under the real-time control of a surgeon. Conclusions: Our robotic system could assist surgeons in performing transurethral procedures in a remote manner with potential advantages of being accurate, less laborious and clean.