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ORIGINAL RESEARCH article

Front. Bioeng. Biotechnol.
Sec. Biomechanics
Volume 12 - 2024 | doi: 10.3389/fbioe.2024.1418148

Development and Clinical Validation of Passive Shoulder Exoskeleton with Novel Gravity Compensation Mechanism for Stabilizing Arm Tremor of Surgeons during Minimally Invasive Surgery

Provisionally accepted
  • 1 Sejong University, Seoul, Seoul, Republic of Korea
  • 2 Korea Institute of Science and Technology, Seoul, Republic of Korea

The final, formatted version of the article will be published soon.

    During tasks like minimally invasive surgery(MIS), various factors can make working environment not be ergonomic, and those situations will accumulate fatigue in the surgeon's muscles which will inevitably lead to poor surgical performance. Therefore, there has been a need for technical solutions to solve this problem and one of the methods is exoskeleton robots. We designed a passive shoulder exoskeleton whose workspace could be used for MIS to assist the surgeon's movements and performed computational and clinical validation. First, the joint order of the shoulder exoskeleton, which consists of three degrees of freedom, was configured differently from previous studies so that the singularity can be located outside the workspace. And a novel gravity compensation mechanism was developed to replace the existing one, which could no longer be used due to these changes on order of joints. Afterwards, it was computationally verified using statics and kinematics whether sufficient shoulder muscle assistance could be implemented for the entire developed system. Lastly, we manufactured an apparatus that simulated the surgical environment in which the shoulder exoskeleton robot would actually be used, recruited human participants, and conducted an experiment. Through computational validation, we can guess that the developed shoulder exoskeleton can provide 18.14\% reduction of muscle activation to the wearers in workspace. And the results of clinical experiments with human subjects show that activation of deltoid posterior, medial and anterior decreased with average -8.33\%, -14.55\%, and -21.0\%, respectively during MIS-simulated tasks with developed shoulder exoskeleton than without it. And arm tremor which is equals to movement variability also decreased with average 9.85\% by using shoulder exoskeleton and maximum -19.5\% in a certain position. These experimental results show that our shoulder exoskeleton and its novel gravity compensation mechanism has enough clinical effectiveness for workers of underhead tasks, especially surgeons who conduct MIS. It reduced deltoid activations of wearers and also stabilized arm tremor which are directly related to performance of fine manipulative task, so that this research implies that shoulder exoskeletons are also need for underhead tasks and our shoulder exoskeleton has possibility to contribute to those utilities.

    Keywords: Shoulder exoskeleton, minimally invasive surgery, Gravity Compensation, Muscle cocontraction, passive exoskeleton

    Received: 17 Apr 2024; Accepted: 29 Nov 2024.

    Copyright: © 2024 Choi, Lee and In. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Hyunki In, Korea Institute of Science and Technology, Seoul, Republic of Korea

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.