Endoscopic Surgical Robots With Dynamic Renal Pressure Control
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Solution Overview
Problem
Conventional PCNL procedures face challenges such as elevated renal pelvic pressures leading to infection, stone fragments blocking the outflow, and high risk of complications due to lack of pressure control and prolonged physician handholding, resulting in low stone-free rates and increased surgery risks.
Innovation Solution
An endoscopic surgical robotic system with a pressure management system that includes a pressure measuring channel, suction channel, and pressure relief valve to control internal organ pressure, combined with a robotic arm for precise movement control of medical instruments like a percutaneous nephroscope.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Illumination intensity
If high-pressure irrigation method is used to maintain visual clarity, then visualization quality is improved, but renal pelvic pressure increases leading to infection risk and complications
Solution Approach 1:
The system employs real-time pressure sensors within the kidney to monitor renal pelvic pressure and provides feedback to the control system. The irrigation pressure is dynamically adjusted based on this feedback, maintaining visual clarity while preventing pressure-induced infections and complications.
Solution Approach 2:
The irrigation system transitions from static high-pressure irrigation to dynamic pressure control. The pressure is continuously adjusted based on real-time monitoring of renal pelvic pressure, allowing the system to maintain optimal visualization while preventing harmful pressure buildup that causes infection.
2Productivity
If high-pressure irrigation is maintained to flush stone fragments, then stone clearance is improved, but pressure inside kidney increases causing tissue damage and bleeding
Solution Approach 1:
Real-time pressure sensors monitor renal pelvic pressure and provide feedback to the control system. When pressure approaches dangerous levels, the system automatically reduces irrigation pressure or activates suction, maintaining stone clearance efficiency while preventing tissue damage and bleeding.
Solution Approach 2:
The system introduces an intermediary control mechanism between the irrigation source and the kidney. The robotic control system acts as a mediator, adjusting irrigation pressure and coordinating with suction based on real-time pressure feedback, thereby preventing direct harmful effects of high pressure on kidney tissue.
3Ease of operation
If physician handholds percutaneous nephroscope throughout procedure, then operational control is improved, but physician fatigue increases leading to prolonged surgery time and higher risk
Solution Approach 1:
The robotic system provides self-service by automatically holding and positioning the percutaneous nephroscope based on pre-programmed trajectories and real-time feedback. This eliminates the need for continuous physician handholding, reducing fatigue and enabling shorter, safer procedures while maintaining precise operational control.
Solution Approach 2:
The system replaces the mechanical action of physician handholding with an automated robotic mechanical system. The robotic arm precisely positions and holds the nephroscope, substituting human physical effort with automated mechanical control, thereby reducing surgery time and physician fatigue.
4Quantity of substance
If constant irrigation pressure is applied outside patient body, then irrigation flow is maintained, but inside pressure control is lost leading to pyelovenous backflow and sepsis
Solution Approach 1:
The system implements feedback control by placing pressure sensors inside the kidney to monitor renal pelvic pressure in real-time. This internal feedback enables precise control of irrigation pressure, maintaining adequate fluid flow for stone clearance while preventing dangerous pressure buildup that causes pyelovenous backflow and sepsis.
Solution Approach 2:
The system performs preliminary action by pre-positioning pressure sensors within the kidney before irrigation begins. This allows the system to establish baseline pressure measurements and proactively adjust irrigation pressure to prevent harmful pressure conditions before they occur, rather than reacting after problems arise.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The system provides safe and efficient kidney stone removal by maintaining optimal internal pressure, reducing complications, and enhancing surgical precision through real-time pressure monitoring and robotic assistance, thereby improving stone-free rates and patient safety.
Implementation Method 1
a pressure measuring channel located along the sheath and connected to a pressure detector constructed to measure a pressure within the organ
Implementation Method 2
a suction channel located within the sheath for removing the irrigation fluid from the organ
Implementation Method 3
a pressure relief valve in fluid communication with the sheath such that, once the pressure reaches a threshold, the pressure relief valve opens to allow removal of the irrigation fluid in the suction channel, thereby lowering pressure within the organ
Data Source
Figure 1A
Figure 1B
Figure 1C
AI summary
Disclosed herein are surgical robotics, and particularly a perfusion and suction circulation system of a medical instrument for operation within organs of a patient's body. Methods for using the same are also provided.