Surgery is trending towards procedures that are less invasive, since reduction in surgical trauma results in improved patient outcomes accompanied by substantially reduced cost. In the past two decades, laparoscopy has proven this concept, and telerobotics has enhanced the surgeon's capacity for visualization and manipulation within the laparoscopic paradigm. In the quest for decreased invasiveness, natural orifice translumenal endoscopic surgery (NOTES) has emerged, with its goal of incisionless, noninvasive surgery. This concept, although accepted somewhat among surgeons, has yet to be successfully implemented on an appreciable scale due to a lack of enabling tools and technology. Our primary goal is to develop a multifunction robotic platform for natural orifice surgery, allowing te technological difficulties of dexterity, size, multifunctionality, and force transmission to be remedied and providing the necessary functionality to perform NOTES procedures. The robot is expected to: 1) provide sufficient dexterity and rigidity for surgical tasks;2) exhibit multifunctionality by integrating multiple tools and cameras;3) be fully insertable and controllable through a natural orifice;and 4) provide intuitive remote control with force-feedback features. It will be equally applicable to laparoendoscopic single-site surgery (LESS). To fill thi critical need to advance NOTES/LESS techniques, two major objectives will be pursued: 1: Develop a multifunction miniature robot with sufficient strength, dexterity, and multifunctionality to perform complex transvaginal and transcolonic endoscopic procedures. 2: Objectively assess robot performance in bench-top environments, and in non-survival swine model studies, to demonstrate and assess robot functionality. The expected outcome will be design and demonstration of a new advanced multifunction miniature robot to overcome the major limitations of current NOTES technology. This will prompt a shift in paradigm towards NOTES/LESS as a more universal standard of care and make incisionless procedures a reality, resulting in significant improvement in patient outcomes for a wide variety of ailments.

Public Health Relevance

The proposed research seeks to develop technology for advanced minimally invasive surgery. The broad goal is to increase the impact of robotic surgery through new technology for improving surgical capabilities.

National Institute of Health (NIH)
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
Exploratory/Developmental Grants (R21)
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Bioengineering, Technology and Surgical Sciences Study Section (BTSS)
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Krosnick, Steven
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University of Nebraska Lincoln
Engineering (All Types)
Schools of Engineering
United States
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Pourghodrat, Abolfazl; Nelson, Carl A (2017) Disposable Fluidic Actuators for Miniature In-Vivo Surgical Robotics. J Med Device 11:0110031-110038
Pourghodrat, Abolfazl; Nelson, Carl A; Oleynikov, Dmitry (2017) Hydraulic Robotic Surgical Tool Changing Manipulator. J Med Device 11:0110081-110086
Zhao, Baoliang; Nelson, Carl A (2016) Estimating Tool-Tissue Forces Using a 3-Degree-of-Freedom Robotic Surgical Tool. J Mech Robot 8:0510151-5101510