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In recent years, single-port access surgery has been on the cutting edge of robotic research. This technique entails the insertion of several instruments with articulated distal tips through a common multiport trocar. When these instruments are handled by external manipulators, a kinematic constraint arises because all the movements have to be performed while taking into account the insertion point, which must be known. A variety of techniques has been used to identify this point using multiaxial force–torque sensors placed on the robot end effector. However, because this kind of sensor provides information regarding exerted forces throughout the instrument, it is difficult to separate abdominal and internal soft tissue interaction forces. Therefore, the aim of this work was to develop a navigation method to teleoperate two manipulators that handle surgical instruments for single-port access surgery. The method can move both instruments inside the abdominal cavity, taking into consideration the insertion point. This point is estimated using the measured force and torque throughout the instruments. To avoid estimation error due to the interaction of instruments with soft tissue inside the abdomen, hidden Markov models have been used to encode the surgeon's gestures and detect the interaction. Finally, a set of experiments has been carried out to validate the proposed method.

The main difficulty in laparoscopic or robot-assisted surgery is the narrow visual field, restricted by the endoscope's access port. This restriction is coupled with the difficulty of handling the instruments, which is due not only to the access port but also to the loss of depth of field and perspective due to the lack of natural lighting. In this article, we describe a global vision system and report on our initial experience in a porcine model.The global vision system consists of a series of intraabdominal devices, which increase the visual field and help recover perspective through the simulation of natural shadows. These devices are a series of high-definition cameras and LED lights, which are inserted and fixed to the wall using magnets. The system's efficacy was assessed in a varicocelectomy and nephrectomy.The various intraabdominal cameras offer a greater number of intuitive points of view of the surgical field compared with the conventional telescope and appear to provide a similar view as that in open surgery. Areas previously inaccessible to the standard telescope can now be reached. The additional light sources create shadows that increase the perspective of the surgical field.This system appears to increase the possibilities for laparoscopic or robot-assisted surgery because it offers an instant view of almost the entire abdomen, enabling more complex procedures, which currently require an open pathway.