Dexterous Tools, Essay Example

Introduction

The existing surgical instruments are associated with few degrees of freedom for their use in minimally invasive surgery (MIS). The current surgical instruments are associated with capability that is limited in the performance of precise and complicated procedures. Some of the complicated procedures would include knot tying and suturing (1). A modular dexterous handheld robot for surgeries that are associated with 4DOF interchangeable instruments and ergonomic handles was developed to solve the problem in the medical field. The handle and kinematic arrangement for the tool were designed to be formulated in the same manner. There were several experiments on the performance of the instrument that was conducted in the evaluation of the effectiveness that is associated with the overall system. From the experiments, the grip forces for the robot ranged from 8.63N to 19.18 N (1). The instrument was associated with suturing performance levels that were higher than the conventional instruments. There was an experiment that was done on animals and the tracking test on the trajectory that was verified for its feasibility and accuracy. The proposed robot was said to be associated with some level of performance increase in the surgical area of MIS, and that had a provision of end effectors and an interface that was intuitive in the medical area.

Discussion

MIS is a procedure that is performed by the insertion of a slim and stiff instrument in the body of the patient with the use of images that are used in the endoscopy guidance. The use of MIS has been associated with different benefits to the patients. Some of the benefits would include the case of reduced blood loss amongst the patients, availability of smaller scars, minimal pain after the operation, and the patient also benefits from a short stay in the hospital. The use of technology is, however, also associated with some form of drawbacks(3). The drawbacks would be sourced from the fact that the small incisions had a limitation of scope on the medical practitioners. The instruments have a limited degree of freedom. The instruments are also associated with some form of incoordination between the eye and the hand because of the effect caused by a fulcrum.

The other downside of the technology is the fact that it is associated with a long learning curve and high ease of fatigue amongst the users. The users would get fatigued from the high level of concentration that is required. The conventional instruments that are used in MIS are associated with a shaft that is both long and rigid, and an end effector that is inflexible and a scissor-like handle and that acted as a limitation to the ability of the surgeons to perform procedures that were complicated. The design of surgical instruments that were associated with an additional degree of freedom was an effective way of enhancing the dexterity associated with MIS. The surgical tools that are dexterous are associated with 2-3 extra DOFs. The extra DOFs are found at the end of the distal to enable the surgeon to have control in the position and orientation arbitrability(2). An example of the dexterous surgical device would be the telesurgery system. The system is associated with 6DOFs and control that is intuitive. The extra degrees of freedom is beneficial in ensuring that delicate and complicated operations are conducted by surgeons. The major setback of the system is the fact that it is associated with a huge footprint, and that would require the availability of a big operation room. The setup of such a room would be time-consuming.

The handheld dexterous tools are unlike the telesurgery system that has some form of separation between the patient, and the surgeon is associated with some form of closure with the patient. The handheld tools allow the surgeons to stand next to the operating table where the patient is found. The handheld tools are usually compact, light, and associated with some form of force feedback that is retained and operated and held with the use of one hand. Some of the handheld instruments include hand radius and instrument, and the real hand largo angle. The handheld tools are mechanical, and they have a handle that is articulated and a joint that is universal between the shaft of the instrument and the handle. The handheld instruments are usually low costs and associated with minimal weight(3). The users of the devices are, however, supposed to provide some form of multiple inputs and combinations that are complex in an attempt to come up with a simple rotation because of the physical arrangement of the gadgets. The handles are also less ergonomic, and they require some form of force in the actuation of the end effector of the too. The instruments are said to be associated with fatigue to the users.

There is another form of dexterous tool that is the handheld robot. The robot has a generator that can help in the handling of instruments that have multiple DOFs. Examples of these forms of instruments would include the kymertax and the human extension. The robots are found with a handle that is optimizable and has a tremor filter used in making the operation precise and comfortable for the practitioner(2). The downside of the tools is the fact that they can on integrate the motor, instrument, and handle with only a specific type of end effector that would be available. That implies that the specified end effector cannot perform different procedures. The mechanically advanced tools are associated with higher costs compared to the other handheld tools.

Transmission analysis and design

There is the design of a cable transmission scheme that is both flexible and compact in ensuring that there is a great design of the transmission. There is the existence of a closed-loop cable that is adopted in ending that there are tip rotation joints. The tip rotation joint is formed behind the yaw joint because the cable at the tip requires some 90-degree turn to pass through the available yaw joint. In trying to avoid the cable tangle, the proportional transmission is adopted.

Ergonomic manipulator handle

The handle is the input interface associated with motion. The interface is beneficial in the conversion of the surgeon’s attitude in hand to electrical signals. The signals are beneficial in controlling the instrument used in carrying out the operations. The handle has a 3 DOF joystick, and it can handle the base. There are three joints in the joystick. The joints are a twist, grip, and wrist yaw. The joystick is divided into two sections. The first is one that moves freely while the second is fixed. That enables ease in operations and stability in the joystick.

Impact of the medical device

The use of dexterous tools is beneficial in ensuring that there is minimal blood loss amongst the patients. The patients would be left with a small scar, and that implies that there is little blood loss. The size of the scar will also help in ensuring that the healing process happens hurriedly compared to the old surgeries, whereby the patients were left with large scars. The large scars were, at times, traumatizing to the patients, and that would mean that the use of the new technology would be an advantage to the patients. The other benefit would be the fact that the patients spend minimal time in the hospitals. During their stay in the hospital, the patient would have recovered well and had the ability to get back to their routine duties. The traditional scars were associated with a huge medical rest to ensure that there is no injury on the stitches from overstretching. That would mean that the patients will recover their economic status or other duties in society within a short period.

From the systematic review of the devices, some benefits are associated with the use of MIS in the medical field and patient care. The gadgets are associated with an increase in the rapid response, facilitation of data accessibility and management, and the ability to prevent errors in the surgical processes. Studies show that time delays are a constraint in the options available for treatment, and they have a direct impact on the chances of patient recovery. The handheld devices that are used by the surgeons can transmit investigatory data on the patient wirelessly, and that would enable the procedures to be conducted fast (2). The wireless transmission of data ensures that the resources required for the procedures are available, and enough staff would be available to help in the procedure at hand. There is also literature that shows that there was an increase in the level of patient decisions made with the use of electronic resources. The physicians in hospitals get more access to electronic resources compared to paper resources. There will be an increase in the patient outcomes that are supported by informed treatment decisions. The decisions are enabled by the management of the patient data with the use of handheld devices.

Conclusion

Advancement in the level of technology of handheld gadgets has increased rapidly. The availability of such technology has been associated with different forms of benefits to both the users and the patients. The health practitioners would have some form of flexibility in their working location because of the ease of carrying the gadgets. The will also be an increased level of data accessibility and transmission amongst the physicians. With the ease in data accessibility, the number of errors would be reduced in the procedures. The patients would benefit from the small scars that are inflicted by the device. The patients ill also enjoy a limited stay in the hospital because of the increased speed of information transmission and the size of the scar that takes limited time to heal. That would mean that the technology is beneficial and should be embraced all over.

References

Bryce, G. (2018). Ergonomics and Handheld medical devices: five vital elements of design success. Medical Design, Briefs. Retrieved on 4th December 2019 from             https://www.medicaldesignbriefs.com/component/content/article/mdb/features/articles/29  108

Pimmer, C., Pachler, N., and Genewin, U. (2013). Reframing clinical workplace using the theory of distributed cognition. Journal of the association of American medical colleges. Retrieved on 4th December 2019 from https://journals.lww.com/academicmedicine/pages/articleviewer.aspx?year=2013&issue=09000&article=00024&type=Full text

Yang, Y., Kong, K., Li, J., Wang, S., and Li, J. (2019).Design and evaluation of a Dexterous and modular handheld surgical robot for minimally invasive surgery. Journal of Medical Devices Vol. 13. Retrieved on 4th December 2019 from  file:///C:/Users/hp/Downloads/Key_Reference.pdf