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Cable-driven mechanism models are, usually, included in actuated systems; however, recently, their use for sensitive systems has been explored. In this paper, two cable-driven multi-body mechanism models are compared, underlining advantages and constraints in using sensitive cable-driven mechanisms for minimally invasive robotic instruments. The proposed approach could be useful in bypassing sterilization problems for surgical robotic instruments because our system allows for the separation of the robotic sterilizable part from the sensitive-actuated part of the surgical instrument. The real implementation of the proposed mechanism models, presented partially in other works, are validated in this paper, performing a simulation using a multi-body environment. Results confirm the feasibility of the proposed sensitive-actuated approach, defining new bases for the next challenges of the future.

Transperineal prostate biopsy is the most reliable technique for detecting prostate cancer, and robot-assisted needle insertion has the potential to improve the accuracy of this procedure. Modeling the interaction between a bevel-tip needle and the tissue, considering tissue heterogeneity, needle bending, and tissue/organ deformation and movement is a required step to enable robotic needle insertion. Even if several models exist, they have never been compared on experimental grounds. Based on this motivation, this paper proposes an experimental comparison for kinematic models of needle insertion, considering different needle insertion speeds and different degrees of tissue stiffness. The experimental comparison considers automated insertions of needles into transparent silicone phantoms under stereo-image guidance. The comparison evaluates the accuracy of existing models in predicting needle deformation.

This paper presents a planar cable-driven model of a simple mechanism that is able to measure forces and displacements. Recently, a preliminary study based on a cable-driven sensitive mechanism was presented to the research community, underlining the innovative characteristics of the model in under-actuation and under-sensing. The core of the research work was to conceive a compliant system able to measure forces and displacements from a point located in a different zone with respect to the one where the force is applied, and this is possible thanks to cable-driven systems. In this paper, a new simplified model with respect to our published work is presented, reducing the number of cables and including the calculation of friction in the developed test bench. The formulation to calculate the displacement of the point of the applied force and the formulation to calculate the force are presented and validated with a simulation and by using a real test bench for experimentation. A multi-body system is used for the simulation, and the results are compared and discussed. Four cases are analysed to test the formulation, including the friction in pulleys and in the joint connection between the mobile part and the fixed part of the mechanism. Future works will be oriented toward reducing the dimensions of the conceived mechanism in order to implement the model in minimally invasive robotic surgery instruments.

ObjectiveDuring nerve-sparing robot-assisted radical prostatectomy (RARP) bipolar electrocoagulation is often used but its use is controversial for the possible thermal damage of neurovascular bundles. Aim of the study was to evaluate the spatial-temporal thermal distribution in the tissue and the correlation with the electrosurgery-induced tissue damage in a controlled, CO2-rich environment modelling the laparoscopy conditions..MethodsWe manufactured a sealed plexiglass chamber (SPC) equipped with sensors to reproduce experimentally the environmental conditions of pneumoperitoneum during RARP. We evaluated in 64 pig musculofascial tissues (PMTs) of approximately 3 cm3 × 3 cm3 × 2 cm3 the spatial-temporal thermal distribution in the tissue and the correlation with the electrosurgery-induced tissue damage in a controlled CO2-rich environment modeling the laparoscopy conditions. Critical heat spread of bipolar cauterizing during surgical procedure was assessed by the employment of a compact thermal camera (C2) with a small core sensor (60 × 80 microbolometer array in the range 7–14 μm).ResultsBipolar instruments used at 30 W showed a thermal spread area of 18 mm2 when applied for 2 s and 28 mm2 when applied for 4 s. At 60 W, bipolar instruments showed a mean thermal spread and 19 mm2 when applied for 2 s; and 21 mm2 when applied for 4 s. Finally, histopathological analysis showed that thermal damage is distributed predominantly on the surface rather than in depth.ConclusionsThe application of these results is very interesting for the definition of an accurate use of bipolar cautery during nerve-sparing RARP. It demonstrates the feasibility of using miniaturized thermal sensors, thus addressing the potential for next developments regarding the design of thermal endoscopic devices for robotic use.

This study aims to evaluate the abdominal aortic atherosclerotic plaque index (API)’s predictive role in patients with pre-operatively or post-operatively developed chronic kidney disease (CKD) treated with robot-assisted partial nephrectomy (RAPN) for renal cell carcinoma (RCC). One hundred and eighty-three patients (134 with no pre- and post-operative CKD (no CKD) and 49 with persistent or post-operative CKD development (post-op CKD)) who underwent RAPN between January 2019 and January 2022 were deemed eligible for the analysis. The API was calculated using dedicated software by assessing the ratio between the CT scan atherosclerotic plaque volume and the abdominal aortic volume. The ROC regression model demonstrated the influence of API on CKD development, with an increasing effect according to its value (coefficient 0.13; 95% CI 0.04–0.23; p = 0.006). The Model 1 multivariable analysis of the predictors of post-op CKD found that the following are independently associated with post-op CKD: Charlson Comorbidity Index (OR 1.31; p = 0.01), last follow-up (FU) Δ%eGFR (OR 0.95; p < 0.01), and API ≥ 10 (OR 25.4; p = 0.01). Model 2 showed API ≥ 10 as the only factor associated with CKD development (OR 25.2; p = 0.04). The median follow-up was 22 months. Our results demonstrate API to be a strong predictor of post-operative CKD, allowing the surgeon to tailor the best treatment for each patient, especially in those who might be at higher risk of CKD.

Motion planning algorithms have seen considerable progress and expansion across various domains of science and technology during the last few decades, where rapid advancements in path planning and trajectory optimization approaches have been made possible by the conspicuous enhancements brought, among others, by sampling-based methods and convex optimization strategies. Although they have been investigated from various perspectives in the existing literature, recent developments aimed at integrating robots into social, healthcare, industrial, and educational contexts have attributed greater importance to additional concepts that would allow them to communicate, cooperate, and collaborate with each other, as well as with human beings, in a meaningful and efficient manner. Therefore, in this survey, in addition to a brief overview of some of the essential aspects of motion planning algorithms, a few vital considerations required for assimilating robots into real-world applications, including certain instances of social, urban, and industrial environments, are introduced, followed by a critical discussion of a set of outstanding issues worthy of further investigation and development in future scientific studies.

Research has demonstrated that Taekwondo training helps to enhance the coordination capabilities in people with developmental coordination disorders. These excellent results depend on many factors, including the behavior of the muscular activation patterns of psychomotor exercises during Taekwondo training. Our basic idea is to study the behavior of the muscular activation pattern of Taekwondo training (performed by athletes) and to apply the adapted behavior of the muscular activation pattern to other subjects with reduced coordination capabilities to enhance them, in line with the sustainable human development goals. This paper presents a preliminary feasibility study and a first step in this direction using a virtual simulation. First, the Taekwondo front-kick exercise was studied and reproduced using a virtual human model in OpenSim. Second, some perturbations were applied to the virtual human model to analyze the behavior of the muscular activation patterns. Third, functional electrical stimulation (FES) patterns were properly simulated to reproduce the same sequence (and value) of signals of muscular activation in another subject. The proposed methodology was conceived on the basis of a simple example of a Taekwondo kick by using a virtual human model, but its general application can fit all kinds of psychomotor exercises. If future works confirm the simulation results presented in this paper with real implementation, the methodology proposed here could be applied every time human capabilities must be increased with or without sports training (e.g., remaining seated on a chair or lying on a bed).

Force–torque sensors are used in many and different domains (i.e., space, medicine, biology, etc.). Design solutions of force–torque sensors can be conceived by using many types of connections or components; however, there are only a few sensors designed using cable-driven systems. This could be related to many reasons, one of which being that cables are able only to pull and not push. In this paper, a new cable-driven model for under-actuated force–torque sensing mechanisms is proposed, simulated, and tested, underlining the novelty of using cables for force–torque sensing. Analytical formulations, simulations, and physical implementations are presented in this paper. Results confirm that the new proposed model can be used for force–torque sensing mechanisms in micro- and macro- applications where under-actuation is a fundamental requirement, as in robotic surgery. The proposed model and mechanism can be used in the design of sensors and actuators. The innovative model is validated with two different test benches, opening new challenges in the design and development of under-actuated force–torque transducers.

The implementation of a thermal endoscope based on the LWIR camera cores Lepton and a custom miniaturized electronics is reported. The sensor and the PCB can be inserted into a cylindrical protective case of diameter down to 15mm, inox tube or plastic, 3D printable envelope, with an optical window in Germanium. Two PCBs were developed for assembling the endoscope in two different schemes, to enable frontal or lateral thermal vision setup. The thermal endoscope unit is controlled by a Raspberry external unit. The Infrared Vision Software is provided for controlling the acquisition of thermal frames, and for the thermographic calculation of the object temperature from the input parameters on object surface emissivity and environment. In general, the device enables to perform thermography in applications in which traditional larger equipment cannot be employed, as nondestructive diagnostics in confined space in the engineering field. The thermal endoscope was designed with dimensions also compatible for robotic-assisted/traditional minimally-invasive surgery.

The integration of intra-operative sensors into surgical robots is a hot research topic since this can significantly facilitate complex surgical procedures by enhancing surgical awareness with real-time tissue information. However, currently available intra-operative sensing technologies are mainly based on image processing and force feedback, which normally require heavy computation or complicated hardware modifications of existing surgical tools. This paper presents the design and integration of electrical bio-impedance sensing into a commercial surgical robot tool, leading to the creation of a novel smart instrument that allows the identification of tissues by simply touching them. In addition, an advanced user interface is designed to provide guidance during the use of the system and to allow augmented-reality visualization of the tissue identification results. The proposed system imposes minor hardware modifications to an existing surgical tool, but adds the capability to provide a wealth of data about the tissue being manipulated. This has great potential to allow the surgeon (or an autonomous robotic system) to better understand the surgical environment. To evaluate the system, a series of ex-vivo experiments were conducted. The experimental results demonstrate that the proposed sensing system can successfully identify different tissue types with 100% classification accuracy. In addition, the user interface was shown to effectively and intuitively guide the user to measure the electrical impedance of the target tissue, presenting the identification results as augmented-reality markers for simple and immediate recognition.

Force-controlled series elastic actuators (SEA) are widely used in novel human-robot interaction (HRI) applications, such as assistive and rehabilitation robotics. These systems are characterized by the presence of the “human in the loop”, so that control response and stability depend on uncertain human dynamics, including reflexes and voluntary forces. This paper proposes a force control approach that guarantees the stability and robustness of the coupled human-robot system, based on sliding-mode control (SMC), considering the human dynamics as a disturbance to reject. We propose a chattering free solution that employs simple task models to obtain high performance, comparable with second order solutions. Theoretical stability is proven within the sliding mode framework, and predictability is reached by avoiding the reaching phase by design. Furthermore, safety is introduced by a proper design of the sliding surface. The practical feasibility of the approach is shown using an SEA prototype coupled with a human impedance in severe stress tests. To show the quality of the approach, we report a comparison with state-of-the-art second order SMC, passivity-based control and adaptive control solutions.

Minimally invasive robotic surgery has gained wide acceptance recently. Computer-aided features to assist the surgeon during these interventions may help to develop safer, faster, and more accurate procedures. Especially physiological motion compensation of the beating heart and online soft tissue modelling are promising features that were developed recently. This paper presents the integration of these new features into the minimally invasive robotic surgery platform MiroSurge. A central aim of this research platform is to enable evaluation and comparison of new functionalities for minimally invasive robotic surgery. The system structure of MiroSurge is presented as well as the interfaces for the new functionalities. Some details about the modules for motion tracking and for soft tissue simulation are given. Results are shown with an experimental setup that includes a heart motion simulator and dedicated silicone organ models. Both features are integrated seamlessly and work reliably in the chosen setup. The MiroSurge platform thus shows the potential to provide valuable results in evaluating new functionalities for minimally invasive robotic surgery.

In this study, we demonstrate a compact actuation mechanism of a silicon capillary stop microvalve, based on electrothermal expansion of a trapped air bubble in a chamber. The bubble is heated using an integrated aluminum microheater deposited on the silicon substrate above the air chamber. The heater occupies an area of 320 µm × 300 µm and has a resistance of 40 Ohms. By applying a 500 ms voltage pulse of 3 V amplitude we could generate a pressure sufficient to breach the capillary barrier pressure of valve, which is around 1000 Pa.

Commercial surgical robots have been in clinical use since the mid-1990s, supporting surgeons in various tasks. In the past decades, many systems emerged as research platforms, and a few entered the global market. This paper summarizes the currently available surgical systems and research directions in the broader field of surgical robotics. The widely deployed teleoperated manipulators aim to enhance human cognitive and physical skills and provide smart tools for surgeons, while image-guided robotics focus on surpassing human limitations by introducing automated targeting and treatment delivery methods. Both concepts are discussed based on prototypes and commercial systems. Through concrete examples the possible future development paths of surgical robots are illustrated. While research efforts are taking different approaches to improve the capacity of such systems, the aim of this survey is to assess their maturity from the commercialization point of view.

The introduction of robotic surgery within the operating rooms has significantly improved the quality of many surgical procedures. Recently, the research on medical robotic systems focused on increasing the level of autonomy in order to give them the possibility to carry out simple surgical actions autonomously. This paper reports on the development of technologies for introducing automation within the surgical workflow. The results have been obtained during the ongoing FP7 European funded project Intelligent Surgical Robotics (I-SUR). The main goal of the project is to demonstrate that autonomous robotic surgical systems can carry out simple surgical tasks effectively and without major intervention by surgeons. To fulfil this goal, we have developed innovative solutions (both in terms of technologies and algorithms) for the following aspects: fabrication of soft organ models starting from CT images, surgical planning and execution of movement of robot arms in contact with a deformable environment, designing a surgical interface minimizing the cognitive load of the surgeon supervising the actions, intra-operative sensing and reasoning to detect normal transitions and unexpected events. All these technologies have been integrated using a component-based software architecture to control a novel robot designed to perform the surgical actions under study. In this work we provide an overview of our system and report on preliminary results of the automatic execution of needle insertion for the cryoablation of kidney tumours.

In this paper, we present a low-cost, adaptable, and flexible pressure sensor that can be applied as a smart skin over both stiff and deformable media. The sensor can be easily adapted for use in applications related to the fields of robotics, rehabilitation, or costumer electronic devices. In order to remove most of the stiff components that block the flexibility of the sensor, we based the sensing capability on the use of a tomographic technique known as Electrical Impedance Tomography. The technique allows the internal structure of the domain under study to be inferred by reconstructing its conductivity map. By applying the technique to a material that changes its resistivity according to applied forces, it is possible to identify these changes and then localise the area where the force was applied. We tested the system when applied to flat and curved surfaces. For all configurations, we evaluate the artificial skin capabilities to detect forces applied over a single point, over multiple points, and changes in the underlying geometry. The results are all promising, and open the way for the application of such sensors in different robotic contexts where deformability is the key point.