Computer Simulation of the Transanal Endoscopic Microsurgery for the Improvement of Optimal Operation Range

Conventional devices for transanal endoscopic microsurgery that are currently used clinically for intestine or rectal cancer patients have 40 mm external diameter of rectoscope tube - induces anal damage and long-term postoperative pain for small-sized patients. In this paper, we designed rectum and rectoscope models and calculated the changing trends of operation area of the surgical tools in accordance with the step-by-step variation of design parameters of the rectoscope tube - external diameter, axial length, and distal angle. Using the results of computer simulation, we suggested an optimal set of design parameters that minimizes external diameter of the rectoscope tube and at the same time, maintains similar operation area of the surgical tools compared with commercialized devices (${\geq}\;4274.7mm^2$). The results of the simulation showed that the optimal design parameters were 35 mm external diameter, 100 mm axial length, and $45^{\circ}$ distal angle of the rectoscope tube. This result can be applied to the development of endoscopic microsurgery device that can minimize side effects to the intestine or rectal cancer patients.

경항문 내시경 수술 도구에서의 최적 활동 반경 개선을 위한 컴퓨터 시뮬레이션 연구