A Single-Port Robotic System for Transanal Microsurgery—Design and Validation

This letter introduces a single-port robotic platform for transanal endoscopic microsurgery (TEMS). Two robotically controlled articulated surgical instruments are inserted via a transanal approach to perform submucosal or full-thickness dissection. This system is intended to replace the conventional TEMS approach that uses manual laparoscopic instruments. The new system is based on master-slave robotically controlled tele-manipulation. The slave robot comprises a support arm that is mounted on the operating table, supporting a surgical port and a robotic platform that drives the surgical instruments. The master console includes a pair of haptic devices, as well as a three-dimensional display showing the live video stream of a stereo endoscope inserted through the surgical port. The surgical instrumentation consists of energy delivery devices, graspers, and needle drivers allowing a full TEMS procedure to be performed. Results from benchtop tests, ex vivo animal tissue evaluation, and in vivo studies demonstrate the clinical advantage of the proposed system.