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Ever since their first introduction in the late 1980s , , surgical robots have played an increasingly prominent role in medical practice ,. For example, a recent study found that over 15% of all general surgery procedures in 2020 were performed robotically, compared to only 1.8% in 2012. The current worldwide robotic surgery market is estimated to be $\$ $ 5.3 billion and is expected to reach $\$ $ 19 billion by 2027, with a compound annual growth rate over 21%. [ABSTRACT FROM AUTHOR]

Continuum robots are not constructed with discrete joints but, instead, change shape and position their tip by flexing along their entire length. Their narrow curvilinear shape makes them well suited to passing through body lumens, natural orifices, or small surgical incisions to perform minimally invasive procedures. Modeling and controlling these robots are, however, substantially more complex than traditional robots comprised of rigid links connected by discrete joints. Furthermore, there are many approaches to achieving robot flexure. Each presents its own design and modeling challenges, and to date, each has been pursued largely independently of the others. This article attempts to provide a unified summary of the state of the art of continuum robot architectures with respect to design for specific clinical applications. It also describes a unifying framework for modeling and controlling these systems while additionally explaining the elements unique to each architecture. The major research accomplishments are described for each topic and directions for the future progress needed to achieve widespread clinical use are identified. [ABSTRACT FROM AUTHOR]

Continuum robots offer the dexterity and obstacle circumvention capabilities necessary to enable surgery in deep surgical sites. They also can enable joint-level ex situ force sensing (JEFS), which provides an estimate of end-effector wrenches given joint-level forces. Prior works on JEFS relied on a restrictive embodiment with minimal actuation line friction and captured model and frictional actuation transmission uncertainties using a configuration space formulation. In this work, we overcome these limitations. First, frictional losses are canceled using a feed-forward term based on support vector regression in joint space. Then, regression maps and their interpolation are used to account for actuation hysteresis. The residual joint-force error is then further minimized using a least-squares model parameter update. An indirect hybrid force/position controller using JEFS is presented with evaluation carried out on a realistic pre-clinically deployable insertable robotic effectors platform (IREP) for single-port access surgery. Automated mock force-controlled ablation, exploration, and knot tightening are evaluated. A user study involving the daVinci Research Kit surgeon console and the IREP as a surgical slave was carried out to compare the performance of users with and without force feedback based on JEFS for force-controlled ablation and knot tightening. Results in automated experiments and a user study of telemanipulated experiments suggest that intrinsic force-sensing can achieve levels of force uncertainty and force regulation errors of the order of 0.2 N. Using JEFS and automated task execution, repeatability, and force regulation accuracy is shown to be comparable to using a commercial force sensor for human-in-the-loop feedback. [ABSTRACT FROM AUTHOR]

During retinal microsurgery, surgeons cannot adequately visualize subsurface anatomical structures. In our previous work, a customized B-mode optical coherence tomography (OCT) probe was integrated into an ophthalmic robotic system to provide depth perception. This paper presents new approaches for implementing and achieving real-time feedback and assistive robotic control based on B-mode OCT imaging. The robotic system was comprised of a parallel robot, a micro-injection tool, and a telemanipulation master interface. A method for calibrating the B-mode OCT image scaling and distortion was presented using thin plate splines. Determining the OCT scanning plane relative to the robot base frame is presented through experiments and analyzed for sensitivity. A dual-rate controller using low frequency OCT feedback and high frequency position servoing was presented and tested for accuracy and latency. Three-dimensional assistive telemanipulation virtual fixtures based on microscope and OCT feedback are presented. The experimental evaluation demonstrated following target anatomy and semi-automated micro-injection. These results present the key steps towards achieving an integrated system for OCT feedback control using a miniature intraocular B-mode probe. [ABSTRACT FROM PUBLISHER]

The purpose of this study is to validate a Jacobian-based iterative method for real-time localization of magnetically controlled endoscopic capsules. The proposed approach applies finite-element solutions to the magnetic field problem and least-squares interpolations to obtain closed-form and fast estimates of the magnetic field. By defining a closed-form expression for the Jacobian of the magnetic field relative to changes in the capsule pose, we are able to obtain an iterative localization at a faster computational time when compared with prior works, without suffering from the inaccuracies stemming from dipole assumptions. This new algorithm can be used in conjunction with an absolute localization technique that provides initialization values at a slower refresh rate. The proposed approach was assessed via simulation and experimental trials, adopting a wireless capsule equipped with a permanent magnet, six magnetic field sensors, and an inertial measurement unit. The overall refresh rate, including sensor data acquisition and wireless communication was 7 ms, thus enabling closed-loop control strategies for magnetic manipulation running faster than 100 Hz. The average localization error, expressed in cylindrical coordinates was below 7 mm in both the radial and axial components and 5$^\circ$ in the azimuthal component. The average error for the capsule orientation angles, obtained by fusing gyroscope and inclinometer measurements, was below 5$^\circ$. [ABSTRACT FROM PUBLISHER]

Cochlear implant surgery is a procedure that requires delicate insertion of an electrode array into the inner ear. This paper reports the clinical motivation, design considerations, analysis, and design optimization of a new robot for electrode arrays insertion. This paper describes a new approach for coordinated insertion of perimodiolar electrode arrays in order to minimize shape discrepancy between the shape of the electrode array and the shape of the inner ear anatomy. A new design of a 3-degrees-of-freedom (DoF) parallel robot with wire-actuated prismatic legs is presented. The dimensional synthesis of the robot design was based on satisfying the accuracy, speed, system size, and workspace requirements. The robot prototype is validated experimentally to execute electrode insertions in plastic models of temporal bones. [ABSTRACT FROM PUBLISHER]

Single port access surgery (SPAS) presents surgeons with added challenges that require new surgical tools and surgical assistance systems with unique capabilities. To address these challenges, we designed and constructed a new insertable robotic end-effectors platform (IREP) for SPAS. The IREP can be inserted through a Ø15 mm trocar into the abdomen and it uses 21 actuated joints for controlling two dexterous arms and a stereo-vision module. Each dexterous arm has a hybrid mechanical architecture comprised of a two-segment continuum robot, a parallelogram mechanism for improved dual-arm triangulation, and a distal wrist for improved dexterity during suturing. The IREP is unique because of the combination of continuum arms with active and passive segments with rigid parallel kinematics mechanisms. This paper presents the clinical motivation, design considerations, kinematics, statics, and mechanical design of the IREP. The kinematics of coordination between the parallelogram mechanisms and the continuum arms is presented using the pseudo-rigid-body model of the beam representing the passive segment of each snake arm. Kinematic and static simulations and preliminary experiment results are presented in support of our design choices. [ABSTRACT FROM PUBLISHER]

Purpose: Over the past five years the Center for Minimally Invasive Radiation Biodosimetry at Columbia University has developed the Rapid Automated Biodosimetry Tool (RABiT), a completely automated, ultra-high throughput biodosimetry workstation. This paper describes recent upgrades and reliability testing of the RABiT. Materials and methods: The RABiT analyses fingerstick-derived blood samples to estimate past radiation exposure or to identify individuals exposed above or below a cut-off dose. Through automated robotics, lymphocytes are extracted from fingerstick blood samples into filter-bottomed multi-well plates. Depending on the time since exposure, the RABiT scores either micronuclei or phosphorylation of the histone H2AX, in an automated robotic system, using filter-bottomed multi-well plates. Following lymphocyte culturing, fixation and staining, the filter bottoms are removed from the multi-well plates and sealed prior to automated high-speed imaging. Image analysis is performed online using dedicated image processing hardware. Both the sealed filters and the images are archived. Results: We have developed a new robotic system for lymphocyte processing, making use of an upgraded laser power and parallel processing of four capillaries at once. This system has allowed acceleration of lymphocyte isolation, the main bottleneck of the RABiT operation, from 12 to 2 sec/sample. Reliability tests have been performed on all robotic subsystems. Conclusions: Parallel handling of multiple samples through the use of dedicated, purpose-built, robotics and high speed imaging allows analysis of up to 30,000 samples per day. [ABSTRACT FROM AUTHOR]

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This paper presents a unified mathematical frame-work for modeling and evaluating the performance of multiple robotic arms that operate on hollow suspended organs. This frame-work is applied to a novel two-armed hybrid robotic system being developed for ophthalmic vitreous surgeries. Four cases are designated to capture the general movements required for any surgical procedure associated with hollow suspended organs. Dexterity measures, based on multiple characteristic lengths, are presented for procedures corresponding to these manipulation cases. Simulation results of the dual-arm robotic system for ophthalmic surgery are presented for all four manipulation cases. A comparison of this robotic system with current surgical tools shows a significant improvement in intraocular dexterity. [ABSTRACT FROM AUTHOR]