Since its earliest developments over 25 years ago, minimally-invasive laparoscopic surgery has eliminated the long gashes of traditional surgery. The development of laparoscopic procedures, and the refinement of instrumentation, has made laparoscopic surgery less invasive, resulting in laparoendoscopic single-site surgery (LESS), common in urology. The LESS technique, along with the growing capabilities of therapeutic flexible endoscopy in treating gastrointestinal conditions, has increased the desire for even less invasive alternatives, such as natural orifice transluminal endoscopic surgery (NOTES), which has been demonstrated in animal models via transvaginal, transgastric, transrectal, and transvesical approaches. A successful LESS and NOTES technique, however, requires superior instrumentation that will be manipulated in confined space and does not interfere with each other. Intelligent Optical Systems (IOS) proposes the development of a Surgical Instrument Guide - MEMS (SIG-MEMS) for emerging LESS and NOTES applications. The proposed device will be used for tracking a surgical instrument within a human body, via noncontact, passive, optical range finding. It will provide information on distances between an organ and an approaching instrument tip, and will feed this information back to the surgeon. The proposed SIG-MEMS will optically produce two spatially separated images to perform a triangulation calculation, but will use only one imaging channel -- unlike conventional stereo-devices, which use two channels. Because of its small dimensions and light weight, the sensor can be incorporated into a surgical tool, or can be a stand-alone part of the system, providing visual feedback and instrument tracking capabilities. In Phase I, Intelligent Optical Systems will demonstrate the tabletop prototype, and in Phase II will develop a detachable SIG-MEMS prototype that can be incorporated into surgical tools.
The major application of the SIG-MEMS will be for use in the new emerging procedures of minimally invasive surgery such as LESS and NOTES. It will warn the surgeon when the instrument is approaching a vital part of the tissue, and will simultaneously provide important instrument positioning information in relation to other instruments.