Development of a double arm endoscopic mini-manipulator system for transurethral resection of bladder tumors (TURBT)

Bladder cancer constitutes the thirteenth most common cause of cancer death worldwide. Transurethral resection of bladder tumors (TURBT) is the established treatment procedure of non-muscle invasive bladder cancer. However, current techniques for this procedure represent several inadequacies such as inaccurate resection of tumors and high recurrence rates due to the lack of dexterity and limited instrumentation. In this paper we proposed a concept to improve the efficiency of this procedure. Starting from the anatomic challenges, the design and fabrication procedure of a double arm surgical manipulator made of nitinol was presented. A new actuation concept was introduced which enables a surgeon to facilitate ten degrees of freedom simultaneously. Finally, in-vitro experiments regarding workspace and functionality were conducted to evaluate the developed system. The workspace experiments showed that the entire surface of the bladder can be reached by the manipulator. We also demonstrated that with the developed system, basic tasks such as pick-and-place and circular path marking can be performed.