Measurement and Optimization of Minimally Invasive Intervention Device Design Fitness Using a Multiobjective Weighted Isotropy Index

The recent transition from multiple-port to single-port systems in minimally invasive intervention (MII) procedures has created a need for more flexible, dexterous robotic manipulation devices capable of spanning an entire surgical workspace without the risk of collateral damage. The design of such devices requires a careful balance of the mechanical complexity needed to facilitate clinical functionality and the cost of manufacturing and operating the device. This paper presents a novel metric for measuring the design fitness of kinematically redundant robotic MII devices and for optimizing them to achieve that balance. The proposed fitness metric rewards designs that are conducive to collision avoidance and energy conservation while penalizing those with exorbitant design complexities that adversely affect the economic feasibility of an MII system. The authors’ metric is used here to design a kinematically redundant, single-port MII device capable of accessing the cardiothoracic cavity through a single subxiphoid port and reaching several regions of interest, consistent with procedures such as epicardial ablation and therapeutic substance injection, with minimal physiologic disturbance. The design of this device is determined by a morphological optimization process, which searches a discrete mechanical design parameter space, consisting of linkage parts, part dimensions, and actuator types, using genetic algorithms. The execution of specific surgical maneuvers is simulated for each candidate MII device design, and the design is improved until the fitness metric is maximized. The results of this optimization study demonstrate that redesigning a 20 degree-of-freedom (DOF) MII device using the proposed metric decreased the DOF in the design by 45% while ensuring near-optimal levels of kinematic flexibility. The results also demonstrate the ability of the fitness metric to elucidate the relationship between functionality and complexity and to produce suitable device designs over a broad range of performance and cost goals. The authors conclude that this new design fitness metric, while heuristic in nature, holds the potential to improve both the clinical value and the economy of a wide variety of single-port MII devices, including those used in cardiothoracic surgery.