Recent advances in the CoBRASurge robotic manipulator and dexterous miniature in vivo robotics for minimally invasive surgery

Minimally invasive surgery (MIS) reduces trauma and improves patient recovery. Traditional laparoscopic procedures are performed using multiple long, thin tools that are inserted through small incisions in the abdominal wall. The advantages of these procedures are often restricted to less complicated procedures owing to imaging and tissue manipulation limitations. These limitations can be overcome using advanced surgical systems, such as da Vinci®, that provide the surgeon with enhanced visualization and improved tool dexterity. However, the da Vinci system is expensive and occupies significant space in the operating room. The compact bevel-geared robot for advanced surgery, CoBRASurge, is a compact robotic system that addresses the space and expense limitations of large external robotic systems. This system provides a stable platform for laparoscopic tool manoeuvring, while also allowing the surgical team improved access to the patient. New methods for performing MIS, including single incision and natural orifice access, are also being developed to further minimize invasiveness through reducing or eliminating external incisions. However, the instruments for these procedures are further limited by accessing the peritoneal cavity through a single insertion point. Dexterous miniature robots that are completely inserted into the peritoneal cavity are being developed that mitigate these limitations to provide improved triangulation.