NOTES. Historia y situación actual de la cirugía endoscópica por orificios naturales en nuestro país

Aguilar, José Francisco Noguera; Moreno-Sanz, Carlos; García, Ángel Cuadrado; Martínez-Mediero, José Manuel Olea; Morales-Soriano, Rafael; Arbona, J.; Bogajo, Ma Luz Herrero; Salvá, Luis Lozano

doi:10.1016/j.ciresp.2010.03.046

Cited by 7 publications

(1 citation statement)

References 32 publications

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“…1–3 The field of natural orifices transluminal endoscopic surgery (NOTES) strives to further reduce the negative effects of surgery using natural orifices such as the mouth, nose, and anus as the surgical entry point. 4,5 This approach does introduce technical challenges as the currently used rigid Ø5-mm instruments designed for MIS are not able to confine to the curved nature of the human anatomy but dictate a straight path from entry point to lesion. Making the Ø5-mm instruments flexible, as for example the MultiFlex of Figure 1(a), could therefore extend the reach of NOTES procedures in compact anatomical areas.…”

Section: Introductionmentioning

confidence: 99%

The MemoSlide: An explorative study into a novel mechanical follow-the-leader mechanism

Henselmans

Gottenbos

Smit

et al. 2017

Proc Inst Mech Eng H

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Follow-the-leader propagation allows for the insertion of flexible surgical instruments along curved paths, reducing the access required for natural orifice transluminal endoscopic surgery. Currently, the most promising follow-the-leader instruments use the alternating memory method containing two mechanical memory-banks for controlling the motion of the flexible shaft, which reduces the number of actuators to a minimum. These instruments do, however, require concentric structures inside the shaft, limiting its miniaturization. The goal of this research was, therefore, to develop a mechanism conforming the principles of the alternating memory method that could be located at the controller-side instead of inside the shaft of the instrument, which is positioned outside the patient and is therefore less restricted in size. First, the three-dimensional motion of the shaft was decoupled into movement in a horizontal and vertical plane, which allowed for a relatively simple planar alternating memory mechanism design for controlling planar follow-the-leader motion. Next, the planar movement of the alternating memory mechanism was discretized, increasing its resilience to errors. The resulting alternating memory mechanism was incorporated and tested in a proof-of-concept prototype called the MemoSlide. This prototype does not include a flexible shaft, but was fully focused on proving the function of the alternating memory mechanism. Evaluation of the MemoSlide shows the mechanism to work very well, being able to transfer any planar path that lays within its physical boundaries along the body of the mechanism without accumulating errors.

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