Sıkma Kuvveti Uygulamadan Değişken Şekilli Yumuşak Dokuların Kavranması İçin Yeni Bir Laparoskopik Tutucu Tasarımı ve Uygulanabilirlik Testleri

Year 2020, Volume: 8 Issue: 3, 2084 - 2091, 31.07.2020

Şenol Ertürk , Fehmi Erzincanlı

https://doi.org/10.29130/dubited.688847

Abstract

Cerrahlar, Laparoskopik cerrahi sırasında yumuşak dokuları tutmak ve hareket ettirmek için tutucular kullanmaktadır. Bu tutucuların kavrama çeneleri, dokuların kaymaması için değişik yapılarda dişli yapıya

sahiptirler. Dokuların tutucu çeneler arasında sıkıştırılması sonucunda doku hasarı riski oluşmaktadır. Bu çalışmada bu riskin ortadan kaldırılması için Bernoulli prensibi kullanılarak çalışan, dokuları sıkmadan

kaldırabilen yeni bir Laparoskopik tutucu tasarlanıp üretilerek deneysel çalışma ile uygulanabilirlik testleri yapılmıştır. Tutucu, doku ile arasında Bernoulli prensibi ile yüksek hava akış hızı ile vakum oluşturularak

çalışmaktadır. Kaldırılan dokuların kuvvetli hava jetinden zarar görmemesi için eksenel yönde akan havanın akış yönünü değiştirmek amacıyla tutucu yüzey merkezine deflektör yerleştirilmiştir. Çalışma, Bernoulli prensibi ile çalışan bir tutucunun yumuşak ve esnek dokuların sıkıştırılmadan kaldırılması ve hareketi için uygulanabileceğini göstermiştir.

Keywords

Laparoskopik tutucu, Bernoulli prensibi, Laparoskopik cerrahi

Design and Feasibility Tests of A New Laparoscopic Gripper for Grasping Soft Tissues of Variable Shape Without Clamping Force

Abstract

Surgeons use grippers for grasping and moving soft tissues during Laparoscopic surgery. The grasping jaws of these grippers have different toothed structures to prevent tissues from slipping. As a result of clamping tissues between grasping jaws, there is a risk of tissue damage. In this study, to eliminate this risk, a new Laparoscopic gripper that works on the Bernoulli principle and can lift tissues without clamping force was designed and produced, and its applicability tests were carried out with an experimental study. The gripper works by creating a vacuum with a high air flow rate with the Bernoulli principle between itself and the tissue. To not damage the lifted tissue by the strong air jet, a deflector was placed onto the center of the grasping surface to change the flowing direction of the air flowing in the axial direction. The study showed that a gripper working with the Bernoulli principle can be applicable to lift and move soft and flexible tissues without clamping force.

Keywords

Laparoscopic gripper, Bernoulli principle, Minimally invasive surgery

References

• [1] D. D. Marucci, J. A. Cartmill, W. R. Walsh, and C. J. Martin, “Patterns of Failure at the Instrument–Tissue Interface,” Journal of Surgical Research, vol. 93, no. 1, pp. 16–20, 2000.
• [2] A. J. Shakeshaft, J. A. Cartmill, W. R. Walsh, and C. J. Martin, “A Curved Edge Moderates High Pressure Generated by A Laparoscopic Grasper,” Surgical. Endoscopy, vol. 15, no. 10, pp. 1232–1234, 2001.
• [3] J. Rosen, B. Hannaford, C. G. Richards, and M. N. Sinanan, “Markov Modeling of Minimally Invasive Surgery Based on Tool/Tissue Interaction and Force/Torque Signatures for Evaluating Surgical Skills,” IEEE Transactions on Biomedical Engineering, vol. 48, no. 5, pp. 579–591, 2001.
• [4] T. Hu, G. Tholey, J. P. Desai, and A. E. Castellanos, “Evaluation of A Laparoscopic Grasper with Force Feedback,” Surgical Endoscopy, vol. 18, no. 5, pp. 863– 867, 2004.
• [5] J. Wang, L. Ma, W. Li, and Z. Zhou, “Safety of Laparoscopic Graspers with Different Configurations During Liver Tissue Clamping,” Biosurface and Biotribology, vol. 4, no. 2, pp. 50–57, 2018.
• [6] J. A. Cartmill, A. J. Shakeshaft, W. R. Walsh, and C. J. Martin, “High Pressures are Generated at the Tip of Laparoscopic Graspers,” Australian and New Zealand Journal of Surgery, vol. 69, no. 2, pp. 127–130, 1999.
• [7] E. A. M. Heijnsdijk, M. Van Der Voort, H. De Visser, J. Dankelman, and D. J. Gouma, “Inter-and Intraindividual Variabilities of Perforation Forces of Human and Pig Bowel Tissue,” Surgical Endoscopy and Other Interventional Techniques, vol. 17, no. 12, pp. 1923–1926, 2003.
• [8] X. F. Brun and. N. Melkote, “Analysis of Stresses and Breakage of Crystalline Silicon Wafers During Handling and Transport,” Solar Energy Materials Solar Cells, vol. 93, no. 8, pp. 1238–1247, 2009.
• [9] B. Ozcelik and F. Erzincanli, “A Non-Contact End-Effector for the Handling of Garments,” Robotica, vol. 20, no. 4, pp. 447–450, 2002.
• [10] B. Ozcelik and F. Erzincanli, “Examination of the Movement of A Woven Fabric in the Horizontal Direction Using A Non-Contact End-Effector,” International Journal of Advanced Manufacturing Technology, vol. 25, no. 5, pp. 527–532, 2005.
• [11] F. Erzincanli, J. M. Sharp, and A. M. Dore, “Grippers for Handling of Flexible Food Products,” in Proceeding of EURISCON’94, Malaga, Spain: Amarc, vol. 3, pp. 798–806, 1994.
• [12] S. Davis, J. O. Gray and G. G. Caldwell “An End Effector Based on the Bernoulli Principle for Handling Sliced Fruit and Vegetables,” Robotics Computer Integrated Manufacturing, vol. 24, no. 2, pp. 249–257, 2008.
• [13] G. Dini, G. Fantoni and F. Failli, “Grasping Leather Plies by Bernoulli Grippers,” CIRP Annals Manufacturing Technology, vol. 58, no. 1, pp. 21–24, 2009.
• [14] Ş. Ertürk, “Laparoskopik Cerrahide Hasta Güvenliğinin Arttırılması için Yeni Tip Tutucu Geliştirilmesi (Development of A New Type of Gripper to Improve Patient Safety in Laparoscopic Surgery) [in Turkish],” Ph.D dissertation, Dept. Mec. Eng., Duzce Univ., Düzce, Turkey, 2019.
• [15] R. Sam and S. Nefti, “Design and Feasibility Tests of Flexible Gripper for Handling Variable Shape of Food Products,” in Proceedings of The 9th WSEAS International Conference on Signal Processing, Robotics and Automation (ISPRA '10), University of Cambridge, UK, 2010, vol. Recent Advances in Signal Processing, Robotics, and Automation, pp. 329–335: WSEAS Press.
• [16] Ş. Ertürk and F. Erzincanli, “Grasping of Soft Tissues by means of Non-Contact Gripper in Minimally Invasive Surgery,” Düzce University Journal and Science Technology, vol. 7, no. 3, pp. 1335–1340, 2019.