A Handheld, Dual-Arm Surgical Device for Semi-Automated Trans-oral Endoscopic Resection

Abstract

While transoral surgery is popular for its minimally invasive nature and cosmetic benefits, the anatomy of the oropharynx and larynx presents narrow and irregularly shaped operative spaces, requiring slender and dexterous surgical instruments. For surgical operations in narrow spaces such as tonsillectomy, visualization and dexterous manipulation are generally indispensable. To address the limitations of conventional transoral tools (e.g., inconvenient eye-hand coordination, limited distal dexterity and large footprint), we propose a portable handheld dual-arm device consisting of a master arm for tissue manipulation and a slave arm carrying an endoscopic camera for monitoring the surgical scene. The master arm is a tendon-driven riveted continuum manipulator, and the slave endoscope is a dual-segment slender arm based on concentric push/pull robot (CPPR). Through delicate design, the actuation unit is miniaturized. In addition, the kinematics was built for eye-hand automatic coordination, and experiments have demonstrated its clinical potential in endoscopic tonsillectomy.