Since the minimally invasive surgery has significant benefits for the patient, special equipment and techniques are constantly enhanced in this relatively new surgical field, so that more challenging surgical applications can be achieved. Thereby, the major aim is to enable the surgeon to manipulate instruments inside the human body intuitively, despite restricted access to the operating field and limited workspace. With our spine like overtube system for use with standard endoscopes and standard endoscopic instruments, we provide a system facilitating tissue manipulation with sufficient triangulation. In this paper we describe our 3D-printed manipulator system for minimally invasive applications and its pure mechanical control and actuation concepts. Following our aim of an individualized disposable system, in a first step we demonstrate the feasibility of a 3D-printed surgical robotic system by laboratory experiments and a clinical evaluation on a porcine model.

The Stapedotomy is a standard ENT (ear, nose and throat) surgery, where the surgeons use surgical micro hooks and forceps to replace the stapes with a small titanium implant. However, there are some challenges with this procedure. Especially, the non-ergonomic posture of the surgeon increases the hand tremor and leads to an inaccurate positioning of the implant. This may cause hearing loss and the patient may need a revision operation. In this paper, we present the first laser sintered disposable manipulator for ENT surgery, which allows the surgeon to move a micro hook in three directions via a joystick console, while his/her hands are located on an armrest. This may increase the surgical outcome by enhancing the ergonomics and therefore may reduce the number of revision operations. We show that the fabrication cost of the single-use robot does not increase the operation expenses drastically. To conclude, our preliminary evaluation with a middle ear phantom indicates that a basic surgical maneuver can be performed via the presented robotic system.