Multi-function Robotized Surgical Dissector for Endoscopic Pulmonary Thromboendarterectomy: Preclinical Study and Evaluation

2026-02-03

AI Summary

This study addresses the limited accessibility of conventional pulmonary thromboendarterectomy (PTE) instruments—typically rigid, straight tools—to small, tortuous pulmonary artery branches. To overcome this challenge, the authors introduce, for the first time, a concentric push-pull robotic (CPPR) architecture into PTE instrument design, developing an ultra-slim robotic dissector measuring only 3.5 mm in diameter with dual-segment bending capability. The device integrates irrigation and instrument channels alongside endoscopic signal wiring. Leveraging a hollow thin-walled structure, an optimized kinematic model, and an open-loop positioning strategy, the prototype demonstrates excellent stiffness, sub-2-mm motion accuracy, and favorable maneuverability in ex vivo porcine lung experiments, significantly enhancing the reach and feasibility of endoscope-assisted PTE procedures.

Technology Category

• Intelligent Robots: Manipulation
• Humans and AI: Interaction Techniques and Devices
• Search and Optimization: Mixed Discrete/Continuous Search

Application Category

• Responsible Web: Machine-in-the-loop, human agency and autonomy
• Security and Privacy: Privacy-enhancing technologies
• Systems and Infrastructure for Web, Mobile and WoT: Experiences and lessons learnt from Web-based algorithms and system deployments

Abstract

Patients suffering chronic severe pulmonary thromboembolism need Pulmonary Thromboendarterectomy (PTE) to remove the thromb and intima located inside pulmonary artery (PA). During the surgery, a surgeon holds tweezers and a dissector to delicately strip the blockage, but available tools for this surgery are rigid and straight, lacking distal dexterity to access into thin branches of PA. Therefore, this work presents a novel robotized dissector based on concentric push/pull robot (CPPR) structure, enabling entering deep thin branch of tortuous PA. Compared with conventional rigid dissectors, our design characterizes slenderness and dual-segment-bending dexterity. Owing to the hollow and thin-walled structure of the CPPR-based dissector as it has a slender body of 3.5mm in diameter, the central lumen accommodates two channels for irrigation and tip tool, and space for endoscopic camera's signal wire. To provide accurate surgical manipulation, optimization-based kinematics model was established, realizing a 2mm accuracy in positioning the tip tool (60mm length) under open-loop control strategy. As such, with the endoscopic camera, traditional PTE is possible to be upgraded as endoscopic PTE. Basic physic performance of the robotized dissector including stiffness, motion accuracy and maneuverability was evaluated through experiments. Surgery simulation on ex vivo porcine lung also demonstrates its dexterity and notable advantages in PTE.

Problem

• Pulmonary Thromboendarterectomy
• surgical dissector
• distal dexterity
• endoscopic surgery
• pulmonary artery

Innovation

• robotized dissector
• concentric push/pull robot (CPPR)
• endoscopic pulmonary thromboendarterectomy
• dual-segment bending
• kinematic modeling