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Minimally invasive procedures such as Natural Orifice Transluminal Endoscopic Surgery (NOTES) require powerful, small, and flexible instruments. A cable-driven instrument was developed, which is able to retract tissue to create sufficient space for an actual operation (e.g. cholecystectomy). In this paper, the work space of a developed instrument is presented. The work space is calculated using direct kinematics equations and verified by measurement using an electromagnetic (EM) tracking system. The angular orientation of the instrument can be up to 85° with a length of the active section of 60 mm. However, a longitudinal rotation up to 17° becomes apparent. This is due to the characteristics of the steel cable used for actuation. Nevertheless, the instrument reaches the intended work space. Further measurements are necessary to evaluate the instrument’s behavior under payload and whether this affects the work space.

Work space analysis of a new instrument for Natural Orifice Transluminal Endoscopic Surgery (NOTES)