A robotic laparoscope holder operated by jaw movements and triaxial head rotations

Authors have been developing a robotic laparoscope holder operated by using a head-mounted interface. Pan-tilt operations of a flexible endoscope are available through surgeon's head rotations in pitch and yaw directions and zoom in/out operations are available through the head rotation in roll direction with this system. In addition to the head rotations, jaw movements are used as control commands. Endoscope operations are available only under the surgeon's gentle chewing effort. Surgeon can anytime stops and restarts camera operation by stop/restart of chewing efforts during the surgery. Therefore no footswitch which is often used in commercialized robotic laparoscope system are needed for this system. Two evaluation tests have been conducted to see the performance of the proposed system. In the first test, the operability of the two control methods, one under chewing efforts which is proposed in this study and the other under footswitch operations, has been compared. It has been shown that the control methods using chewing efforts allow users to have a camera work of the equivalent operability as that under footswitch operation through the test. In the second evaluation test, the efficiency of a forceps task under the surgeon's camera work by using the proposed system has been evaluated. The time for completing a forceps task was compared between the case of surgeon's camera work by using the proposed system and the case of under scope operations of a human assistant. It was shown that the forceps task under scope operations using the proposed system always takes more time than that under scope operation of camera assistant because the surgeon needs to play a double role, a surgeon and a camera assistant during the surgery. The increase rates of the time for completing the task of general adult subjects and surgeon subjects from that of the task under camera work given by a camera assistant were 40[%] and 70[%], respectively.