A minimally invasive surgery, which typically involves endoscopic camera and laparoscopic instruments, may seem to be the ideal surgical procedure for its apparent benefits. However, in comparison to open surgeries, the spatial and mechanical tool limitations posed on surgeons are so high that often MIS is foregone for complex cases and even when it is possible, the procedure requires a high dexterity, caliber and experience from the surgeon. This research was motivated by the need for dexterous surgical instruments that offer an intuitive control and an ergonomic interface, with the final objective of developing a suitable robotic hand-held surgical device for laparoscopic interventions. The research was based on comparative evaluation of different interfaces, control modes and kinematics, using a virtual reality simulator, developed specially for this purpose. The results show that: 1. The optimal interface has a WYSIWYD (what you see is what you do) control mode and is finger-operated. 2. The optimal distal motorized mobilities of the end-effector produce two independent DOF for exion and rotation of the end-effector which are sufficient for complex MIS gestures. 3. Adding a free articulation to the instrument's handle allows the surgeon to have an ergonomic posture. 4. An active trocar makes the rotation of the shaft with a free joint possible. This research also resulted in the development of a proof-of-concept prototype. The prototype was tested successfully, in vitro and in vivo on a porcine model.
