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Recent trends in the medical field are pushing for a reduction in the invasiveness of surgical operations. Minimally Invasive Surgery (MIS) has been successfully improved in the last few years for abdominal operations. MIS procedures are based on the use of tools introduced through four or five access points (trocars) placed on the abdominal wall. In order to reduce the number of trocars, the instruments can be inserted by Single Port Laparoscopy (SPL) or Natural Orifice Translumenal Endoscopic surgery (NOTES)1. These procedures prevent external visible scars, but increase the difficulty for the clinicians in executing the surgery. This limitation is mainly due to the reduced points of access and to the rigid and semi-rigid nature of the instruments, which are not able to avoid or pass around organs2, 3. Dexterity and motility can be improved using articulated and hyper-redundant robots which can cover a wider and more complex workspace, thus enabling a specific target in the body to be reached more easily4, 5, 6 and to work as retraction systems when necessary7. A flexible manipulator can improve tissue compliance, thus making contact safer than by traditional tools.
However, these manipulators often lack stability when the target is reached and generally they cannot control the contact with the surrounding tissues8, 9. Studies on biological structures, such as the octopus arm10 and the elephant trunk11, have recently inspired the design of flexible, deformable and compliant manipulators with a redundant number of Degrees of Freedom (DoFs) and controllable stiffness12. These kinds of devices utilize passive springs, smart materials, pneumatic elements, or tendons13, 14, 15. Generally, manipulators fabricated with soft and flexible materials do not guarantee the generation of high forces.
The STIFF-FLOP (STIFFness controllable Flexible and Learnable manipulator for surgical OPerations) manipulator has been recently presented as a novel surgical device for NOTES and SPL inspired by the octopus’s capabilities. In order to overcome the limitations of previous soft manipulators, it has a soft body as well as high dexterity, high force and controllable stiffness16.
The architecture of the manipulator is based on a modular approach: multiple units, with the same structure and functionalities, are integrated together. The single unit is shown in Figure 1. It is based on an elastomeric cylinder obtained by a multiphase fabrication. The assembly steps of the mold components and the casting processes enable three empty chambers (for fluidic actuation) and one hollow central channel17 (for housing a granular jamming-based mechanism18) to be embedded. The chambers are placed at 120°, so that their combined inflation produces omnidirectional motion and elongation. In addition an external braided sheath is placed externally to limit the outward radial expansion of the fluidic chambers when pressurized, thus optimizing the effect of the chamber actuation in the module motion (bending and elongation).
The central channel houses a cylindrical device composed of an external membrane filled with granular material. When a vacuum pressure is applied, it changes its elastic properties causing a stiffening which affects the entire module’s properties.
Motion and stiffness performances are controlled by an external setup including an air compressor and three pressure valves for actuating the chambers and one vacuum pump for activating the vacuum in the stiffening channel. An intuitive user interface allows control of actuation and vacuum pressures inside the module.
This paper details the fabrication process of the single module of this manipulator and reports the most significant results on basic motion capabilities. Considering the modular nature of the device, the assessment of the fabrication and performance of just one single module also enables the results to be extended and to predict the basic behavior of a multi-module manipulator integrating two or more modules.