Stitching Planning in Laparoscopic Surgery: Towards Robot-assisted Suturing

Authors:
Florent Nageotte;Philippe Zanne;Christophe Doignon;Michel De Mathelin
Affiliations:
LST (UMR 7005 CNRS), Louis Pasteur University, Parcd'Innovation, boulevard S. Brant, 67400 Illkirch, Strasbourg, France;LST (UMR 7005 CNRS), Louis Pasteur University, Parcd'Innovation, boulevard S. Brant, 67400 Illkirch, Strasbourg, France;LST (UMR 7005 CNRS), Louis Pasteur University, Parcd'Innovation, boulevard S. Brant, 67400 Illkirch, Strasbourg, France;LST (UMR 7005 CNRS), Louis Pasteur University, Parcd'Innovation, boulevard S. Brant, 67400 Illkirch, Strasbourg, France
Venue:
International Journal of Robotics Research
Year:
2009

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Abstract

The work presented in this paper addresses the problem of the stitching task in laparoscopic surgery using a circular needle and a conventional four-degree-of-freedom needle holder. This task is particularly difficult for surgeons because of the kinematic constraints generated by the fulcrum in the abdominal wall of the patient. In order to assist the surgeons during suturing, we propose to compute possible paths for the needle through the tissues, which limit tissues deformation as much as possible while driving the needle towards the desired target. We propose a kinematic analysis and geometric modeling of the stitching task from which useful information can be obtained to assist the surgeon. The description of the task with appropriate state variables allows us to propose a simple practical method for computing optimal paths. Simulations show that the obtained paths are satisfactory even under difficult configurations and short computation times make the technique useful for intra-operative planning. The use of the stitching planning is shown for manual as well as for robot-assisted interventions in in vitro experiments.