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Origami using da Vinci Surgical System

Article  in  Surgical Endoscopy · August 2007

DOI: 10.1007/s00464-007-9416-4 · Source: PubMed

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Title Origami using da Vinci Surgical System

Ishikawa, Norihiko; Watanabe, Go; Hirano, Yasumitsu; Inaki, Noriyuki;

Author(s) Kawachi, Kenji; Oda, Makoto

Citation Surgical Endoscopy, 21(7): 1252-1253

Issue Date 2007-07

Type Journal Article

Text version author

URL http://hdl.handle.net/2297/6698

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Surgical Endoscopy: Letter to the Editor

Origami using da Vinci Surgical System

Norihiko Ishikawa MD PhD1, Go Watanabe MD PhD2,3, Yasumitsu Hirano

MD PhD1, Noriyuki Inaki MD PhD1, Kenji Kawachi MD PhD3, Makoto
Oda MD PhD1.

1. Department of Telesurgery and Geomedicine, Kanazawa University

School of Medicine, Kanazawa, Japan
2. Department of General and Cardiothoracic Surgery, Kanazawa
University School of Medicine, Kanazawa, Japan
3. Department of Cardiac Surgery, Tokyo Medical University, Tokyo, Japan

Corresponding Author: Norihiko Ishikawa (E-mail: nori-i@mnx.jp)

Department of Telesurgery and Geomedicine,
Kanazawa University School of Medicine
Address: 13-1 Takara-machi, Kanazawa 920-8641, Japan
Tel: Japan +81-76-265-2354 Fax: Japan +81-76-222-6833
Introduction
Great progress has been made in the development of robotic surgical
technology, but it is necessary to become skilled in using the robot. Among
the advantages of the robot is practice in acquiring skill with stereoscopic
three-dimensional (3D) imaging. We describe use of the da Vinci surgical
system (Intuitive Surgical, Inc. Sunnyvale, CA) in developing necessary
skills by practicing traditional Japanese Origami (paper folding) , and we
quantified the robotic-assisted dexterity.

Technique
We prepared square sheets of paper (2 cm x 2 cm), and folded crane
origami using the da Vinci surgical system. Scaling was kept constant as
“ultra fine” mode throughout the maneuver with 0 degree scope of 10 times
magnification, and Endowist black diamond forceps were mounted on both
robotic arms. Folding of the crane origami was done using the same way as
in the traditional Japanese manual method. The time to successful
completion, and all maneuvers were recorded. On the first two occasions
we failed to fold the origami because we tore the paper. The third trial was
successful, the total folding time being 23 minutes (Fig 1).

Comment
Origami designs generally begin with a square sheet of paper, and
usually the paper is not cut. The crane origami is one of the more advanced
origami designs, and the best results are obtained by carefully matching the
corners and making the creases sharp without tearing the paper.
The surgical robot offers the advantages of allowing accurate
maneuvering and providing depth perception during operation. We were
able to evaluate enhanced dexterity in Origami work by means of two
intuitive master handles at the remote console and the 3D imaging afforded
by the da Vinci Surgical System.
The disadvantage of the surgical robot is the lack of tactile feedback,
son that the console surgeon must perform suturing relying on visual
feedback only. Badani et al have reported advantages of robotic
three-dimensional suturing [1]. A high-resolution, binocular, 3D and
magnified imaging of da Vinci Surgical System enable the console surgeon
to feel that he or she is operating as if the open surgical technique were
being used. Our study confirms that the console surgeon can benefit from
3D imaging. The development of robotic instruments has added two more
degrees of freedom than conventional endoscopic instruments, to obtain
seven degrees of freedom. The presence of the “wrist like” joint is
particularly useful in procedures like suturing and knot tying , which need
high maneuverability and flexibility. The technology of the surgical robot,
such as tremor filtration and motion scaling, also facilitates maneuverability.
Moorthy et al reported that these technological advantages enhanced
dexterity by nearly 50% as compared to laparoscopic surgery [2].
We believe that practicing origami with the robot is excellent training
for robotic surgery by acquiring the sense of tactility from 3D imaging and
precise maneuverability.
 References
1. Badani KK, Bhandari A, Tewari A, Menon M. Comparison of
two-dimensional and three-dimensional suturing: is there a difference in a
robotic surgery setting? J Endourol. 2005;19:1212-5.
2. Moorthy K, Munz Y, Dosis A, Hernandez J, Martin S, Bello F, Rockall T,
Darzi A. Dexterity enhancement with robotic surgery. Surg Endosc.
2004;18:790-5.

Fig 1
Crane origami using da Vinci Surgical System.

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