LAPAROSCOPIC WORM ROBOT

Design Review II

The Docs- Tim Cousins, Chris Miller, Ismail Mustafa, Emily Nathan COLUMBIA UNIVERSITY SCHOOL OF ENGINEERING AND APPLIED SCIENCE

Introduction The field of healthcare stands to benefit greatly from the development of robotic surgical aids. In a recent study published in The Journal of Minimally Invasive Adverse effect reports for robot-assisted surgery have been growing at faster rates than robot adoptioniv. In a recent FDA report, all doctors interviewed agreed that mastering the user interface of the da Vinci was a challenge and that more training would be helpfulv. In addition, the da Vinci is a highly expensive

Gynecology, certain procedures performed with robotic assistance result in decreased blood loss, length of hospital stay, and readmittance rates compared with open and even traditional laparoscopic surgeryi. The most common type of robotic surgical system used today is the da Vinci Surgical System,

produced by Intuitive Surgical. In this system, a surgeon sits at a detached console controlling

autonomous arms and tools inside the patient. The use of this system is growing rapidly: Approximately
Figure 1: Da Vinci Robot during Surgery

523,000 patients received da Vinci-assisted surgical procedures in 2013, up 16% from 2012ii and 45% from 2011iii.Very few other robotic surgical systems currently exist on the market, and systems which place the surgeon at the operating table are virtually nonexistent. While the da Vinci has been hailed for its improvements to the already less-invasive laparoscopic procedure, there has been growing concern about how much benefit it actually brings to patients and surgeons.

and large piece of equipment. With these advantages and disadvantages in mind, our team will propose a different type of surgical robot which can maintain the positive aspects of current tools while removing some of the limitations of large da Vinci type systems. What we have designed is a laparoscopic tool with four robotic joints that provide a range of movement controlled by the user. This snake robot takes some of the benefits of traditional laparoscopic surgery, such as the surgeons proximity to and physical

interaction with the patient, and combines them with more advanced robotic features as seen in the da Vinci and many prototyped surgical robots. This project will be an important bridge between the rigid tools of laparoscopic surgery commonly used today and the massively dissimilar da Vinci system that drastically changes the surgeons role in surgery. After a few iterations of physical and control design, as well as stress and torque analysis, we have designed a very small snake robot with just a 15 mm diameter and 180 mm length to maintain its application in laparoscopic, minimally-invasive surgery. Including motors and gears, each joint will house less than 15 components. When possible parts are held together by adhesives to avoid the necessity of many small screws. Motors are contained within the joints to reduce torque and cabling necessary. Joints are driven by worm gears, each with two degrees of freedom, so the combination of four joints provides a wide range of motion for the end effector which will be fitted with video or surgical tools. The first goal of this project is to build a functional robot of considerably small size. We must take special care in designing and performing the assembly process to ensure all parts come together as necessary and the

space inside the joints is sufficient to house all parts and cables. We will have at minimum three joints on the robot, with the addition of a fourth joint if assembly and control constraints allow it. We would like to fit the end joint with a camera or surgical tool, with interchangeability if possible. The second goal of this project is to create an intuitive control system that would not require large amounts of training to use. We would like to employ a joystick which moves the end effector without the user needing to manually control each motor separately, ideally without the use of a multiplexor but using a call system that switches motors on and off in a specified order. Finally, we plan to design a simulation setup where a user maneuvers the robot into and around the inside of a cavity, similar to a laparoscopic procedure.

Background Information A literature search was performed at the onset of this project, which provided one similar project we relied on to guide us during our design process. This robot is called the iSnake, and it too has the premise of a flexible as opposed to rigid laparoscopic tool. An article on this snake and its applications, as well as a video showing the robot in action, are available here:

http://theinstitute.ieee.org/technologyfocus/technology-topic/the-next-generation . One of the PhD candidates working on the i-Snake, David Noonan, is now advising on our project as an employee of Philips, the company lending motors and other out of budget components to our project. He and Prof. Aleksandra Popovic, a SEAS instructor and senior research staff member at Philips, have provided guidance throughout the design process and continue to meet with us regularly. A project we found later on which was created at Columbia is an in-vivo imaging device developed by Peter Allen and Dennis Fowler of the computer science and surgery departments of the university, respectively. Information on the project can be found here: http://www.cs.columbia.edu/~allen/device/. Their device features similar worm gears and structure, but they focused on imaging and software over mechanics. This resulted in what we believe to be inferior mechanical design to the project we aim to build. For example, the motors they used were in our initial design plan, but the amount of cables necessary to control them increased the size of the casing so we opted for a different type. Their robot also featured a rack and pinion for their tilt motion, but we felt this was an unnecessary rotary to linear motion feature

that worm gears avoid, and it increases bulk in the compartment. One positive aspect of their project was the use of a joystick, which we hope to employ as well. They also

managed to bring the diameter of their robot down to 10 mm since they had only one joint, while ours is 1.5 times that size due to the electrical wiring necessary for motors in multiple joints. The rest of our literature search provided a variety of patents on various surgical robots and research on one-to-many motors; the problems with these were that most of the robots were cable-based with motors outside of the joints and the one-to-many motors were projects within themselves. So, we focused on the two projects discussed above when looking for inspiration and confidence in our design.

Concept Generation & Selection Our original concept was not dissimilar to the design we are presenting in this report, but we did go through a few iterations. One of the original ideas generated was designing a gear system which could allow one motor to control multiple degrees of freedom to reduce diameter. This was nixed early on as one-to-many motors are still in the realm of academic research. We also planned to encase three motors in each joint and have an

additional roll component on each segment. Later we realized that the control on this ability would be very complex and having the extra degree of freedom is unnecessary to create most paths, so we simplified our design to two motors per joint (which also decreased the overall size). We further simplified the final joint to only have one direction of motion because the appropriate camera could provide movement (via an image pan) if necessary. This reduces the weight of the final joint, decreasing the load supported by joints further down the robot, and simplifies controls. Original design plans assumed screws and press fits for assembly. Current plans have removed most screws and replaced any press fits with a strong adhesive. This simplifies assembly, but does add time to the process as the adhesive needs to be heated over the course of a few days after application to enhance its strength. Avoiding press fits on very small parts is very desirable as well, to avoid damaging delicate parts like gear teeth. Finally, various control methods were discussed, and we have settled on an Arduino-based cascading joint movement system. In this system, joints are moved one by one until the end effector reaches its goal. This was chosen over our second potential system, an averaged-angle movement,

because it allows for more complex, wormlike movements. An average angled

movement implies that the final angle positions are pre-calculated before motion begins. The cascading joint movement gets rid of this calculation step as it would just require incrementing through angles.

Furthermore, the cascading joint movement system limits the control system to only operating up to two motors at any given time, which will be computationally cheaper than averaging out an angle movement profile for the worm robot to follow. The cascading joint movement provides a simple and intuitive way to control the worm robot with only forward kinematics. The original design required a handle attachment that the operator of the device would use to lower the laparoscopic worm into the operational cavity. The handle would be kept stationary by the operator. However, this introduces issues such as subjecting the end effector of the robot to unnecessary vibrations. Instead, the laparoscopic device will be mounted to the patient via a passive arm that can be locked in place once the worm robot is lowered into the patient at the desired height. As a result, the operator need only worry about controlling the motion of the worm robot without the added hassle of keeping the entire device still.

Specification & Parameter Analysis The primary motivating state variable of our design is the outer diameter of the robot. A hard limit of 15mm was imposed on it because that is the largest tool that can fit into commercially available trocars. With this limit in mind we chose the smallest motors that are commercially available. 6mm diameter servo quality motors are available from several German manufacturers. Initially, we wanted to use DC motors because of their favorable torque characteristics. With DC motors we would then require encoders in order to have any amount of repeatability with our position control. Only Maxon Motors manufactures a 6mm encoder, and it only fits on a brushless DC motor. Brushless motors are not feasible in our design because they require 8 wires per motor as opposed to 2 for a dc motor, in addition to the wires required by the encoder. The wiring we will be using is a super flexible, very small, medical grade wire which has 10 conductors in a 3mm diameter casing. We will only be able to fit a maximum of 4 wires through our joints, so using brushless motors would limit our robot to 2 joints. Brushed motors could be used, but there are no commercially available 6mm encoders that can be used with brushed motors. Our only remaining option was to

use 6mm stepper motors from Faulhaber and control them without active sensing. While the steppers will slip some amount, the very high gear reductions we are going to use will make this have a negligible effect on the robots accuracy. With our motors selected, we could move forward with the rest of the packaging and joint design. We had initially planned a pitch-roll type joint, but predicted that there would be significant issues with the wires getting tangled. We decided on a pitch-yaw type joint, with the axes of each degree of freedom offset from each other slightly. Each degree of freedom will be actuated by one motor. The motors gearhead output shaft will be fitted with a worm. The worm will mesh with a worm gear which is fixed to a shaft that is part of the interlink segment. When the motor rotates, it causes the worm gear to tilt, which in turn causes everything past that joint on the robot to tilt. The small size of our robot means that we must take extra care in designing the assembly method. The method of fixing the gears to their shafts is particularly difficult on this scale, mechanical fasteners such as keys or set screws are impractical. After researching different methods, we decided that using a retaining compound was the best option. These adhesives are specifically designed

for retaining cylindrical assemblies and formulas are available for calculating their expected strength. After performing joint strength analysis we found that the torque limit on the worm gear would be 0.135 Nm. This is the weakest joint and is directly connected to the links. So the max torque our robot could experience before failure would be 0.135 Nm. This is perfectly reasonable considering our robot will be used primarily as an imaging tool and will not feel large forces. This has the additional benefit of placing the failure point on the robot at the adhesive, which is easy to fix in a short amount of time. The links of our robot will be machined in-house out of aluminum or steel, depending on the strength requirements. The link which holds the motors will be machined in two halves. These two halves will be assembled using dowel pins and retaining compound as well. This will make our assembly process very simple and has the benefit of eliminating the play found in mechanical attachment methods. The primary motivating state variable of our design is the outer diameter of the robot. A hard limit of 15mm was imposed on it because that is the largest tool that can fit into commercially available trocars. With this limit in mind we chose the

smallest motors that we could find. 6mm diameter servo quality motors are available from several German manufacturers. The control system for the

laparoscopic worm robot has to provide an intuitive and easy to learn way to achieve the complex shapes the worm robot is able to produce. The robot will be fixed at the entrance point of surgery, with the control device place externally so that the doctor can use it without have to worry about balancing the whole tool in the patient while simultaneously operating it. The final control system for the robot will not be fully developed until the design is finalized and being tested. As of now it will be controlled by incrementing joint angles starting from the furthest joint away from the operator. Since the robot is an assistive laparoscopic tool, high precision control is not necessary. For the simulation, it is necessary to determine the forward

kinematics of the robot for plotting purposes. Each link consists of two revolute joints. The distance between the joints is small relative to the overall length of the link, and therefore negligible and the two joints can be considered on top of each other. The transformation from one link to the next involves a rotation around the z-axis by theta1, a rotation around the y-axis by theta2,

and a displacement along the x-axis by the length of the link l. This results in a transformation matrix for each link given by: 1 2 [ 1 2 2 0 1 1 0 0 1 2 1 2 2 0 1 2 1 2 ] 2 1 These kinematics can easily be expanded to accommodate for the addition of more joints. As of now, the design contains four links. The forward kinematics of four joints are not displayed here for the sake of tersity.

Final Concept Description For each link added, another transformation matrix is multiplied on. From this the equations for forward kinematics are

obtained. For example, for three links the forward kinematic equations are as follows: = [1 2 + 1 2 3 4 1 2 4 1 3 4 6 (1 2 4 1 3 4 + 1 2 3 4 ) 5 6 (1 3 + 1 2 3 ) 5 6 (1 2 4 + 1 3 4 1 2 3 4 )] = [1 2 + 1 2 3 4 + 1 3 4 1 2 6 (1 2 4 + 1 3 4 + 1 2 3 4 ) 5 6 (1 3 1 2 3 ) + 5 6 (1 3 4 1 2 4 + 1 2 3 4 )] = [2 + 2 4 2 3 5 6 + 6 (2 4 3 2 4 ) + 5 6 (2 4 + 2 3 4 )]
Figure 2: Joint Assembly

Laparoscopic Worm Robot The robot is constructed from rigid links which are joined by 2-DOF universal type joints. The joints are actuated by embedded micro stepper motors. The motors actuate worm - worm gear pairs which cause the joints to rotate. The rigid links will be machined from steel. The two halves of the main rigid link sections are located to each other using dowel pins and will be retained with adhesives. The two halves closing together will fully assemble each link in addition to locking the motors in place through friction. The shafts will be bonded to the gears with retaining compounds. A

total of four cables will be routed through the device which will deliver power to the motors and additionally the camera on the end. The actuated portion of the robot will be fitted onto the end of a passive arm. The user will be able to position the robot in space freely and by locking the arm, constrain the position and orientation of the base of the robot. The user will then be able to control the rest of the robot using the embedded motors. Control System Currently, the control of the laparoscopic worm robot will be dictated by a so-called cascading motion. The idea of cascading motion can be described much more easily with the use of the figure below.

For the robot to move up in the frame of reference we have defined for it, the fourth link increments clockwise (CW) when facing the XZ axis. Downwards would result in a counter-clockwise (CCW) motion when facing the XZ axis. A leftward motion would increment the forth link CCW when facing the XY axis. Finally, a rightward motion would increment the fourth link CW when facing the XY axis. As of now, the maximum angle that each link can move through is 45o. If all the links were incremented to their maximum angle in a single direction, this would result in the fourth link being at an angle of 180o with respect to the origin. This results in a workspace dictated by 5/8th of a sphere of a radius that is four times the link length. Zeroing of the device (all links at an angle of zero with respect to the x-axis) occurs by remembering how many times each angle was incremented. Since stepper motors are being used, this can easily be

Figure 3: Joint assembly in the zero position

counted as the number of steps each motor is taken through. Since there are eight motors, the increment value of each motor is stored is stored as a variable. A CW increment is taken to be positive while a CCW increment is taken to be negative. If the maximum angle is set to 45o, then each increment variable will contain a value ranging from -45 to 45. By

The motion of the worm robot always begins with the fourth link. The fourth link continues to move until the maximum angle it can turn is reached. Once this occurs, the third link begins to move. This continues in one direction until all links have reached their respective maximum angles.

knowing this value, each motor can be brought to its zero position by incrementing the stepper motor until the known increment variable reaches zero. A simulation was created to test all of these features out as shown in the figure below. The figure shows an eight-direction pad that is used to control the motion of the four link laparoscopic device. The largest of the graphs is a three dimensional plot of the robot as well as a plot of the workspace of the end effector of the robot. The other three graphs are two dimensional plots of different views of the same robot. Problem Analysis We have focused on eliminating risk throughout the design process. The current major risks we see as a result of this design include: Laparoscopic Worm Robot There are two primary problems that we may have trouble with. The first problem is that we are unsure if the cables will run into issues of binding in the joints when they are actuated. We plan on 3D printing a model of our robot and running the cables we will use through it. This will prove whether or not the cables will bind. The second major problem we foresee is that the adhesives we use to retain the worm gear will fail during normal use. We have performed calculation that say they will not fail, but we will leave ample time for testing
Figure 3: Matlab Control Simulation

to verify the strength. If need be, we can enhance the strength of the adhesives up to 175% through a heat curing process. Control System

A part list required to create our final concept is provided below in the appendix.

Planning Please see the appendix for our Gantt chart. We have focused the majority of our time on machining and assembly; if these steps do not take up the entire four weeks weve given them, we will use this time to test and refine control operations.

The main problem associated with the control system is attempting to come up with an intuitive way to control the robot. The current cascading design is very intuitive as long as the sum of maximum angles made by all the links is less than or equal to 90o. It was that the more this value was exceeded, the

less intuitive the control system became. Currently, different control methods are being explored in order to achieve a more optimal control system.

design with the least risk possible to perform in the short amount of time we have to execute. Lessons we have learned so far, such as dropping the degrees of freedom from three to two per joint, to using brushless

Conclusions We hope that this robot adds to the growing body of research and prototyping of surgical robots. It will be a challenging capstone project for our time at Columbia, but we believe that we have created the best

motors to decrease bulk, to finding an intuitive way to control the complex three dimensional movement of the robot have helped us in this process. We look forward to beginning to assemble the robot as soon as possible.

Appendices 1. Gantt Chart for Project Timeline

2. Parts list
ASSEMBLY Part Name 6mm Stepper Motors w/ 64:1 gearhead Flexible Motor Wire Stepper Motor Controller Power Components Casing Mid-Link Steel Worm Brass Worm Gear Loctite 648 Adhesive Track Ball Mouser Control System $20 (Mouser) Arduino Pro Mini Control box Video Camera [Optional] Misc. Fasteners dowel pin 1/32" dowel pin 3/32" Passive Arm Manufacturer Faulhaber [Phillips provided] Faulhaber In-House In-House In-House Northwest Shore Line Northwest Shore Line McMaster Mouser Mouser Spark Fun In-House Super Circuits McMaster McMaster McMaster 90145A305 90145A440 30403-6 31012-6 91458A790 Part Number Cost $0 $0 $0 $0 $0 $0 $9.95 $9.95 $15.61 $15 $20 $10 $0 $49.99 $25.00 $10.50 $15.83 $0 Qty. 8 1 2 1 8 4 4 4 1 1 1 1 1 1 1 1 1 1 Total Cost $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $39.80 $39.80 $15.61 $15.00 $20.00 $10.00 $0.00 $49.99 $25.00 $10.50 $15.83 $0.00

TOTAL

$241.53

3. Adhesive Bonding Calculation Chart

4. CAD Assembly

Barakat E.E., et.al. Robotic-assisted, laparoscopic, and abdominal myomectomy: a comparison of surgical outcomes. Feb. 2011. http://www.ncbi.nlm.nih.gov/pubmed/21252737 ii Intuitive Surgical Announces Preliminary Fourth Quarter and Full Year 2013 Results. Jan . 14, 2014. http://investor.intuitivesurgical.com/phoenix.zhtml?c=122359&p=irol-newsArticle&ID=1890591 iii Intuitive Surgical Announces Fourth Quarter Earnings. Jan 22, 2014. http://investor.intuitivesurgical.com/phoenix.zhtml?c=122359&p=irol-news iv Langreth, Robert. Robotic Surgery Damaging Patients Rises with Marketing. Oct. 8 2013. http://www.bloomberg.com/news/2013-10-08/robot-surgery-damaging-patients-rises-with-marketing.html. v FDA Small Sample Report: da Vinci Surgical System. November 2013. http://www.fda.gov/downloads/MedicalDevices/ProductsandMedicalProcedures/SurgeryandLifeSupport/Computer AssistedRoboticSurgicalSystems/UCM374095.pdf
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