Trocar and instrument positioning system TISKA : An assist device for endoscopic solo surgery

The assistance received by the surgeon from support personnel during surgical laparoscopy is extremely important. This includes the retracting of instruments and the positioning of the endoscope. However, human assistance is costly and often does not provide satisfaction for the surgeon. The aim of the project was to develop a mechanical arm capable of manipulating a laparoscopic instrument under the control of the operating surgeon. The system design is based on a particular kinematic construction that maintains an invariant point of constraint motion coincident with the trocar puncture site through the abdominal wall. The guidance system allows transparent and intuitive operation, and its setup is easy and quick. It may be adapted either as an instrument retractor or as an optic positioning device. A new generation of instrument positioning systems, with improved ergonomy, will be a first step toward the diffusion of solo surgery techniques in minimally invasive therapy. We believe this prototype represents a valid compromise between human and robotic control for conventional laparoscopic instruments.