A new type of single-arm single-port micro-trauma laparoscopic surgery robot

A new type of single-arm single-port micro-trauma laparoscopic surgery robot | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A new type of single-arm single-port micro-trauma laparoscopic surgery robot Jichen QU, Naijing JIANG, Liangliang CHEN, Chao He, Jiang FAN, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3847825/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract As the robot-assisted single-port surgery gets more attention, we proposed a novel single-arm single-port micro-traumatic laparoscopic surgery robot system with multiple innovative techniques. From a mechanical perspective, joints with high rigidity and reliability were used to realize the remote center of motion. The cost of consumables was reduced by adding the support of a rigid endoscope. From the algorithm perspective, a high-precision motion control method and feedback-force protection mechanism were implemented. The effectiveness of the aforementioned characteristics was verified by 10 clinical cholecystectomy experiments. The results showed that the system can reduce the amount of bleeding, accelerate patient recovery, reduce infection risk, and shorten the learning period. Other gynecology and urology clinical trials using the new surgery robot are underway. The proposed surgery robot system had significant clinical application value. Single port Microtrauma Surgery robot Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 1. Introduction Micro-traumatic surgery gradually emerged in the 1980s. Compared with traditional surgery, this operation only requires a few small incisions and inserting endoscopy and laparoscopic surgery tools in the incision. The surgery has the advantages of fast recovery, less bleeding during the operation, and reduced postoperative complications [ 1 ]. However, micro-traumatic surgery has high requirements, increasing learning costs and surgical risks. To this end, the use of robotic remote operations in surgery came into being. In 1999, the da Vinci porous surgical robot IS1000 developed by the Intuitive Surgical company was launched[ 2 ]. Following its successful commercialization, the advantages of single-hole surgery due to small trauma, less blood loss, and fast recovery have become the direction of the new era surgery [ 3 – 6 ]. Early single-hole robots mainly adopted a multi-arm single-hole form [ 7 – 10 ]. The surgery is generally based on the da Vinci Si or Xi systems. Through the "chopsticks method" device layout, single-port robotic surgery is performed using a single-port puncture. However, there are many shortcomings in this solution: ① The insertion angle of the instrument restricts the scope of activity of the wrist joints. ② The crowded layout of the multi-arm increases the possibility of collision between arms reducing the safety and fluency of surgery. ③ The multi-arm expansion in a single hole demands large space, and it is difficult for assistant doctors to perform auxiliary operations. The da Vinci single-site surgery system solves the above problems to a certain extent. In this system, the number of operating arms is reduced to three, and a single-port surgery is performed in the puncture [ 11 ]. The biggest feature of the puncture is the curved structure that enhances the wrist joints by inserting the special semi-rigid device. However, removing one operating arm can alleviate the problem of collision between operation arms and make it easier for assistant doctors to operate. However, it is limited to available surgery. At the same time, although the introduction of the semi-rigid equipment relieves the limitation of the wrist joints, it reduces the overall stiffness of the equipment and reduces accuracy during the operation. To address the above problems, a single-arm and single-port deployment scheme is needed, as shown in the da Vinci single-port (SP) system. This system is equipped with elbow and wrist joints, and four armored arms, with a targeted design of a SP surgery. Robotics SP surgery is gradually developing from multi-arm SP to single-arm SP system[ 12 ]. In addition to high prices, there are many shortcomings in the da Vinci SP system[ 13 ] ① Adjusting the arm through the wire transmission structure; it is necessary to regularly disassemble and maintain it to prevent the loosening of the wire transmission structure. ② The endoscope uses a flexible design and does not support rigid endoscopes. After disinfecting, it can only be used dozens of times, which further increases the cost. ③ If one of the arms needs to be replaced during the operation, the entire machine needs to be withdrawn. Therefore, we designed a novel single-arm SP micro-trauma laparoscopy robot system and applied it to clinical abdominal surgery. 2. Materials and methods 2.1 A new type of single-arm single-port robot system With the gradual increase in the demand for SP robot surgery, Chinese single-arm SP surgery robots with independent intellectual property rights need to be developed considering the above problems. We designed a new type of single-arm SP micro-traumatic laparoscopic robot system, which achieved a motionless point through the C-shaped arm to avoid frequent disassembly maintenance. In addition to a flexible endoscope, rigid endoscopes are also supported, which significantly reduces the cost of equipment consumables. On the control system, high-precision control was achieved by correcting the control parameters of the device. The external force of the device is estimated through the motor output torque. The feedback force function of the robotic arm is achieved by combining the power feedback and with motion speed of the equipment. The new single-arm SP micro-traumatic laparoscopic robot system consists of a doctor's console, image trolley, and patient‘s trolley, as shown in Fig. 1 . During surgery, the surgeon uses the image transmitted by the image trolley to control the equipment of the patient's trolley by remotely operating the main control arm of the doctor's console. The doctor’s console is the control center of the endoscopic surgery system. It is mainly composed of the main arm control, pedal switch, and three-dimensional monitor. The doctor's console is equipped with two main control arms, which respectively receive the operator's left and right operating signals. During the operation, the surgeon sat outside the sterile area and controlled the instrument arm, surgical equipment, and three-dimensional electronic bending endoscopes using the controllers at the end of the main arm. The pedal switch installed on the trolley can help the surgeon complete the operation and control of electrical surgical equipment such as electrical cutting and coagulation. The surgeon uses the three-dimensional monitor to observe the focus and surgical equipment in the patient's body. The surgeon observes the images in the three-dimensional monitors through the mirror of the two windows. The three-dimensional monitor is designed with the principle of three-dimensional imaging to make the light path so that the surgeon has a three-dimensional view by observing the two observations on the window. The image trolley transmits the image collected by the three-dimensional electronic endoscopy to the three-dimensional imaging instrument of the doctor's console, so that the surgeon can see the three-dimensional images in the patient during surgery, and the image will also be on the top of the image trolley. The above shows that it is convenient for the assistant to check the endoscopic image. The patient's trolley is a direct operating subsystem of the patient's surgical bed. With four parallel arms arranged, one arm must use endoscopy, and the other three arms can use different surgical equipment. The four equipment arms can be adjusted through the adjusting arm. The arm has six degrees of. Among them, the three degrees of freedom away from the base are rotating freedom. The three-axis axis coincides with no moving point. Three degrees of freedom near the base can adjust the position of no moving point. The main difference between the new single-arm single-hole minimally invasive surgical robot system and the multi-arm single-hole surgery robot system (such as the surgical robot of Beijing Morika Robot Co., Ltd.) is in adjusting the arm part. Our single-arm single-hole minimally invasive surgical robot system is achieved through large and small C-shaped arms. The adjustment arm of the multi-arm single-hole surgery robot system is a separate robotic arm. 2.1.1. Adjusting arm The four operating arms of the new single-arm SP micro-traumatic laparoscopic operating machine system are mounted on a smaller C-shaped arm (referred to as small C). Small C is mounted on a large C-shaped arm (referred to as Big C). Big C is connected to the trolley through a rotary joint, which is called a suspension joint. The suspension joint, big C, and small C axes intersect at one point. This point is called no moving point, as shown in Fig. 2 . The position of the non-moving point is controlled by the three joints of the adjustment of the arm. The height of the non-moving point is adjusted by the red telescopic joint (Fig. 2 ). The position of the non-moving point is determined by the green rotation and the blue telescopic joints (Fig. 2 ). Before surgery, the position of the teaching operation can be used and the position can be moved to re-coincide with the puncture point. After connecting the puncturer with the patient's trolley, surgery can start. During operation, the position of the joint is fixed. The positions of the suspension, the large C, and the small C joints can change the overall orientation of the four arms and adjust the operation space. It is worth noting that compared to the da Vinci SP system, the method of using the wire entanglement driver, this system realizes mechanical motionless points through big C and small C. This system has higher rigidity and more reliable mechanical transmission methods. It effectively avoids the disadvantages of driving wires that need to be disassembled and maintained, and achieves an improved mechanical structure. 2.1.2 Equipment The equipment has 5 + 1 degrees of freedom, as shown in Fig. 5 , and is equipped with elbow and wrist joints. The elbow joints are realized by parallel joints of two degrees of freedom. The parallel joints of the device can expand after the stretch of the puncture. This can avoid the lack of linear vision and equipment in the SP surgery, as shown in Fig. 3 (b). By controlling the parallel, pitch bias, and rotation joints with the overall movement of the operating arm slide rail along the operating arm slide rails, control with six degrees of freedom at the end of the equipment can be achieved. In addition to special equipment, open and closing joints are generally equipped at the end. The single-arm and SP surgical robot system we designed also supports the use of rigid endoscopes in addition to the use of conventional flexible endoscopes. The flexible endoscope is used to adjust the field of vision through the mainstay during the operation. The elbow joint is implemented by parallel joints of two degrees of freedom, as shown in Fig. 4 (a) and Fig. 4 (b). Relying on the characteristics of a large-scale flexible motion of the equipment, this system supports the use of 30° rigid endoscopy to complete the surgery. The rigid endoscope is shown in Fig. 4 (c), and the position of the operation is shown in Fig. 5 . In the da Vinci SP system, due to the small angle of joint development, it only supports the use of wire transmission flexible endoscopy to avoid vision blocking during surgery. Due to the use of wire transmission, the number of allowable times will be significantly lower than those of rigid endoscopes, resulting in increased surgical costs. This system can adjust the field of vision through the movement of flexible endoscopes. When using rigid endoscopes, the field of vision can be adjusted by suspending joints, large C, and small C. There is no need to remove the entire machine to replace one of the arms during surgery. The change is done from the back end, without affecting the surgery process. 2.2. Control system There are three main links in the figure: First, exercise control links: Doctors manipulate the main control arm. Motor information at the main control of the arm is maximized by proportional mapping to obtain the amount of motion control at the end of the instrument. Therefore, the main control of the remote operation is controlled; The second is the force feedback link: The device obtains the virtual feedback power of the main control of the arm through the feedback module. Based on the principle of virtual skills, the main control arm of the joint output torque is equivalent to achieve the force feedback of the equipment; The third is the image link: The doctor receives a high-definition three-dimensional image transmitted from the endoscope in real time. In the motion control link, the high-precision control of the device is achieved by introducing non-linear correction quantities. In the force feedback link, the protection technology is achieved by introducing the multi-mode simulation mechanism. 2.2.1 Equipment high-precision control In the motion modeling of the equipment, the four-parameter joint modeling method is usually used. That is, to describe the geometric position relationship of the rods through the axis corner bias α, rod long A, axis position bias D, and corner θ. However, in this modeling method, the parameters are often considered constant and determined by design value. In this system, the parameters are assumed to be the non-linear amount of corner and the non-linear correction quantity is pre-made through design parameters. Its coordinate conversion matrix is ​​shown in the formula. To analyze the advantages of this modeling method in theory, assuming that the long design value of the rod is L, the long measurement value of the rod long measuring value is uniformly distributed in the interval of (1 ± 0.5%) L, and the joint angle is obeyed by the uniform distribution of the maximum mobilized range. The actual value and joint corner data of 10,000 sets of poles and joint angle data were randomly generated using the Monte Carlo method, and the error distribution was obtained as shown in Fig. 6 . For each group of randomly generated rod long measurement values ​​and joint angle data, the end reference point can be calculated based on the position of different sports models; in the same way, based on the long design value of the rod, the theoretical location of the terminal reference point can be calculated. By calculating the error of the position of the end reference point and the reasoning position, the positioning error at the theoretical position of the reference point of the terminal can be obtained. The position of the point cloud position is the theoretical location of the end reference point in Fig. 6 (a). The point cloud color is the positioning error obtained by using the standard four-parameter joint model. In Fig. 6 (b), the point cloud position is consistent with Fig. 6 (a). The difference is that the point cloud color is a positioning error obtained by the model modeling of non-linear parameters. The blue color indicates that the positioning error is small, and the yellow color indicates a large position error. It can be seen from the distribution of point cloud positioning errors that the non-linear parameter modeling method has a smaller global positioning error, which theoretically reflects the advantages of the modeling method. After the analysis of the results of the obtained point, the statistics of the two methods were obtained as shown in Table 1 . The method of sports modeling used was theoretically compared to the traditional modeling method, the absolute positioning accuracy of the absolute positioning was approximately 0.58 mm, the lifting rate was approximately 78.0%, and the positioning error had a very low standard difference. Table 1 The mean positioning error and the standard positioning error deviation derived by different kinematics models Sports model An average value of error(mm) Standard deviation(mm) Standard four parameters 0.7463 0.3836 Non -linear parameters proposed in this article 0.1644 0.0833 2.2.2 Force feedback protection technology The feedback control of the system means that based on remote operation control, the information of the surgical device is used to feedback the information of the surgical equipment through the force to achieve multi-dimensional perception synchronization. The force feedback module implements two functions: First, when the equipment is connected to the near-hardware boundary, the force feedback module will calculate the frictional power of the equipment at the end of the equipment. Second, when the equipment is not at the boundary and is accurately static, the force feedback module calculates the actual contact force at the end of the equipment. Calculation principles [ 14 ]: where QS is the joint location of the patient's platform, τ is the torque of the joint, J is the elegant matrix of the system, f is the contact force at the end of the equipment, M is the quality matrix, C is the Kelai matrix, G is a heavy force vector, and F is the interference item. When the system is accurately static, . Assuming that interference can be ignored, That is, the contact force of the equipment can be obtained through the recognition of gravity and interference items. Through the above methods, the stress at the end of the two functions can be calculated. After the output is out of the control output module, the device ending signal can obtain the end feedback of the control arm after filtering and gain scaling of the force signal. Based on the principle of virtual skills, the joint control torque of the main control arm can be obtained, and the power feedback can be achieved. 2.3. Patients And Methods 2.3.1. Patients We reviewed our general surgery database at the Beijing Friendship Hospital (Beijing, China) for patients with benign diseases of gallbladder. Between February 2022 and March 2022, a total of 10 patients underwent curative single-arm SP robot-assisted cholecystectomy. The study protocol was approved by the Institutional Ethics Committee. The inclusion criteria for robotic cholecystectomy were as follows: 18 years old ≤ age ≤ 80 years old Benign diseases of gallbladder, including gallbladder stones, gallbladder polyps-like lesions, gallbladder adenocia, etc. Those who accepted laparoscopic surgery in physiological conditions. Patients willing to cooperate and complete research follow-up and related examinations. Patients willing to participate in this test and sign consent. The exclusion criteria: Women in pregnancy or lactation. Patients with malignant tumors. Abnormal coagulation function. Severe cardiovascular or circulation system diseases that cannot tolerate surgery. Having participated in other clinical trials in the past month. Unable to understand the test requirements or complete the research follow-up plan. Other situations that researchers believe are not suitable for entering the group. Routine preoperative evaluations consisted of abdominal contrast-enhanced computed tomography, electrocardiogram, cardiac evaluation, and arterial blood gas analysis (Table 2 ). Table 2 General patient status (n = 10) Variable Data Age (y) 47 ± 16.19 Gender (male/female) 6/4 Weight (kg) 69.2 ± 14.17 Blood albumin level (g/L) 5.8 ± 1.23 Hemoglobin level (g/L) 141.3 ± 14.69 Average length of hospital stay after the operation(d) 2.9 ± 1.21 2.3.2. Surgical technique Body position and anesthesia: After single-lumen endotracheal intubation under general anesthesia, the patient was placed in a flat position (Fig. 7 ). The abdominal cavity was entered through the umbilicus. The postoperative incision was sutured as shown in Fig. 7 (b). Cholecystectomy: The cholecystectomy procedure was as shown in the video(Video 1). Postoperative care: All patients were awakened in the operating room soon after the surgery and transferred to the unit. Discharge was approved when the patient recovered well, with no infection. 2.3.3. Statistical analysis Continuous variables were summarized as mean ± standard deviation and compared using the two-sample Student’s t-test. Categorical data were presented as frequencies and percentages. The chi-square (χ 2 ) test or Fisher’s exact test was used to compare the distributions of categorical variables between groups. A two-sided p < 0.05 was considered statistically significant. All statistical analyses were performed using the IBM SPSS Statistics for Windows, version 25.0 (IBM Corporation). 3. Results 3.1. Baseline characteristics The baseline characteristics of the 10 patients who underwent cholecystectomy using the single-arm SP micro-trauma laparoscopic surgery robot are summarized in Table 2 . 3.2. Intraoperative characteristics All 10 patients underwent cholecystectomy using the single-arm SP micro-trauma laparoscopic surgery robot with no conversion to large incision surgery. The mean total surgical duration was 32.6 ± 11.41 min. Intraoperative blood loss was about 5 ml. All patients were extubated at the end of the surgery. It can be seen from Fig. 11 that the actual resection time in surgery decreased significantly with the number of uses of the robot system. The ninth patient had abdominal adhesions due to a history of abdominal surgery. Therefore, the operation took longer. 3.3. Histologic type The postoperative pathological diagnosis was gallstone with cholecystitis or gallbladder polyp. 3.4. Postoperative outcomes The mean postoperative hospital stay was 2.9 ± 1.21 days. The overall operative mortality and morbidity rates were 0%. Postoperative recovery at six months was uneventful in all patients. 4. Discussion During the operation, a rigid endoscope was used to avoid the replacement of the back lens, which reduced the cost of surgery. The feasibility of a rigid endoscope in a SP system was verified. The surgeon's feedback adjusted the arm position before surgery and it was easy to operate. The equipment positioning during the operation was accurate. The main control arm remote operation was comfortable to control, and the instrument flexibly and freely completed the operation. The perspective adjustment function based on the adjustment of the arm movement was in line with intuitive operation habits and easy to master. After surgery, the wounds and bleeding of patients were significantly lower than with traditional gallbladder resection. They found value in the clinical innovation. It can be seen from Fig. 7 that the actual resection time in surgery decreased significantly with the number of surgeries of the robot system. The initial verification of this surgical robot system can speed up the learning curve of surgical operations of the doctors, which plays a positive role in clinical physician training. From Fig. 7 , the average surgical resection of 10 clinical surgeries was 32.6 min, and the average bleeding was approximately 5 ml. Lee et al. [ 15 ] found that the average length of the five cases of clinical surgery using the da Vinci single-site system was 53.4 min, with the average bleeding of 20 ml. The single-arm and SP configuration is more suitable for SP surgery, which enhances clinical application value. Because of the advantages of small trauma, less blood loss, and fast recovery, SP surgery is widely used in clinical practice. The development of SP laparoscopic robots has received more attention. During the technical iteration, it was transformed from a multi-arm SP configuration to a single-arm SP configuration. This system has the following advantages: ① The unmounted structure is realized through suspension joints, large C joints, and small C joints. It has higher rigidity and reliability. It improves the safety of surgery. It reduces daily maintenance costs. ② Surgical equipment has a larger joint motion angle. In addition to flexible endoscope, it also supports rigid endoscopes, which significantly reduces the cost of surgical consumables. ③This system improves traditional standards for four parameters, and introduces non-linear parameters. Compared with the traditional method of this exercise algorithm, this sports algorithm can greatly improve the absolute positioning accuracy of theory, and ensure high-precision control of surgical equipment. ④ The feedback power is divided into two modes, which is more convenient for the doctors and enhances the "presence" of doctors. The above characteristics were fully verified in clinical gallbladder resection. The main limitations of this study are the limited number of patients and the single disease. The effectiveness of single-arm single-hole surgery assisted by robot in general surgery needs to be verified by large samples and multiple diseases in the future. Several hospitals have applied our new single-arm SP micro-traumatic laparoscopic robot system, and conducted surgery such as gynecological ovary tumor resection, urological renal cysts, and adrenal and clippy resection. The clinical trials of gynecology and urology are currently underway. 5. Conclusion The design of new robots has important clinical application value. Declarations ACKNOWLEDGMENT We had full control of the study design, methods used, out come measurements, data analysis, and production of the written report. We thank Prof Jiang Fan, Xing Wang, Wei Huang, and Liang Wu for all their help in preparing this work. We would like to thank Editage (www.editage.com) for their linguistic assistance during the preparation of this manuscript. Funding None. COMPETING INTERESTS All authors have no competing interest to declare. DATA AVAILABILITY STATEMENT All data included in this study are available upon request by contact with the corresponding author. References Cloyd JM. micro-traumatic Surgery for Palliation. Surg Oncol Clin N Am. 2019;28(1):79–88. doi: 10.1016/j.soc.2018.07.004 . Epub 2018 Oct 23. PMID: 30414683 Leal Ghezzi T, Campos Corleta O. 30 Years of Robotic Surgery. World J Surg. 2016;40(10):2550-7. doi: 10.1007/s00268-016-3543-9 . PMID: 27177648. White MA, Haber GP, Kaouk JH. Robotic single-site surgery. Curr Opin Urol. 2010;20(1):86–91. doi: 10.1097/MOU.0b013e3283337a10 . PMID: 19887947. Moonsamy P, Park B. Uniportal Robotic Lung Resection Techniques. Thorac Surg Clin. 2023;33(3):283–289. doi: 10.1016/j.thorsurg.2023.04.006 . PMID: 37414484. WANG GJ, AFANEH C, AULL M, et al. 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The first experiences of robotic single-site cholecystectomy in Asia: a potential way to expand minimally-invasive single-site surgery?[J]. Yonsei Med J., 2015, 56(1): 189–195. Additional Declarations No competing interests reported. Supplementary Files WeChat20231013155235.zip Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3847825","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":266088541,"identity":"908d1aa2-d4a3-4953-8d74-0c73b1ccbf73","order_by":0,"name":"Jichen QU","email":"","orcid":"","institution":"Shanghai General Hospital Jiuquan Hospital, Shanghai Jiaotong University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Jichen","middleName":"","lastName":"QU","suffix":""},{"id":266088542,"identity":"59a01624-4d8e-45a8-b0e5-9def140a1411","order_by":1,"name":"Naijing JIANG","email":"","orcid":"","institution":"MicroPort (Shanghai) Medbot Co., Ltd","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Naijing","middleName":"","lastName":"JIANG","suffix":""},{"id":266088543,"identity":"58b5c6a0-e5b5-433e-b9f1-3e88fcd95c40","order_by":2,"name":"Liangliang CHEN","email":"","orcid":"","institution":"MicroPort (Shanghai) Medbot Co., Ltd","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Liangliang","middleName":"","lastName":"CHEN","suffix":""},{"id":266088544,"identity":"0f73866e-9672-45ae-9565-f915a9c89775","order_by":3,"name":"Chao He","email":"","orcid":"","institution":"MicroPort (Shanghai) Medbot Co., Ltd","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Chao","middleName":"","lastName":"He","suffix":""},{"id":266088545,"identity":"c0d84120-39e8-46f1-8a63-bc0b0ad2287b","order_by":4,"name":"Jiang FAN","email":"","orcid":"","institution":"Shanghai General Hospital, Shanghai Jiaotong University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Jiang","middleName":"","lastName":"FAN","suffix":""},{"id":266088546,"identity":"a293fbbc-8bcf-4cd7-b7d0-78ea634f05f5","order_by":5,"name":"Yaping ZHAO","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAq0lEQVRIie3PMQrCMBTG8RcCdXny1gQ9RDcrFHuVgODkEToEegDXehHnVwqOuhZyifQG0niB100w/ynD9yM8gFzuVzNQI5EXrvFLLnvb8xoCMNald0LSEKupat9YAqs4XyW/GKcr8wx40F7b+0NEoDDWBzx6LvRWRIgX8sKSnZSAWwivIVO65Yy2HzrZLZsbq2DaU0PUDXGWEACKO5Meyov2KRvl21wul/vHPoiELUmayDGBAAAAAElFTkSuQmCC","orcid":"","institution":"MicroPort (Shanghai) Medbot Co., Ltd","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Yaping","middleName":"","lastName":"ZHAO","suffix":""}],"badges":[],"createdAt":"2024-01-09 09:29:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3847825/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3847825/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":49486827,"identity":"25fcd1bf-a640-42e6-a5be-02692d8ac7e9","added_by":"auto","created_at":"2024-01-11 16:25:50","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":33237,"visible":true,"origin":"","legend":"\u003cp\u003eThe proposed novel single-arm single-port micro-traumatic laparoscopic surgery robot system where the surgeon console, the vision cart and the patient cart are listed from left to right\u003c/p\u003e","description":"","filename":"fig1..jpg","url":"https://assets-eu.researchsquare.com/files/rs-3847825/v1/0f7a6af8882a6ea644de9aab.jpg"},{"id":49486018,"identity":"4e36069e-52c3-431c-ba51-8a9e2e3c31f0","added_by":"auto","created_at":"2024-01-11 16:17:50","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":26306,"visible":true,"origin":"","legend":"\u003cp\u003eThe remote center of motion (RCM) and the position adjust joints where the red arrow and the blue arrow denote the directions of the prismatic joints placed at the corresponding links, the green arrow denotes the direction of the rotation joint, the black dash-dotted lines denote the axes of the suspension joint, the large C-shape arm and the small C-shape arm, respectively. The three axes intersects at the same point that is known as the RCM.① large C-shape arm，②small C-shape arm，③suspension joint，④fixed point\u003c/p\u003e","description":"","filename":"fig2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-3847825/v1/ba05d3127bb86691aceec7e1.jpg"},{"id":49486019,"identity":"38adfa15-c6dc-4b67-8ad5-d055004ade6b","added_by":"auto","created_at":"2024-01-11 16:17:50","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":11800,"visible":true,"origin":"","legend":"\u003cp\u003eThe motion illustration of the robotic instrument a) zero position b) movement of the parallel joint c) movement of the parallel joint, the pitch joint, the yaw joint and the roll joint.① parallel joint②the yaw joint ③ roll joint.\u003c/p\u003e","description":"","filename":"fig3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-3847825/v1/2b20d2bba845fedfb817d741.jpg"},{"id":49485021,"identity":"dd3aedbd-a32f-4ac4-88d6-eac9b7f9e980","added_by":"auto","created_at":"2024-01-11 16:09:51","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":11406,"visible":true,"origin":"","legend":"\u003cp\u003eFigures of the endoscopes a) the flexible endoscope at zero postion b) movement of the flexible endoscope c) 30 degree rigid endoscope. ① parallel joint ②the yaw joint\u003c/p\u003e","description":"","filename":"fig4.jpg","url":"https://assets-eu.researchsquare.com/files/rs-3847825/v1/216ef71b5854ae05d9988a84.jpg"},{"id":49486021,"identity":"ea8d8668-0ae4-4c8e-b90d-0baeb29666bc","added_by":"auto","created_at":"2024-01-11 16:17:51","extension":"jpg","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":48204,"visible":true,"origin":"","legend":"\u003cp\u003eThe configuration example of the robotic instruments in the single-port surgery when using the rigid endoscope\u003c/p\u003e","description":"","filename":"fig5.jpg","url":"https://assets-eu.researchsquare.com/files/rs-3847825/v1/4629a22c8e238aea334a4800.jpg"},{"id":49485022,"identity":"242887c2-509a-4659-aa4b-cb1bd739d887","added_by":"auto","created_at":"2024-01-11 16:09:51","extension":"jpg","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":37054,"visible":true,"origin":"","legend":"\u003cp\u003ea) The positioning error point cloud derived by the standard four-parameters kinematics model b) The positioning error point cloud derived by the proposed nonlinear parameter kinematics model\u003c/p\u003e","description":"","filename":"fig6.jpg","url":"https://assets-eu.researchsquare.com/files/rs-3847825/v1/474546fd108b24fadc8cd039.jpg"},{"id":49485018,"identity":"3db61be3-e39a-4506-adff-1ae91d94bfe2","added_by":"auto","created_at":"2024-01-11 16:09:50","extension":"jpg","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":88274,"visible":true,"origin":"","legend":"\u003cp\u003ea) The proposed single-arm single-port micro-traumatic laparoscopic surgery robot system during the cholecystectomy b) An example of the surgical incision after suture\u003c/p\u003e","description":"","filename":"fig7.jpg","url":"https://assets-eu.researchsquare.com/files/rs-3847825/v1/c73af05d0c1b143f617f008b.jpg"},{"id":49485016,"identity":"3d59c26e-ba1b-40f9-924a-269c0d45786d","added_by":"auto","created_at":"2024-01-11 16:09:50","extension":"jpg","order_by":8,"title":"Figure 8","display":"","copyAsset":false,"role":"figure","size":17173,"visible":true,"origin":"","legend":"\u003cp\u003eThe statistics of the surgery\u003c/p\u003e","description":"","filename":"fig8.jpg","url":"https://assets-eu.researchsquare.com/files/rs-3847825/v1/d62355f5ea31cd4df003d634.jpg"},{"id":51503968,"identity":"1b768568-406d-4f92-9a95-2c97873c97fc","added_by":"auto","created_at":"2024-02-22 18:16:41","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":522186,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3847825/v1/eac6b5ed-49b5-4bbc-9660-31f59246a5eb.pdf"},{"id":49485025,"identity":"0aa0a078-49f0-4cfa-aafe-5fd9aabc42c3","added_by":"auto","created_at":"2024-01-11 16:09:53","extension":"zip","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":42680509,"visible":true,"origin":"","legend":"","description":"","filename":"WeChat20231013155235.zip","url":"https://assets-eu.researchsquare.com/files/rs-3847825/v1/56f0594ab1f06ebcfdc955ef.zip"}],"financialInterests":"No competing interests reported.","formattedTitle":"A new type of single-arm single-port micro-trauma laparoscopic surgery robot","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eMicro-traumatic surgery gradually emerged in the 1980s. Compared with traditional surgery, this operation only requires a few small incisions and inserting endoscopy and laparoscopic surgery tools in the incision. The surgery has the advantages of fast recovery, less bleeding during the operation, and reduced postoperative complications [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. However, micro-traumatic surgery has high requirements, increasing learning costs and surgical risks. To this end, the use of robotic remote operations in surgery came into being. In 1999, the da Vinci porous surgical robot IS1000 developed by the Intuitive Surgical company was launched[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Following its successful commercialization, the advantages of single-hole surgery due to small trauma, less blood loss, and fast recovery have become the direction of the new era surgery [\u003cspan additionalcitationids=\"CR4 CR5\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eEarly single-hole robots mainly adopted a multi-arm single-hole form [\u003cspan additionalcitationids=\"CR8 CR9\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. The surgery is generally based on the da Vinci Si or Xi systems. Through the \"chopsticks method\" device layout, single-port robotic surgery is performed using a single-port puncture. However, there are many shortcomings in this solution: ① The insertion angle of the instrument restricts the scope of activity of the wrist joints. ② The crowded layout of the multi-arm increases the possibility of collision between arms reducing the safety and fluency of surgery. ③ The multi-arm expansion in a single hole demands large space, and it is difficult for assistant doctors to perform auxiliary operations. The da Vinci single-site surgery system solves the above problems to a certain extent. In this system, the number of operating arms is reduced to three, and a single-port surgery is performed in the puncture [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. The biggest feature of the puncture is the curved structure that enhances the wrist joints by inserting the special semi-rigid device. However, removing one operating arm can alleviate the problem of collision between operation arms and make it easier for assistant doctors to operate. However, it is limited to available surgery. At the same time, although the introduction of the semi-rigid equipment relieves the limitation of the wrist joints, it reduces the overall stiffness of the equipment and reduces accuracy during the operation. To address the above problems, a single-arm and single-port deployment scheme is needed, as shown in the da Vinci single-port (SP) system. This system is equipped with elbow and wrist joints, and four armored arms, with a targeted design of a SP surgery. Robotics SP surgery is gradually developing from multi-arm SP to single-arm SP system[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn addition to high prices, there are many shortcomings in the da Vinci SP system[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e] ① Adjusting the arm through the wire transmission structure; it is necessary to regularly disassemble and maintain it to prevent the loosening of the wire transmission structure. ② The endoscope uses a flexible design and does not support rigid endoscopes. After disinfecting, it can only be used dozens of times, which further increases the cost. ③ If one of the arms needs to be replaced during the operation, the entire machine needs to be withdrawn.\u003c/p\u003e \u003cp\u003eTherefore, we designed a novel single-arm SP micro-trauma laparoscopy robot system and applied it to clinical abdominal surgery.\u003c/p\u003e"},{"header":"2. Materials and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 A new type of single-arm single-port robot system\u003c/h2\u003e \u003cp\u003eWith the gradual increase in the demand for SP robot surgery, Chinese single-arm SP surgery robots with independent intellectual property rights need to be developed considering the above problems. We designed a new type of single-arm SP micro-traumatic laparoscopic robot system, which achieved a motionless point through the C-shaped arm to avoid frequent disassembly maintenance. In addition to a flexible endoscope, rigid endoscopes are also supported, which significantly reduces the cost of equipment consumables. On the control system, high-precision control was achieved by correcting the control parameters of the device. The external force of the device is estimated through the motor output torque. The feedback force function of the robotic arm is achieved by combining the power feedback and with motion speed of the equipment.\u003c/p\u003e \u003cp\u003eThe new single-arm SP micro-traumatic laparoscopic robot system consists of a doctor's console, image trolley, and patient\u0026lsquo;s trolley, as shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. During surgery, the surgeon uses the image transmitted by the image trolley to control the equipment of the patient's trolley by remotely operating the main control arm of the doctor's console.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe doctor\u0026rsquo;s console is the control center of the endoscopic surgery system. It is mainly composed of the main arm control, pedal switch, and three-dimensional monitor. The doctor's console is equipped with two main control arms, which respectively receive the operator's left and right operating signals. During the operation, the surgeon sat outside the sterile area and controlled the instrument arm, surgical equipment, and three-dimensional electronic bending endoscopes using the controllers at the end of the main arm. The pedal switch installed on the trolley can help the surgeon complete the operation and control of electrical surgical equipment such as electrical cutting and coagulation. The surgeon uses the three-dimensional monitor to observe the focus and surgical equipment in the patient's body. The surgeon observes the images in the three-dimensional monitors through the mirror of the two windows. The three-dimensional monitor is designed with the principle of three-dimensional imaging to make the light path so that the surgeon has a three-dimensional view by observing the two observations on the window.\u003c/p\u003e \u003cp\u003eThe image trolley transmits the image collected by the three-dimensional electronic endoscopy to the three-dimensional imaging instrument of the doctor's console, so that the surgeon can see the three-dimensional images in the patient during surgery, and the image will also be on the top of the image trolley. The above shows that it is convenient for the assistant to check the endoscopic image.\u003c/p\u003e \u003cp\u003eThe patient's trolley is a direct operating subsystem of the patient's surgical bed. With four parallel arms arranged, one arm must use endoscopy, and the other three arms can use different surgical equipment. The four equipment arms can be adjusted through the adjusting arm. The arm has six degrees of. Among them, the three degrees of freedom away from the base are rotating freedom. The three-axis axis coincides with no moving point. Three degrees of freedom near the base can adjust the position of no moving point.\u003c/p\u003e \u003cp\u003eThe main difference between the new single-arm single-hole minimally invasive surgical robot system and the multi-arm single-hole surgery robot system (such as the surgical robot of Beijing Morika Robot Co., Ltd.) is in adjusting the arm part. Our single-arm single-hole minimally invasive surgical robot system is achieved through large and small C-shaped arms. The adjustment arm of the multi-arm single-hole surgery robot system is a separate robotic arm.\u003c/p\u003e \u003cdiv id=\"Sec4\" class=\"Section3\"\u003e \u003ch2\u003e2.1.1. Adjusting arm\u003c/h2\u003e \u003cp\u003eThe four operating arms of the new single-arm SP micro-traumatic laparoscopic operating machine system are mounted on a smaller C-shaped arm (referred to as small C). Small C is mounted on a large C-shaped arm (referred to as Big C). Big C is connected to the trolley through a rotary joint, which is called a suspension joint. The suspension joint, big C, and small C axes intersect at one point. This point is called no moving point, as shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. The position of the non-moving point is controlled by the three joints of the adjustment of the arm. The height of the non-moving point is adjusted by the red telescopic joint (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The position of the non-moving point is determined by the green rotation and the blue telescopic joints (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Before surgery, the position of the teaching operation can be used and the position can be moved to re-coincide with the puncture point. After connecting the puncturer with the patient's trolley, surgery can start. During operation, the position of the joint is fixed. The positions of the suspension, the large C, and the small C joints can change the overall orientation of the four arms and adjust the operation space. It is worth noting that compared to the da Vinci SP system, the method of using the wire entanglement driver, this system realizes mechanical motionless points through big C and small C. This system has higher rigidity and more reliable mechanical transmission methods. It effectively avoids the disadvantages of driving wires that need to be disassembled and maintained, and achieves an improved mechanical structure.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section3\"\u003e \u003ch2\u003e2.1.2 Equipment\u003c/h2\u003e \u003cp\u003eThe equipment has 5\u0026thinsp;+\u0026thinsp;1 degrees of freedom, as shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e, and is equipped with elbow and wrist joints. The elbow joints are realized by parallel joints of two degrees of freedom. The parallel joints of the device can expand after the stretch of the puncture. This can avoid the lack of linear vision and equipment in the SP surgery, as shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e (b). By controlling the parallel, pitch bias, and rotation joints with the overall movement of the operating arm slide rail along the operating arm slide rails, control with six degrees of freedom at the end of the equipment can be achieved. In addition to special equipment, open and closing joints are generally equipped at the end. The single-arm and SP surgical robot system we designed also supports the use of rigid endoscopes in addition to the use of conventional flexible endoscopes. The flexible endoscope is used to adjust the field of vision through the mainstay during the operation. The elbow joint is implemented by parallel joints of two degrees of freedom, as shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e (a) and Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e (b). Relying on the characteristics of a large-scale flexible motion of the equipment, this system supports the use of 30\u0026deg; rigid endoscopy to complete the surgery. The rigid endoscope is shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e (c), and the position of the operation is shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e. In the da Vinci SP system, due to the small angle of joint development, it only supports the use of wire transmission flexible endoscopy to avoid vision blocking during surgery. Due to the use of wire transmission, the number of allowable times will be significantly lower than those of rigid endoscopes, resulting in increased surgical costs. This system can adjust the field of vision through the movement of flexible endoscopes. When using rigid endoscopes, the field of vision can be adjusted by suspending joints, large C, and small C. There is no need to remove the entire machine to replace one of the arms during surgery. The change is done from the back end, without affecting the surgery process.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.2. Control system\u003c/h2\u003e \u003cp\u003eThere are three main links in the figure: First, exercise control links: Doctors manipulate the main control arm. Motor information at the main control of the arm is maximized by proportional mapping to obtain the amount of motion control at the end of the instrument. Therefore, the main control of the remote operation is controlled; The second is the force feedback link: The device obtains the virtual feedback power of the main control of the arm through the feedback module. Based on the principle of virtual skills, the main control arm of the joint output torque is equivalent to achieve the force feedback of the equipment; The third is the image link: The doctor receives a high-definition three-dimensional image transmitted from the endoscope in real time. In the motion control link, the high-precision control of the device is achieved by introducing non-linear correction quantities. In the force feedback link, the protection technology is achieved by introducing the multi-mode simulation mechanism.\u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003e2.2.1 Equipment high-precision control\u003c/h2\u003e \u003cp\u003eIn the motion modeling of the equipment, the four-parameter joint modeling method is usually used. That is, to describe the geometric position relationship of the rods through the axis corner bias α, rod long A, axis position bias D, and corner θ. However, in this modeling method, the parameters are often considered constant and determined by design value. In this system, the parameters are assumed to be the non-linear amount of corner and the non-linear correction quantity is pre-made through design parameters. Its coordinate conversion matrix is ​​shown in the formula.\u003c/p\u003e \u003cp\u003e\u003cimg 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Fuj65S9/uXnXu941R4hsw4OtiNTHSxh4bCM54RPpgx0vfvGLm4ceekjF2tDX4+MUiogZYsfXug0QyamhSH5rxI5SNM4FTweNCBpi0KrAEzsyyrfnOIiVouRk/KJhidhVH+1ZIrIDP2V83A+AqocwyvP2YGs0cbGyyNjJgNqI0r1+lPU2SV6hbUtpXi8fp1wk19e+knxXunSrhREuyETpq8JrUbsjnVala+Qf+dGSEP1PcWHrZWWfJaFIDnkNlKpLYSld+asMsRMb0JcxiZW7VsLoQZ6IO4rTL5Rv9fIkRR7YaMWudnl+hMH87rvvbuupyfGzQjv5sG1q8mW3e8kvpVvZdZ1DTODm8QWzCE+Pd4Tvb3/724b72k8//fRMbY8tdQ/BlgkB2JZWx2DodwBonHZf/vKX7/ktvV15CwN469SpUy3vYb98be+xW7lF9NkasXPx0HjfA8dyEeiwcc7pCBxD61V9pTAidl2MOJn2WLlLN/SQLtQZxdE3OqwdyqfDiKRxsJ1EqAx62NUxOlFO7SAH1irH8wqc2/q6bFI7Cmt6qi4uqAcffLAdrJCtyVl91JZC6S6ca+nK7xNuG68hdq9T1y7/QOQlv4Kxl1W/RQ77ICHvO+TwK9vQPq+U3sefi5Q5efJkc+jQodkCg2d/ICH00gNMEGUt7tumPPZpgmNtZjFz5MiR5pFHHmnx4RpWuUgO2WPHjrX6sFMY3a+mDH3E3wbpSidv3QdEZvHFbmyF7Ibg6ydPPEz2ox/9aDapUr+x2ELSYGtXv/hEcdneF1ttpUuO8MYbb2w+85nPzPRQHvowEcBG7rPznMr555/f+l2+BoNl9bH34ml7a8TOhW+3sAVEKWTgoLP7A+BwGvnrOCJiZxDgfop2GRgE0AP9lMZ5Le71pTy2UJc9IGLq5WKO7utzIfv78ODLhAM5Zq2q06bb2wglm6weOo/0lB9oDzweffTRdnJh7YnkqLNmH2UiG7vSpWvf0OKyCbzQa1G716Vr5B/8yqBj/QpJ41cNTNgiWZvW176xkVDfPtOnHPixparVfx8Zyiwqh6xWgJ4ES+l9dRpjOV7687rXva45c+ZMb/Usth6jWiURhrzO9q1vfetsjK3V4fPRJ/oduy8XxaWPXe1TbmvEzkDAYFEjZIxmoKWsBhdrYGnAt2U4pxyrWNUThZEuEbH7ulcVx9bod+y1+tHb7hLUyi+bv6iei8qhb8nGUvqyNq5Sfh12r1I/1bWMnshCYFzXQw75zw+wpfQhdY+lLBMxJkerevNcl11qy98qKaV31TWVPLbk4Yjvf//7e1bMJRuExxCfSEb376n79ttvbz7ykY80f/vb30pN9Upn631oH5GM1UeNbY3YpcCyIWBrq3rZuiL5TRI77WMPqyG2L/scKs/EZZOH2u2rp3RbRE4y3sZSutoaUyhdh+AlGW/3Ou1Sm0P0lD5DZVU+IiGuAZ+udqYYgicPObHj5icxXfYMkWP1plsIts5Sui2zC+d2t6iPPcK2dEvD1lHCcGibtk5/vgp9VOfkiZ2Zvd3ulWGrCjdN7OiNg5mBRtvu1i5s120Am76p8756en2GyJVsLKX7tsYUX4Xdm7BniJ5en76yJf+V0n07GU8EEoEyApMjdmb5kJkOtqAZDGrHFLbiazZkfiKQCCQCiUAiUENgcsRuDRJZ9yF2KzfkfBsr9iH6ZdlEIBFIBBKBRMAiMCliZ7XOA3CEPKzDFjwPwfF0N2nrOJLY14Fq1pkIJAKJQCKwLgQmReyAgMKbfJgoiX1dXS/rTQQSgUQgEVgHApMidggdhTd5JLFvEu1sKxFIBBKBRGBZBCZF7Gy3D3mpzbLgIJ/EvgoUs45EIBFIBBKBTSEwKWLv+1KbVYKXxL5KNLOuRCARSAQSgXUjMCliXzcYUf1J7BEqmZYIJAKJwGYQeOaZZzbTkGllG22a5pc+TWKvQLgosff9fX1X89HLPrgVwa8A7HveF3mpx7r067JHeZFd5A2xbRGb1f62wlXY3aX7sj4t6dfVpvJKst6nJb+V0lX/roTgtMo30B0/frw577zz2vFA35AvvSWtlD5WbH/zm98073//+5uf/vSnC72tz79Rri9W//3vf5trr722+eIXv9g8++yzveEBX33sxb5dUD5fVJ/eCpiCSewGjOh0W8TO8wT+1bIMfnrLHvn2VbrEh3yudlkSiPSL8PNpJblFbBtqs9dlk/FV2l3SexmflvQrtWXTS7LyKa/dpIw+Vco5fdW/jrOUbtua8jn2DX0fOPaW5CASxgOPr2Tst9uFG3VF6cofS/i73/2u/dzq3//+90EqdWEF9nzRjTL0Rb1jvYQJE6WjR482/gMrJYX4Cbb/pKve5+7fSY/vSvogg4/81+dK7UbpSewRKiZtUWI3VQw+jT7GQeezRM4vBPwX3bTqGdzgQIFIvz5VlOSWsW1TNvexr1RmHXaX2lokvaRfn7qQjT7+Ip/qfe/0V/sVN/nNrmxor5TeR5cxlxFOq/rKG/hqooTdHl/StEL3GJfSx4IfK+ZXvOIVDSv2IYfF2NosrETkYOU/vRphQh2XX355873vfa/XjgH18hlZtYM+0VfbIG47sbD6SG/p03dS4XFKYveIuHiN2LXVqBfl8ICfHvJjBcVh4yrPJ1VxaHRQXitz5TPg8adDA6etg3O+gW7T1N669ZNevN9etwqww+oZ2YXcorYhG9ksXYaEXIT2K4L4jjTq1+dvwdC+zjjCNmpz1XZH7dIG+i3S50r6YUvJnyJsyfrVd+RTT0SHDx/e86EX8I7SI1xXnYa/2SYHR2GJXeh0ySWXzNLpAxqAtb1Lefp9ibjBiRWax+nEiROzrXRkRUIW30iOgR+MpYeXA5sSlqX0oXgKL31P/eqrr27t83jx7XXpGeGlPLX/4x//uHn9618frpS78CphXMJKBNyF1b333tu87W1vC3VBzuqD/exEaaVd+s6618cTvfSxkwRh0zdMYq8g1UXsIi1COjmDKp2Lg4tOg6ziEITKQtyUiQ4vS92U14Cj0JO/ykmHTeknG2iXwY12ubivuuqq9pvjstPbhZx0lk0Ka7apTcnLZqUPCVWH9ITMaP+JJ55oQ6VjF28+pK0ubH3bq7S7q13fDvE+fc7LSX/584EHHgj9SblIFjwhI/lSIZiK2FTG+62ULp3WFapd7IFo1Afox9iidPDne/SWhMEHeSaG3h7py2DOeGBJjLLcHxe+EAPfsFdbyEZy0lW4KrT4Iqty6GrbLaVL1z6h6pCuEBw4DcXL60bbN9xwQ/PRj350TmfSIcouvEpYsT0ujBSClQiYurHHb6OT/qc//al50Yte1Pz73/8mOndIn9OnT7fp+N/6WPrYVbfa0WRI+kDiffSZU6AjksTeAQ5ZXcROJ2agZxDwBx3eE7uNc06Z6PB5tOO33Slj61M9VnZT+tE2HZaLRTYRZ/ZKZ+ecw+omfRe1TfKlem1+7VxkiS72iNLl1y5sbR2cr9Lurnalm9r38UiPkn6RP9lyt/4syaIjq3Pw0+EHPdJJU39Rua50W2bV5+hqdxRUf5SuAZtVNSTPQ1G1Q7aKYMHXThiIC19NfqjTy5EmfJkQ6IjwLcl3pau+WhjhgkyUHuElHKJ23vnOdzZf+MIX5ohdeN16661teoRXCSu/7T4Eq6effrol9kcffXROVdpnIiB9yKReO1Gp6SMM2CXi2rQTAOojnetD5eYUqESS2CsAdRE7onRkVkX2KXXS/aDq46VBFlmfRxv+/rpWjl79SHbd+gkHqyMdH6K3KxivWyQn4rJysjGSJ6+ULrla6PFV+Sjd+rHke8krjPTzdQ+xu9Su1Y22fTzSg3JRuvTTlrAGVu+XPrLYBgF6WQ18wklhKV356wixdyixM+AixzY917+eSo/0k00apH17whdisIeXI8/LCl8vS9lIvivdtt117nVQ2ShdxN4XLwjzK1/5yhyh+XotXsI0slVy2nYHqwMHDswRsHSP5Kn7JS95SfPLX/5SxdowqjeaQHANSj8E/bZ7lz5J7HOQrzZSI3a1hqMt2fpB1cejAVF1+Tzqtk+8M0DSFp3CH15W+evUjza8Tj5OmUi3VdgW1Su7+4ToYCclkonSvR8p67GVvMJIv1XY7dv1uvl4pAc6Runyn4jdx/vYppVnSVYDqepSWEpX/jpCsFyE2KUL8tqiV5oNZZMGeTChvMXXxiXr5UinLVb3Ft9IlrKRfFe62q2Fq8RLmKhNdP70pz89R4hse2OjCNrHSzZ5rCI52y7XjNUHjNmKf/zxx1WsDX09Pl7Sxz/xHsmpoSR2IbGGsIvYuTgZFJk9QrKsjEnjIJ0/HVGcThQdfkCmc4p4+E2knUBYefSwq+RN6YcOVke1y4N8Dz74YHP33Xe3anq7vNwQ22S3t1npQ0J8B6byB3qwlaW6ue/JudVPNpLufe/bXqXdXe1Gfcz3QdlodezSD+JRm96f1FGTBTMGZOqwB7ixFd033cqu4xwfoif2MLCrDzCwoyd9gHPZw+pYuJCOPCv3aNWMvnbVStwSo+oBXwZ+rheRi5fzslYfj4swRifVR5lSupfvigsvbUWjx8c//vEWoy68IG2Pl9WNNj/5yU8211xzzZzOHi/q8Xh1YcWEAB1Lq3Uwie6xP/zww825557bsCVvD+lDvZAz+jD2njp1qu0X2CR97Ba7XbEvoo/Voes8t+K70KncYz958mRz8ODB2YMZPC1LB+FC1UMRnNfiXgXK00moSwcDC3Wy5Rfd06ccFxsTADodxyb1Q1d0Rkdw4J4UZGntiOxCz0Vsaw0MbFb60BDMmJihPxepsLfp9nZLCduo3VXaXWq31sd8vtUz0i/yJ8SHPxmYdUjWppFX8yl9lRWyvU+MXCld7a0zxNd6+l0ERHs23W6544tDhw7NrnX6vcdB+oIThKd88CVOf+Op8UceeaSdWET4WjnVd+zYsfZlKOjjX3yiMiUsS+mS6xtaXJhAyjabbvGC9Cxe2C0Z2ya/+b7gggvmyLQPXhDsMlj5rXR0+vznP9988IMfnJtkkI4+TAT0Qhr68fnnn9/6UjZJH/tQHLJ9fYc+PJjnJz4Wq9J5EnsJmf+n33fffe3Fd+bMmUrJ1WXTadh6ZzAYckSrpyHyfcsuqt+icuhVsq2U3teWTZRbh92r1HsZ/ZCNfsde009+84NWKb1W39jzhVNpRV/Sf1E56tOK0WNcSi/psI30d7/73c3Xvva1QaRmsfI212yIMPnHP/7RvPKVr2weeuihmniYjz7R79jDwi5R+tjVvivSGU1i74Snae65556NEzsqMetl9s52TZ9D5ZmNb+JQe331k06LyEnG21ZKV1tjCqXrELwk4+1eh11qa4h+0mOorMrr/rKvx6crf+ohdrOi9G8hq9m1iJxkPJal9JoOm85n1cuK+Ac/+MGep8W7dJF9QzCWjMWKhdyVV14521bvarMrj633oT6XjJ4n6Kq/lJfEXkLm/+nbInaaZ5BlS7C09S7VWeXoNoDSNhH21c/rMkSuZFsp3bc1pvgq7F6nPUP083r0lS35rZTu25l6HJx4KIpresiqcogcq73otkApfayYPvXUU81Xv/rV5ic/+clCWJVuUVh7I0xYJd98882DJ2C2Xnsu3y2qj62r73kSewWpbRJ7RbXMTgQSgUQgEUgE9iCQxL4HkvmEJPZ5PDKWCCQCiUAiMG4Ektgr/klirwCU2YlAIpAIJAKjQiCJveKOJPYKQJmdCCQCiUAiMCoEktgr7thlYucBG/02ni+G5TFtBNKf0/LfddddN/stetfraKdl1Xi15UM1XCNDHlocrzXdmiWxd+OztZ+7VdRaOpunkPXyGH7uwYskhv5ufmklsoKVIZD+XBmUG6mIp7H1MhquP75aNvQ37htRdEcaAW9eJsMX9JLY9zr1rL1Ju52yiyt2XpzAoAIZ6PCvI1V6huNHIP05fh9ZDfEXv23m+hPJ8LNWrkHFbfk8Xw4BSJ03wxHuF4xzxV7pMzPoq1oAAAHhSURBVLtI7LzwxL9v3q74KpBk9sgQSH+OzCEVdfAXr+e1K3S7gq+IZ/aCCCSxl4HLFXsZm8nksPUHsRPqSGIXEtML05/T8hn+gtjte/KT2NfvwyT2MsZJ7GVsJpOTRDAZV/VSNP3ZC6bRFEpi344rktjLuCexl7GZTE5u3U7GVb0UTX/2gmk0hXIrfjuuSGIv457EXsZmMjn5sNVkXNVL0fRnL5hGUygfntuOK5LYy7gnsZexmVQO99T5/jirh2grd1LGpLLtE9bpz+l0BEgGf/FFsWhrfjqWTEfTJPayr/YtsfMJvWeffbb9K8MznRxWDfzERi+oqX1BbjqW7U9N05/T8jv+4itvuv76fPlrWhaOR9vjx483hw4darEW3keOHNm5nxbyU0lx1Mc+9rHmwgsv7O2EfUfsp0+fbo4ePTr7u+OOO3qDlQUTgUQgEUgEEoFNIPDYY481119//Yyrbrnllt7N7jti741MFkwEEoFEIBFIBCaIQBL7BJ2WKicCiUAikAgkAiUEkthLyGR6IpAIJAKJQCIwQQSS2CfotFQ5EUgEEoFEIBEoIZDEXkIm0xOBRCARSAQSgQkikMQ+QaelyolAIpAIJAKJQAmBJPYSMpmeCCQCiUAikAhMEIH/AcAHV+/x0GC6AAAAAElFTkSuQmCC\" width=\"502\" height=\"91\"\u003e\u003c/p\u003e \u003cp\u003eTo analyze the advantages of this modeling method in theory, assuming that the long design value of the rod is L, the long measurement value of the rod long measuring value is uniformly distributed in the interval of (1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5%) L, and the joint angle is obeyed by the uniform distribution of the maximum mobilized range. The actual value and joint corner data of 10,000 sets of poles and joint angle data were randomly generated using the Monte Carlo method, and the error distribution was obtained as shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e6\u003c/span\u003e. For each group of randomly generated rod long measurement values ​​and joint angle data, the end reference point can be calculated based on the position of different sports models; in the same way, based on the long design value of the rod, the theoretical location of the terminal reference point can be calculated. By calculating the error of the position of the end reference point and the reasoning position, the positioning error at the theoretical position of the reference point of the terminal can be obtained. The position of the point cloud position is the theoretical location of the end reference point in Fig.\u0026nbsp;\u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e6\u003c/span\u003e (a). The point cloud color is the positioning error obtained by using the standard four-parameter joint model. In Fig.\u0026nbsp;\u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e6\u003c/span\u003e (b), the point cloud position is consistent with Fig.\u0026nbsp;\u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e6\u003c/span\u003e (a). The difference is that the point cloud color is a positioning error obtained by the model modeling of non-linear parameters. The blue color indicates that the positioning error is small, and the yellow color indicates a large position error. It can be seen from the distribution of point cloud positioning errors that the non-linear parameter modeling method has a smaller global positioning error, which theoretically reflects the advantages of the modeling method. After the analysis of the results of the obtained point, the statistics of the two methods were obtained as shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The method of sports modeling used was theoretically compared to the traditional modeling method, the absolute positioning accuracy of the absolute positioning was approximately 0.58 mm, the lifting rate was approximately 78.0%, and the positioning error had a very low standard difference.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe mean positioning error and the standard positioning error deviation derived by different kinematics models\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSports model\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAn average value of error(mm)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStandard deviation(mm)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStandard four parameters\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.7463\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.3836\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon -linear parameters proposed in this article\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.1644\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.0833\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003e2.2.2 Force feedback protection technology\u003c/h2\u003e \u003cp\u003eThe feedback control of the system means that based on remote operation control, the information of the surgical device is used to feedback the information of the surgical equipment through the force to achieve multi-dimensional perception synchronization.\u003c/p\u003e \u003cp\u003eThe force feedback module implements two functions: First, when the equipment is connected to the near-hardware boundary, the force feedback module will calculate the frictional power of the equipment at the end of the equipment. Second, when the equipment is not at the boundary and is accurately static, the force feedback module calculates the actual contact force at the end of the equipment. Calculation principles [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]:\u003c/p\u003e \u003cp\u003e\u003cimg src=\"data:image/png;base64,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\"\u003e\u003cbr\u003e\u003c/p\u003e \u003cp\u003ewhere QS is the joint location of the patient's platform, τ is the torque of the joint, J is the elegant matrix of the system, f is the contact force at the end of the equipment, M is the quality matrix, C is the Kelai matrix, G is a heavy force vector, and F is the interference item.\u003c/p\u003e \u003cp\u003eWhen the system is accurately static, \u003cimg width=\"99\" src=\"data:image/png;base64,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\" alt=\"image\" height=\"16\"\u003e. Assuming that interference can be ignored, \u003cimg src=\"data:image/png;base64,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\" alt=\"image\" width=\"122\" height=\"20\"\u003e\u003c/p\u003e\u003cp\u003eThat is, the contact force of the equipment can be obtained through the recognition of gravity and interference items.\u003c/p\u003e \u003cp\u003eThrough the above methods, the stress at the end of the two functions can be calculated. After the output is out of the control output module, the device ending signal can obtain the end feedback of the control arm after filtering and gain scaling of the force signal. Based on the principle of virtual skills, the joint control torque of the main control arm can be obtained, and the power feedback can be achieved.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e2.3. Patients And Methods\u003c/h2\u003e \u003cdiv id=\"Sec10\" class=\"Section3\"\u003e \u003ch2\u003e2.3.1. Patients\u003c/h2\u003e \u003cp\u003eWe reviewed our general surgery database at the Beijing Friendship Hospital (Beijing, China) for patients with benign diseases of gallbladder. Between February 2022 and March 2022, a total of 10 patients underwent curative single-arm SP robot-assisted cholecystectomy. The study protocol was approved by the Institutional Ethics Committee.\u003c/p\u003e \u003cp\u003eThe inclusion criteria for robotic cholecystectomy were as follows:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e18 years old\u0026thinsp;\u0026le;\u0026thinsp;age\u0026thinsp;\u0026le;\u0026thinsp;80 years old\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eBenign diseases of gallbladder, including gallbladder stones, gallbladder polyps-like lesions, gallbladder adenocia, etc.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eThose who accepted laparoscopic surgery in physiological conditions.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003ePatients willing to cooperate and complete research follow-up and related examinations.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003ePatients willing to participate in this test and sign consent.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003eThe exclusion criteria:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eWomen in pregnancy or lactation.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003ePatients with malignant tumors.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eAbnormal coagulation function.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eSevere cardiovascular or circulation system diseases that cannot tolerate surgery.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eHaving participated in other clinical trials in the past month.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eUnable to understand the test requirements or complete the research follow-up plan.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eOther situations that researchers believe are not suitable for entering the group.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003eRoutine preoperative evaluations consisted of abdominal contrast-enhanced computed tomography, electrocardiogram, cardiac evaluation, and arterial blood gas analysis (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eGeneral patient status (n\u0026thinsp;=\u0026thinsp;10)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eData\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (y)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47\u0026thinsp;\u0026plusmn;\u0026thinsp;16.19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender (male/female)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6/4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeight (kg)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69.2\u0026thinsp;\u0026plusmn;\u0026thinsp;14.17\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlood albumin level (g/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHemoglobin level (g/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e141.3\u0026thinsp;\u0026plusmn;\u0026thinsp;14.69\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAverage length of hospital stay after the operation(d)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section3\"\u003e \u003ch2\u003e2.3.2. Surgical technique\u003c/h2\u003e \u003cp\u003eBody position and anesthesia: After single-lumen endotracheal intubation under general anesthesia, the patient was placed in a flat position (Fig.\u0026nbsp;\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e7\u003c/span\u003e). The abdominal cavity was entered through the umbilicus. The postoperative incision was sutured as shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e7\u003c/span\u003e (b).\u003c/p\u003e\u003cp\u003eCholecystectomy: The cholecystectomy procedure was as shown in the video(Video 1).\u003c/p\u003e \u003cp\u003ePostoperative care: All patients were awakened in the operating room soon after the surgery and transferred to the unit. Discharge was approved when the patient recovered well, with no infection.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section3\"\u003e \u003ch2\u003e2.3.3. Statistical analysis\u003c/h2\u003e \u003cp\u003eContinuous variables were summarized as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation and compared using the two-sample Student\u0026rsquo;s t-test. Categorical data were presented as frequencies and percentages. The chi-square (χ\u003csup\u003e2\u003c/sup\u003e) test or Fisher\u0026rsquo;s exact test was used to compare the distributions of categorical variables between groups. A two-sided p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant. All statistical analyses were performed using the IBM SPSS Statistics for Windows, version 25.0 (IBM Corporation).\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e3.1. Baseline characteristics\u003c/h2\u003e \u003cp\u003eThe baseline characteristics of the 10 patients who underwent cholecystectomy using the single-arm SP micro-trauma laparoscopic surgery robot are summarized in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e3.2. Intraoperative characteristics\u003c/h2\u003e \u003cp\u003eAll 10 patients underwent cholecystectomy using the single-arm SP micro-trauma laparoscopic surgery robot with no conversion to large incision surgery. The mean total surgical duration was 32.6\u0026thinsp;\u0026plusmn;\u0026thinsp;11.41 min. Intraoperative blood loss was about 5 ml. All patients were extubated at the end of the surgery.\u003c/p\u003e \u003cp\u003eIt can be seen from Fig.\u0026nbsp;11 that the actual resection time in surgery decreased significantly with the number of uses of the robot system. The ninth patient had abdominal adhesions due to a history of abdominal surgery. Therefore, the operation took longer.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e3.3. Histologic type\u003c/h2\u003e \u003cp\u003eThe postoperative pathological diagnosis was gallstone with cholecystitis or gallbladder polyp.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003e3.4. Postoperative outcomes\u003c/h2\u003e \u003cp\u003eThe mean postoperative hospital stay was 2.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.21 days. The overall operative mortality and morbidity rates were 0%. Postoperative recovery at six months was uneventful in all patients.\u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eDuring the operation, a rigid endoscope was used to avoid the replacement of the back lens, which reduced the cost of surgery. The feasibility of a rigid endoscope in a SP system was verified. The surgeon's feedback adjusted the arm position before surgery and it was easy to operate. The equipment positioning during the operation was accurate. The main control arm remote operation was comfortable to control, and the instrument flexibly and freely completed the operation. The perspective adjustment function based on the adjustment of the arm movement was in line with intuitive operation habits and easy to master. After surgery, the wounds and bleeding of patients were significantly lower than with traditional gallbladder resection. They found value in the clinical innovation. It can be seen from Fig.\u0026nbsp;\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e7\u003c/span\u003e that the actual resection time in surgery decreased significantly with the number of surgeries of the robot system. The initial verification of this surgical robot system can speed up the learning curve of surgical operations of the doctors, which plays a positive role in clinical physician training. From Fig.\u0026nbsp;\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e7\u003c/span\u003e, the average surgical resection of 10 clinical surgeries was 32.6 min, and the average bleeding was approximately 5 ml. Lee et al. [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e] found that the average length of the five cases of clinical surgery using the da Vinci single-site system was 53.4 min, with the average bleeding of 20 ml. The single-arm and SP configuration is more suitable for SP surgery, which enhances clinical application value.\u003c/p\u003e \u003cp\u003eBecause of the advantages of small trauma, less blood loss, and fast recovery, SP surgery is widely used in clinical practice. The development of SP laparoscopic robots has received more attention. During the technical iteration, it was transformed from a multi-arm SP configuration to a single-arm SP configuration. This system has the following advantages: ① The unmounted structure is realized through suspension joints, large C joints, and small C joints. It has higher rigidity and reliability. It improves the safety of surgery. It reduces daily maintenance costs. ② Surgical equipment has a larger joint motion angle. In addition to flexible endoscope, it also supports rigid endoscopes, which significantly reduces the cost of surgical consumables. ③This system improves traditional standards for four parameters, and introduces non-linear parameters. Compared with the traditional method of this exercise algorithm, this sports algorithm can greatly improve the absolute positioning accuracy of theory, and ensure high-precision control of surgical equipment. ④ The feedback power is divided into two modes, which is more convenient for the doctors and enhances the \"presence\" of doctors. The above characteristics were fully verified in clinical gallbladder resection.\u003c/p\u003e \u003cp\u003eThe main limitations of this study are the limited number of patients and the single disease. The effectiveness of single-arm single-hole surgery assisted by robot in general surgery needs to be verified by large samples and multiple diseases in the future.\u003c/p\u003e \u003cp\u003eSeveral hospitals have applied our new single-arm SP micro-traumatic laparoscopic robot system, and conducted surgery such as gynecological ovary tumor resection, urological renal cysts, and adrenal and clippy resection. The clinical trials of gynecology and urology are currently underway.\u003c/p\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eThe design of new robots has important clinical application value.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eACKNOWLEDGMENT\u003c/p\u003e\n\u003cp\u003eWe had full control of the study design, methods used, out come measurements, data analysis, and production of the written report. We thank Prof Jiang Fan, Xing Wang, Wei Huang, and Liang Wu for all their help in preparing this work. We would like to thank Editage (www.editage.com) for their linguistic assistance during the preparation of this manuscript.\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eNone.\u003c/p\u003e\n\u003cp\u003eCOMPETING INTERESTS\u003c/p\u003e\n\u003cp\u003eAll authors have no competing interest to declare.\u003c/p\u003e\n\u003cp\u003eDATA AVAILABILITY STATEMENT\u003c/p\u003e\n\u003cp\u003eAll data included in this study are available upon request by contact with the corresponding author.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eCloyd JM. micro-traumatic Surgery for Palliation. Surg Oncol Clin N Am. 2019;28(1):79\u0026ndash;88. doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.soc.2018.07.004\u003c/span\u003e\u003cspan address=\"10.1016/j.soc.2018.07.004\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2018 Oct 23. PMID: 30414683\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLeal Ghezzi T, Campos Corleta O. 30 Years of Robotic Surgery. World J Surg. 2016;40(10):2550-7. doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s00268-016-3543-9\u003c/span\u003e\u003cspan address=\"10.1007/s00268-016-3543-9\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 27177648.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWhite MA, Haber GP, Kaouk JH. Robotic single-site surgery. Curr Opin Urol. 2010;20(1):86\u0026ndash;91. doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1097/MOU.0b013e3283337a10\u003c/span\u003e\u003cspan address=\"10.1097/MOU.0b013e3283337a10\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 19887947.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMoonsamy P, Park B. 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J Urol., 2012, 187(5): 1696\u0026ndash;1701.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGonzalez-Rivas D, Manolache V, Bosinceanu ML, Gallego-Poveda J, Garcia-Perez A, de la Torre M, Turna A, Motas N. Uniportal pure robotic-assisted thoracic surgery-technical aspects, tips and tricks. Ann Transl Med. 2023;11(10):362. doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.21037/atm-22-1866\u003c/span\u003e\u003cspan address=\"10.21037/atm-22-1866\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2022 Jun 24. PMID: 37675313; PMCID: PMC10477623.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKong Yue, Deng Jiarong, Sun Xiaochun, et al. The application status and development of robotic single hole laparoscopy in gynecology [J]. Progress in modern obstetrics and gynecology, 2021, 30(2): 146\u0026ndash;149.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSu Mingxuan, Wang Jiayin, Li Zihan, et al. A novel micro-traumatic laparoscopic surgical robot system [J]. Chinese Journal of Medical Devices, 2019, 43(3): 165\u0026ndash;169.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJIANG N, ZHANG S, GUO D, et al. Experimental study of event-based neural network control on parallel manipulator[J]. Mechatronics, 2021, 75(1): 1\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLEE SH, JUNG MJ, HWANG HK, et al. The first experiences of robotic single-site cholecystectomy in Asia: a potential way to expand minimally-invasive single-site surgery?[J]. Yonsei Med J., 2015, 56(1): 189\u0026ndash;195.\u003c/span\u003e\u003c/li\u003e \u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Single port, Microtrauma, Surgery robot","lastPublishedDoi":"10.21203/rs.3.rs-3847825/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3847825/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eAs the robot-assisted single-port surgery gets more attention, we proposed a novel single-arm single-port micro-traumatic laparoscopic surgery robot system with multiple innovative techniques. From a mechanical perspective, joints with high rigidity and reliability were used to realize the remote center of motion. The cost of consumables was reduced by adding the support of a rigid endoscope. From the algorithm perspective, a high-precision motion control method and feedback-force protection mechanism were implemented. The effectiveness of the aforementioned characteristics was verified by 10 clinical cholecystectomy experiments. The results showed that the system can reduce the amount of bleeding, accelerate patient recovery, reduce infection risk, and shorten the learning period. Other gynecology and urology clinical trials using the new surgery robot are underway. The proposed surgery robot system had significant clinical application value.\u003c/p\u003e","manuscriptTitle":"A new type of single-arm single-port micro-trauma laparoscopic surgery robot","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-11 16:09:46","doi":"10.21203/rs.3.rs-3847825/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5d684a6b-ee43-4723-82de-e14acaf2ec18","owner":[],"postedDate":"January 11th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-02-22T18:16:32+00:00","versionOfRecord":[],"versionCreatedAt":"2024-01-11 16:09:46","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3847825","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3847825","identity":"rs-3847825","version":["v1"]},"buildId":"zQwnuV7TCBrMSSSToR1PI","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}