# On the Control and Validation of the PARA-SILSROB Surgical Parallel Robot
## 3 Results
### Medical Protocol Used for Experimental Tests
#### 3.2.2 Testing the PARA-SILSROB Robot Using a Torso with the Target Organ  
In this stage, the simulation of an esophagectomy and digestive reconstruction procedure is presented. A torso that housed the esophagus and nearby organs (aortic arch with the descending aorta, superior and inferior vena cava, trachea) was used for testing the PARA-SILSROB robot. To generate the target organ (esophagus), 3D reconstruction was performed using computed tomography (CT) images. An analysis of the surfaces was carried out with the 3D Slicer software, which resulted in the 3D model shown in Figure 16a. The 3D reconstructed organs (Figure 16a) were simplified, followed by modeling and printing using Polylet 3D printing technology (Medijet J5 3D printer, developed by Stratasys, Eden Prairie, MN., U.S., [51]), which is a technology that allows for printing organs with soft materials. The result of the 3D simplified model is illustrated in Figure 16b. The simplified model of the organs used in this phase may influence the results and their accuracy due to the lower level of complexity and the absence of neighboring organs. However, for this stage of robot testing, this simplified version was validated by experts in the field, and the model was approved for conducting these experimental studies. For the next testing phase and after analyzing the results obtained from these experiments, areas  
Figure 14: Tissue cutting stages simulation using a silicon module. Figure 15: Simulating the suturing stage using a silicone training module. where improvements can be made to both the organs and the approach used with the robot presented in this paper will be reviewed and considered. To replicate the surgical environment for tumor resection on the 3D-printed esophagus, the esophagus was placed inside a torso positioned on the PARA-SILSROB robot's table. The SILS port was securely integrated into the torso, which allowed for the introduction of active instruments and a laparoscope through this access point. The intervention presented in this subsection focused on the thoracoscopic procedure, specifically on esophageal resection and reconstruction via a right intercostal approach. During this stage, the patient was positioned in the left lateral decubitus. The complete setup used for this procedure is illustrated in Figure 17.  
The following steps outline the simulation of tumor resection in the lower esophagus under laboratory conditions using the PARA-SILSROB robot:  
* Initialization of the homing procedure and functionality testing of all PARA-SILSROB robot components. Figure 16: The virtual and 3D printed model of the esophagus (the 3D model of the real organs generated based on the 3D reconstruction is shown in (**a,b**) represented the simplified 3D printed model of the organs using 3D printing technology). Figure 17: Experimental setup with the esophagus placed inside the torso. * Securing the torso with the 3D-printed esophagus on the PARA-SILSROB robot's table. * Positioning the mobile platform with the laparoscope above the designated insertion point and inserting the laparoscope into the torso (laparoscope RCM saved). * Attaching and inserting the commercial active instruments used for medical procedures (one 8 mm thoracic grasper and one 10 mm linear stapler). * Performing the resection procedure and suturing the esophagus. * Retracting the active instruments and laparoscope from the intraoperative field. * Moving the robot to a safe position and completing the simulation by removing the port from the torso. The results of these steps are illustrated in Figures 18-21. The time history diagram of the laparoscope tip velocities for the procedure presented in the previous figures was generated \((\dot{X}_{E},\dot{Y}_{E},\dot{Z}_{E},\dot{y},\dot{\theta},\dot{\varphi})\) using both inverse and direct kinematic models [20].