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Robotic Assisted Cleft Palate Repair Using Novel 3 mm Tools: A Reachability and Collision Analysis | IEEE Journals & Magazine | IEEE Xplore

Robotic Assisted Cleft Palate Repair Using Novel 3 mm Tools: A Reachability and Collision Analysis


Abstract:

Objective: Cleft palate repair is technically challenging: visualization is reduced, delicate dissection is required, and instrument reachability is limited within the in...Show More

Abstract:

Objective: Cleft palate repair is technically challenging: visualization is reduced, delicate dissection is required, and instrument reachability is limited within the infant oral cavity using standard instruments. A 3 mm diameter pin-jointed wristed tool was developed that couples to a da Vinci Research Kit (dVRK) to perform infant cleft palate surgery. Methods: A reachability simulation analysis was performed to determine the number of collisions (tool-tool and tool-cavity) for tool tip positions within the oral cavity and the impact of dVRK trocar height. Tool reachability was measured using a reachability ratio of collision-free to total poses considered for a given oral cavity target point. Three physical experiments were performed using a high-fidelity cleft palate simulator: (1) the 3 mm tools were compared to existing 8 mm tools assessing visual field obstruction and the number of collisions during suturing tasks; (2) an end-to-end robotic assisted cleft palate repair was performed on the simulator using the new tool assessing collisions; and (3) the impact of trocar height on tool performance was investigated to validate the reachability simulation analysis. Results: The 3 mm tools demonstrated fifteen times fewer tool-cavity collisions and 21% less visual obstruction than the 8 mm tools. Average tool-cavity collisions per throw demonstrated an increasing trend posteriorly within the oral cavity (nasal mucosa: R^{2}=0.344, p=0.013; oral mucosa: R^{2}=0.811, p< 0.001); and a 31% increase (R^{2}=0.988, p=0.069) with increasing trocar height. Conclusion/Significance: Physical experiments validated tool functionality for cleft repair and the reachability analysis reveals increasing collision risk deeper within the oral cavity.
Published in: IEEE Transactions on Biomedical Engineering ( Volume: 72, Issue: 7, July 2025)
Page(s): 2085 - 2094
Date of Publication: 27 January 2025

ISSN Information:

PubMed ID: 40031353

Funding Agency:


I. Introduction

Cleft palate surgery is a challenging procedure to perform, requiring precise dissection and interaction with delicate tissue within the confines of the infant oral cavity workspace. Visualization and instrument manipulability is limited by the confined workspace when using conventional surgical instruments [1]. A surgical robot provides enhanced visualization [2], access and precision [3], [4]. Therefore, infant cleft palate repair is a suitable application for the implementation of robotic technology.

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References

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