Soft Robotics in Minimally Invasive Surgery

Integrated Design and Fabrication of Pneumatic Soft Robot Actuators in a Single Casting Step

Bio-inspired soft robots have already shown the ability to handle uncertainty and adapt to unstructured environments. However, their availability is partially restricted by time-consuming, costly, and highly supervised design-fabrication processes, often based on resource-intensive iterative workflows. Here, we propose an integrated approach targeting the design and fabrication of pneumatic soft actuators in a single casting step. Molds and sacrificial water-soluble hollow cores are printed using fused filament fabrication. A heated water circuit accelerates the dissolution of the core's material and guarantees its complete removal from the actuator walls, while the actuator's mechanical operability is defined through finite element analysis. This enables the fabrication of actuators with non-uniform cross-sections under minimal supervision, thereby reducing the number of iterations necessary during the design and fabrication processes. Three actuators capable of bending and linear motion were designed, fabricated, integrated, and demonstrated as 3 different bio-inspired soft robots, an earthworm-inspired robot, a 4-legged robot, and a robotic gripper. We demonstrate the availability, versatility, and effectiveness of the proposed methods, contributing to accelerating the design and fabrication of soft robots. This study represents a step toward increasing the accessibility of soft robots to people at a lower cost.

Focused ultrasound enables selective actuation and Newton-level force output of untethered soft robots

Untethered miniature soft robots have significant application potentials in biomedical and industrial fields due to their space accessibility and safe human interaction. However, the lack of selective and forceful actuation is still challenging in revolutionizing and unleashing their versatility. Here, we propose a focused ultrasound-controlled phase transition strategy for achieving millimeter-level spatially selective actuation and Newton-level force of soft robots, which harnesses ultrasound-induced heating to trigger the phase transition inside the robot, enabling powerful actuation through inflation. The millimeter-level spatial resolution empowers single robot to perform multiple tasks according to specific requirements. As a concept-of-demonstration, we designed soft robot for liquid cargo delivery and biopsy robot for tissue acquisition and patching. Additionally, an autonomous control system is integrated with ultrasound imaging to enable automatic acoustic field alignment and control. The proposed method advances the spatiotemporal response capability of untethered miniature soft robots, holding promise for broadening their versatility and adaptability.

Thermally Drawn-Based Microtubule Soft Continuum Robot for Cardiovascular Intervention

Cardiovascular disease is becoming the leading cause of human mortality. In order to address this, flexible continuum robots have emerged as a promising solution for miniaturizing and automating vascular interventional equipment for diagnosing and treating cardiovascular diseases. However, existing continuum robots used for vascular intervention face challenges such as large cross-sectional sizes, inadequate driving force, and lack of navigation control, preventing them from accessing cerebral blood vessels or capillaries for medical procedures. Additionally, the complex manufacturing process and high cost of soft continuum robots hinder their widespread clinical application. In this study, we propose a thermally drawn-based microtubule soft continuum robot that overcomes these limitations. The proposed robot has cross-sectional dimensions several orders of magnitude smaller than the smallest commercially available conduits, and it can be manufactured without any length restrictions. By utilizing a driving strategy based on liquid kinetic energy advancement and external magnetic field for steering, the robot can easily navigate within blood vessels and accurately reach the site of the lesion. This innovation holds the potential to achieve controlled navigation of the robot throughout the entire blood vessel, enabling in situ diagnosis and treatment of cardiovascular diseases.

Interference Morphology of Free-Growing Tendrils and Application of Self-Locking Structures

Organisms can adapt to various complex environments by obtaining optimal morphologies. Plant tendrils evolve an extraordinary and stable spiral morphology in the free-growing stage. By combining apical and asymmetrical growth strategies, the tendrils can adjust their morphology to wrap around and grab different supports. This phenomenon of changing tendril morphology through the movement of growth inspires a thoughtful consideration of the laws of growth that underlie it. In this study, tendril growth is modeled based on the Kirchhoff rod theory to obtain the exact morphological equations. Based on this, the movement patterns of the tendrils are investigated under different growth strategies. It is shown that the self-interference phenomenon appears as the tendril grows, allowing it to hold onto its support more firmly. In addition, a finite element model is constructed using continuum media mechanics and following the finite growth theory to simulate tendril growth. The growth morphology and self-interference phenomenon of tendrils are observed visually. Furthermore, an innovative class of fluid elastic actuators is designed to verify the growth phenomena of tendrils, which can realize the wrapping and locking functions. Several experiments are conducted to measure the end output force and the smallest size that can be clamped, and the output efficiency of the elastic actuator and the optimal working pressure are verified. The results presented in this study could reveal the formation law of free tendril spiral morphology and provide an inspiring idea for the programmability and motion control of bionic soft robots, with promising applications in the fields of underwater rescue and underwater picking.

Integrated Sensors for Soft Medical Robotics

Minimally invasive procedures assisted by soft robots for surgery, diagnostics, and drug delivery have unprecedented benefits over traditional solutions from both patient and surgeon perspectives. However, the translation of such technology into commercialization remains challenging. The lack of perception abilities is one of the obstructive factors paramount for a safe, accurate and efficient robot-assisted intervention. Integrating different types of miniature sensors onto robotic end-effectors is a promising trend to compensate for the perceptual deficiencies in soft robots. For example, haptic feedback with force sensors helps surgeons to control the interaction force at the tool-tissue interface, impedance sensing of tissue electrical properties can be used for tumor detection. The last decade has witnessed significant progress in the development of multimodal sensors built on the advancement in engineering, material science and scalable micromachining technologies. This review article provides a snapshot on common types of integrated sensors for soft medical robots. It covers various sensing mechanisms, examples for practical and clinical applications, standard manufacturing processes, as well as insights on emerging engineering routes for the fabrication of novel and high-performing sensing devices.

A multimodal virtual vision platform as a next-generation vision system for a surgical robot

Robot-assisted surgery platforms are utilized globally thanks to their stereoscopic vision systems and enhanced functional assistance. However, the necessity of ergonomic improvement for their use by surgeons has been increased. In surgical robots, issues with chronic fatigue exist owing to the fixed posture of the conventional stereo viewer (SV) vision system. A head-mounted display was adopted to alleviate the inconvenience, and a virtual vision platform (VVP) is proposed in this study. The VVP can provide various critical data, including medical images, vital signs, and patient records, in three-dimensional virtual reality space so that users can access medical information simultaneously. An availability of the VVP was investigated based on various user evaluations by surgeons and novices, who executed the given tasks and answered questionnaires. The performances of the SV and VVP were not significantly different; however, the craniovertebral angle of the VVP was 16.35° higher on average than that of the SV. Survey results regarding the VVP were positive; participants indicated that the optimal number of displays was six, preferring the 2 × 3 array. Reflecting the tendencies, the VVP can be a neoconceptual candidate to be customized for medical use, which opens a new prospect in a next-generation surgical robot.

Untethered soft actuators for soft standalone robotics

Soft actuators produce the mechanical force needed for the functional movements of soft robots, but they suffer from critical drawbacks since previously reported soft actuators often rely on electrical wires or pneumatic tubes for the power supply, which would limit the potential usage of soft robots in various practical applications. In this article, we review the new types of untethered soft actuators that represent breakthroughs and discuss the future perspective of soft actuators. We discuss the functional materials and innovative strategies that gave rise to untethered soft actuators and deliver our perspective on challenges and opportunities for future-generation soft actuators.

Design and navigation method of a soft robot for single-port transvesical radical prostatectomy

PURPOSE

Currently, the rigid instruments used for laparoscopic radical resection of prostate cancer not only have the risk of damage to tissues, blood vessels, and nerves, but their limited freedom will also cause surgical blind areas. Soft robots are expected to solve these issues due to inherent flexibility, compliance, and safe interaction with tissues and organs. In addition, to achieve high surgical accuracy and provide precise guidance for surgeons, the navigation method should be studied for the soft robot.

METHODS

A soft robot system for single-port transvesical radical prostatectomy (STRP) is developed, and a navigation method combining fiber Bragg gratings and electromagnetic tracking is proposed for the soft robot. To validate the soft robot design and the effectiveness of the navigation method, different groups of experiments are conducted.

RESULTS

The proposed navigation method can achieve accurate location and shape sensing of the soft manipulator. The experiments show that the maximum tip sensing error is 2.691 mm, which is 5.38 % of the robot length for static configurations, and that the average tip sensing error is 1.966 mm, which corresponds to 3.93 % of the robot length for dynamic scenarios. Additionally, phantom tests demonstrate that the designed soft robot can enter the prostate through navigation guidance in a master-slave control mode and cover the entire prostate space.

CONCLUSIONS

The designed soft robot system, due to its soft structure, good flexibility, and accurate navigation, is expected to improve surgical safety and precision, thereby exhibiting significant potential for STRP.

Actuation for flexible and stretchable microdevices

Flexible and stretchable microdevices incorporate highly deformable structures, facilitating precise functionality at the micro- and millimetre scale. Flexible microdevices have showcased extensive utility in the fields of biomedicine, microfluidics, and soft robotics. Actuation plays a critical role in transforming energy between different forms, ensuring the effective operation of devices. However, when it comes to actuating flexible microdevices at the small millimetre or even microscale, translating actuation mechanisms from conventional rigid large-scale devices is not straightforward. The recent development of actuation mechanisms leverages the benefits of device flexibility, particularly in transforming conventional actuation concepts into more efficient approaches for flexible devices. Despite many reviews on soft robotics, flexible electronics, and flexible microfluidics, a specific and systematic review of the actuation mechanisms for flexible and stretchable microdevices is still lacking. Therefore, the present review aims to address this gap by providing a comprehensive overview of state-of-the-art actuation mechanisms for flexible and stretchable microdevices. We elaborate on the different actuation mechanisms based on fluid pressure, electric, magnetic, mechanical, and chemical sources, thoroughly examining and comparing the structure designs, characteristics, performance, advantages, and drawbacks of these diverse actuation mechanisms. Furthermore, the review explores the pivotal role of materials and fabrication techniques in the development of flexible and stretchable microdevices. Finally, we summarise the applications of these devices in biomedicine and soft robotics and provide perspectives on current and future research.

A Versatile 3D-Printable Soft Pneumatic Actuator Design for Multi-Functional Applications in Soft Robotics

Soft pneumatic actuators (SPAs) play a crucial role in generating movements and forces in soft robotic systems. However, existing SPA designs require significant structural modifications to be used in applications other than their original design. The present article proposes an omni-purpose fully 3D-printable SPA design inspired by membrane type mold and cast SPAs. The design features a spring-like zig-zag structure 3D-printed using an affordable 3D printer with thermoplastic polyurethane and a minimum wall thickness between 0.4 and 0.6 mm. The new SPA can perform unidirectional extension (30% extension) and bidirectional (rotation around same axis) bending (100°), with the ability to exert 10 N blocking force for 350 kPa pressure input. In addition, the design exhibits the capability to be scaled down for the purpose of accommodating limited spaces, while simultaneously enabling the reconfigurable interconnection of multiple SPAs to adapt to larger areas and navigate intricate trajectories that were not originally intended. The SPA's ability to be used in multiple applications without structural modification was validated through testing as a robot end-effector (gripper), artificial muscles in a soft tendon-driven prosthetic hand, a tube/tunnel navigator, and a robot crawler.

Multifunctional flexible magnetic drive gripper for target manipulation in complex constrained environments

Soft actuators capable of remote-controlled guidance and manipulation within complex constrained spaces hold great promise in various fields, especially in medical fields such as minimally invasive surgery. However, most current magnetic drive soft actuators only have the functions of position control and guidance, and it is still challenging to achieve more flexible operations on different targets within constrained spaces. Herein, we propose a multifunctional flexible magnetic drive gripper that can be steered within complex constrained spaces and operate on targets of various shapes. On the one hand, changing the internal pressure of the magnetic gripper can achieve functions such as suction or injection of liquid and transportation of targets with smooth surfaces. On the other hand, with the help of slit structures in the constrained environment, by simply changing the position and orientation of the permanent magnet in the external environment, the magnetic gripper can be controlled to clamp and release targets of linear, flaked, and polyhedral shapes. The full flexibility and multifunctionality of the magnetic gripper suggest new possibilities for precise remote control and object transportation in constrained spaces, so it could serve as a direct contact operation tool for hazardous drugs in enclosed spaces or a surgical tool in human body cavities.

MorphGI: A Self-Propelling Soft Robotic Endoscope Through Morphing Shape

Colonoscopy is currently the best method for detecting bowel cancer, but fundamental design and construction have not changed significantly in decades. Conventional colonoscope (CC) is difficult to maneuver and can lead to pain with a risk of damaging the bowel due to its rigidity. We present the MorphGI, a robotic endoscope system that is self-propelling and made of soft material, thus easy to operate and inherently safe to patient. After verifying kinematic control of the distal bending segment, the system was evaluated in: a benchtop colon simulator, using multiple colon configurations; a colon simulator with force sensors; and surgically removed pig colon tissue. In the colon simulator, the MorphGI completed a colonoscopy in an average of 10.84 min. The MorphGI showed an average of 77% and 62% reduction in peak forces compared to a CC in high- and low-stiffness modes, respectively. Self-propulsion was demonstrated in the excised tissue test but not in the live pig test, due to anatomical differences between pig and human colons. This work demonstrates the core features of MorphGI.

Learning-Based Control for Soft Robot-Environment Interaction with Force/Position Tracking Capability

Soft robotics promises to achieve safe and efficient interactions with the environment by exploiting its inherent compliance and designing control strategies. However, effective control for the soft robot-environment interaction has been a challenging task. The challenges arise from the nonlinearity and complexity of soft robot dynamics, especially in situations where the environment is unknown and uncertainties exist, making it difficult to establish analytical models. In this study, we propose a learning-based optimal control approach as an attempt to address these challenges, which is an optimized combination of a feedforward controller based on probabilistic model predictive control and a feedback controller based on nonparametric learning methods. The approach is purely data-driven, without prior knowledge of soft robot dynamics and environment structures, and can be easily updated online to adapt to unknown environments. A theoretical analysis of the approach is provided to ensure its stability and convergence. The proposed approach enabled a soft robotic manipulator to track target positions and forces when interacting with a manikin in different cases. Moreover, comparisons with other data-driven control methods show a better performance of our approach. Overall, this work provides a viable learning-based control approach for soft robot-environment interactions with force/position tracking capability.

Ductile adhesive elastomers with force-triggered ultra-high adhesion strength

Elastomers play a vital role in many forthcoming advanced technologies in which their adhesive properties determine materials' interface performance. Despite great success in improving the adhesive properties of elastomers, permanent adhesives tend to stick to the surfaces prematurely or result in poor contact depending on the installation method. Thus, elastomers with on-demand adhesion that is not limited to being triggered by UV light or heat, which may not be practical for scenarios that do not allow an additional external source, provide a solution to various challenges in conventional adhesive elastomers. Herein, we report a novel, ready-to-use, ultra high-strength, ductile adhesive elastomer with an on-demand adhesion feature that can be easily triggered by a compression force. The precursor is mainly composed of a capsule-separated, two-component curing system. After a force-trigger and curing process, the ductile adhesive elastomer exhibits a peel strength and a lap shear strength of 1.2 × 104 N m-1 and 7.8 × 103 kPa, respectively, which exceed the reported values for advanced ductile adhesive elastomers. The ultra-high adhesion force is attributed to the excellent surface contact of the liquid-like precursor and to the high elastic modulus of the cured elastomer that is reinforced by a two-phase design. Incorporation of such on-demand adhesion into an elastomer enables a controlled delay between installation and curing so that these can take place under their individual ideal conditions, effectively reducing the energy cost, preventing failures, and improving installation processes.

Design Optimization of a Hybrid-Driven Soft Surgical Robot with Biomimetic Constraints

The current study investigated the geometry optimization of a hybrid-driven (based on the combination of air pressure and tendon tension) soft robot for use in robot-assisted intra-bronchial intervention. Soft robots, made from compliant materials, have gained popularity for use in surgical interventions due to their dexterity and safety. The current study aimed to design a catheter-like soft robot with an improved performance by minimizing radial expansion during inflation and increasing the force exerted on targeted tissues through geometry optimization. To do so, a finite element analysis (FEA) was employed to optimize the soft robot's geometry, considering a multi-objective goal function that incorporated factors such as chamber pressures, tendon tensions, and the cross-sectional area. To accomplish this, a cylindrical soft robot with three air chambers, three tendons, and a central working channel was considered. Then, the dimensions of the soft robot, including the length of the air chambers, the diameter of the air chambers, and the offsets of the air chambers and tendon routes, were optimized to minimize the goal function in an in-plane bending scenario. To accurately simulate the behavior of the soft robot, Ecoflex 00-50 samples were tested based on ISO 7743, and a hyperplastic model was fitted on the compression test data. The FEA simulations were performed using the response surface optimization (RSO) module in ANSYS software, which iteratively explored the design space based on defined objectives and constraints. Using RSO, 45 points of experiments were generated based on the geometrical and loading constraints. During the simulations, tendon force was applied to the tip of the soft robot, while simultaneously, air pressure was applied inside the chamber. Following the optimization of the geometry, a prototype of the soft robot with the optimized values was fabricated and tested in a phantom model, mimicking simulated surgical conditions. The decreased actuation effort and radial expansion of the soft robot resulting from the optimization process have the potential to increase the performance of the manipulator. This advancement led to improved control over the soft robot while additionally minimizing unnecessary cross-sectional expansion. The study demonstrates the effectiveness of the optimization methodology for refining the soft robot's design and highlights its potential for enhancing surgical interventions.

Kinematics, dynamics and control of stiffness-tunable soft robots

Modeling and control methods for stiffness-tunable soft robots (STSRs) have received less attention compared to standard soft robots. A major challenge in controlling STSRs is their infinite degrees of freedom, similar to standard soft robots. In this paper, demonstrate a novel STSR by combing a soft-rigid hybrid spine-mimicking actuator with a stiffness-tunable module. Additionally, we introduce a new kinematic and dynamic modeling methodology for the proposed STSR. Based on the STSR characteristics, we model it as a series of PRP segments, each composed of two prismatic joints(P) and one revolute joint(R). This method is simpler, more generalizable, and more computationally efficient than existing approaches. We also design a multi-input multi-output (MIMO) controller that directly adjusts the pressure of the STSR's three pneumatic chambers to precisely control its posture. Both the novel modeling methodology and MIMO control system are implemented and validated on the proposed STSR prototype.

Soft touchless sensors and touchless sensing for soft robots

Soft robots are characterized by their mechanical compliance, making them well-suited for various bio-inspired applications. However, the challenge of preserving their flexibility during deployment has necessitated using soft sensors which can enhance their mobility, energy efficiency, and spatial adaptability. Through emulating the structure, strategies, and working principles of human senses, soft robots can detect stimuli without direct contact with soft touchless sensors and tactile stimuli. This has resulted in noteworthy progress within the field of soft robotics. Nevertheless, soft, touchless sensors offer the advantage of non-invasive sensing and gripping without the drawbacks linked to physical contact. Consequently, the popularity of soft touchless sensors has grown in recent years, as they facilitate intuitive and safe interactions with humans, other robots, and the surrounding environment. This review explores the emerging confluence of touchless sensing and soft robotics, outlining a roadmap for deployable soft robots to achieve human-level dexterity.

Advancements in robotic surgery: innovations, challenges and future prospects

The use of robots has revolutionized healthcare, wherein further innovations have led to improved precision and accuracy. Conceived in the late 1960s, robot-assisted surgeries have evolved to become an integral part of various surgical specialties. Modern robotic surgical systems are equipped with highly dexterous arms and miniaturized instruments that reduce tremors and enable delicate maneuvers. Implementation of advanced materials and designs along with the integration of imaging and visualization technologies have enhanced surgical accuracy and made robots safer and more adaptable to various procedures. Further, the haptic feedback system allows surgeons to determine the consistency of the tissues they are operating upon, without physical contact, thereby preventing injuries due to the application of excess force. With the implementation of teleoperation, surgeons can now overcome geographical limitations and provide specialized healthcare remotely. The use of artificial intelligence (AI) and machine learning (ML) aids in surgical decision-making by improving the recognition of minute and complex anatomical structures. All these advancements have led to faster recovery and fewer complications in patients. However, the substantial cost of robotic systems, their maintenance, the size of the systems and proper surgeon training pose major challenges. Nevertheless, with future advancements such as AI-driven automation, nanorobots, microscopic incision surgeries, semi-automated telerobotic systems, and the impact of 5G connectivity on remote surgery, the growth curve of robotic surgery points to innovation and stands as a testament to the persistent pursuit of progress in healthcare.

A 3D-MICROPRINTED COAXIAL NOZZLE FOR FABRICATING LONG, FLEXIBLE MICROFLUIDIC TUBING

A variety of emerging applications, particularly those in medical and soft robotics fields, are predicated on the ability to fabricate long, flexible meso/microfluidic tubing with high customization. To address this need, here we present a hybrid additive manufacturing (or "three-dimensional (3D) printing") strategy that involves three key steps: (i) using the "Vat Photopolymerization (VPP) technique, "Liquid-Crystal Display (LCD)" 3D printing to print a bulk microfluidic device with three inlets and three concentric outlets; (ii) using "Two-Photon Direct Laser Writing (DLW)" to 3D microprint a coaxial nozzle directly atop the concentric outlets of the bulk microdevice, and then (iii) extruding paraffin oil and a liquid-phase photocurable resin through the coaxial nozzle and into a polydimethylsiloxane (PDMS) channel for UV exposure, ultimately producing the desired tubing. In addition to fabricating the resulting tubing-composed of polymerized photomaterial-at arbitrary lengths (e.g., > 10 cm), the distinct input pressures can be adjusted to tune the inner diameter (ID) and outer diameter (OD) of the fabricated tubing. For example, experimental results revealed that increasing the driving pressure of the liquid-phase photomaterial from 50 kPa to 100 kPa led to fluidic tubing with IDs and ODs of 291±99 μm and 546±76 μm up to 741±31 μm and 888±39 μm, respectively. Furthermore, preliminary results for DLW-printing a microfluidic "M" structure directly atop the tubing suggest that the tubing could be used for "ex situ DLW (esDLW)" fabrication, which would further enhance the utility of the tubing.

Effects of chamber shapes on maneuverability and control property of endoscope-support soft actuators

Introduction: Minimally Invasive Surgery (MIS) offers targeted surgical access with reduced invasiveness; however, the maneuverability challenges of traditional instruments in this domain underscore the need for innovative solutions. Soft actuators activated by fluids or gases present a promising strategy for augmenting endoscopic capabilities, thereby enhancing the surgical precision in MIS. This study aimed to explore the intricate dynamics of the interactions between soft actuators and endoscopes, with an emphasis on the pivotal role of cross-sectional chamber shapes. While previous studies have touched on the influence of chamber shapes on bending properties, we provide a comprehensive exploration. We explore how these shapes modulate friction forces, which in turn influence the interactions governing bending, response, and stiffness adjustability, all of which are essential for enhancing endoscope maneuverability in MIS contexts. Methods: A novel bilateral symmetrical air chamber design was adopted to investigate various chamber shapes. We employed finite element analysis (FEA) simulations followed by prototype testing to evaluate the interactions driven by these chamber shapes and to discern their impact on actuator properties. Recognizing the pivotal role of friction in these interactions, we conducted dedicated friction experiments. These experiments further deepened our understanding of the relationship between chamber shape and friction, and how this synergy influences the properties of the actuator. Results: Our findings showed that actuators with wider chambers generate larger friction forces, thereby enhancing the interaction and improving the bending, response, and stiffness adjustability. Additionally, the soft actuator significantly improved the maneuverability and bending radius of the endoscope, demonstrating enhanced navigation capabilities in complex environments. Discussion: The shape of a cross-sectional chamber plays a pivotal role in designing soft actuators for MIS applications. Our research emphasizes the importance of this design component, offering key insights for the development of endoscope-supporting soft actuators that can effectively handle intricate actuator-endoscope interactions, thereby enhancing surgical outcomes.

Deep CNN-Based Static Modeling of Soft Robots Utilizing Absolute Nodal Coordinate Formulation

Soft continuum robots, inspired by the adaptability and agility of natural soft-bodied organisms like octopuses and elephant trunks, present a frontier in robotics research. However, exploiting their full potential necessitates precise modeling and control for specific motion and manipulation tasks. This study introduces an innovative approach using Deep Convolutional Neural Networks (CNN) for the inverse quasi-static modeling of these robots within the Absolute Nodal Coordinate Formulation (ANCF) framework. The ANCF effectively represents the complex non-linear behavior of soft continuum robots, while the CNN-based models are optimized for computational efficiency and precision. This combination is crucial for addressing the complex inverse statics problems associated with ANCF-modeled robots. Extensive numerical experiments were conducted to assess the performance of these Deep CNN-based models, demonstrating their suitability for real-time simulation and control in statics modeling. Additionally, this study includes a detailed cross-validation experiment to identify the most effective model architecture, taking into account factors such as the number of layers, activation functions, and unit configurations. The results highlight the significant benefits of integrating Deep CNN with ANCF models, paving the way for advanced statics modeling in soft continuum robotics.

Magnetic Continuum Robot with Intraoperative Magnetic Moment Programming

Magnetic continuum robots (MCRs), which are free of complicated structural designs for transmission, can be miniaturized and are therefore widely used in the medical field. However, the deformation shapes of different segments, including deflection directions and curvatures, are difficult to control simultaneously under an external programmable magnetic field. This is because the latest MCRs have designs with an invariable magnetic moment combination or profile of one or more actuating units. Therefore, the limited dexterity of the deformation shape causes the existing MCRs to collide readily with their surroundings or makes them unable to approach difficult-to-reach regions. These prolonged collisions are unnecessary or even hazardous, especially for catheters or similar medical devices. In this study, a novel magnetic moment intraoperatively programmable continuum robot (MMPCR) is introduced. By applying the proposed magnetic moment programming method, the MMPCR can deform under three modalities, that is, J, C, and S shapes. Additionally, the deflection directions and curvatures of different segments in the MMPCR can be modulated as desired. Furthermore, the magnetic moment programming and MMPCR kinematics are modeled, numerically simulated, and experimentally validated. The experimental results exhibit a mean deflection angle error of 3.3° and correspond well with simulation results. Comparisons between navigation capacities of the MMPCR and MCR demonstrate that the MMPCR has a higher capacity for dexterous deformation.

Beyond Conventional Operations: Embracing the Era of Contemporary Minimally Invasive Cardiac Surgery

Over the past two decades, minimally invasive cardiac surgery (MICS) has gained a significant place due to the emergence of innovative tools and improvements in surgical techniques, offering comparable efficacy and safety to traditional surgical methods. This review provides an overview of the history of MICS, its current state, and its prospects and highlights its advantages and limitations. Additionally, we highlight the growing trends and potential pathways for the expansion of MICS, underscoring the crucial role of technological advancements in shaping the future of this field. Recognizing the challenges, we strive to pave the way for further breakthroughs in minimally invasive cardiac procedures.

Submillimeter Multifunctional Ferromagnetic Fiber Robots for Navigation, Sensing, and Modulation

Small-scale robots capable of remote active steering and navigation offer great potential for biomedical applications. However, the current design and manufacturing procedure impede their miniaturization and integration of various diagnostic and therapeutic functionalities. Herein, submillimeter fiber robots that can integrate navigation, sensing, and modulation functions are presented. These fiber robots are fabricated through a scalable thermal drawing process at a speed of 4 meters per minute, which enables the integration of ferromagnetic, electrical, optical, and microfluidic composite with an overall diameter of as small as 250 µm and a length of as long as 150 m. The fiber tip deflection angle can reach up to 54o under a uniform magnetic field of 45 mT. These fiber robots can navigate through complex and constrained environments, such as artificial vessels and brain phantoms. Moreover, Langendorff mouse hearts model, glioblastoma micro platforms, and in vivo mouse models are utilized to demonstrate the capabilities of sensing electrophysiology signals and performing a localized treatment. Additionally, it is demonstrated that the fiber robots can serve as endoscopes with embedded waveguides. These fiber robots provide a versatile platform for targeted multimodal detection and treatment at hard-to-reach locations in a minimally invasive and remotely controllable manner.

A multifunctional soft robot for cardiac interventions

In minimally invasive endovascular procedures, surgeons rely on catheters with low dexterity and high aspect ratios to reach an anatomical target. However, the environment inside the beating heart presents a combination of challenges unique to few anatomic locations, making it difficult for interventional tools to maneuver dexterously and apply substantial forces on an intracardiac target. We demonstrate a millimeter-scale soft robotic platform that can deploy and self-stabilize at the entrance to the heart, and guide existing interventional tools toward a target site. In two exemplar intracardiac procedures within the right atrium, the robotic platform provides enough dexterity to reach multiple anatomical targets, enough stability to maintain constant contact on motile targets, and enough mechanical leverage to generate newton-level forces. Because the device addresses ongoing challenges in minimally invasive intracardiac intervention, it may enable the further development of catheter-based interventions.

A review on self-healing featured soft robotics

Soft robots are becoming more popular because they can solve issues stiff robots cannot. Soft component and system design have seen several innovations recently. Next-generation robot-human interactions will depend on soft robotics. Soft material technologies integrate safety at the material level, speeding its integration with biological systems. Soft robotic systems must be as resilient as biological systems in unexpected, uncontrolled situations. Self-healing materials, especially polymeric and elastomeric ones, are widely studied. Since most currently under-development soft robotic systems are composed of polymeric or elastomeric materials, this finding may provide immediate assistance to the community developing soft robots. Self-healing and damage-resilient systems are making their way into actuators, structures, and sensors, even if soft robotics remains in its infancy. In the future, self-repairing soft robotic systems composed of polymers might save both money and the environment. Over the last decade, academics and businesses have grown interested in soft robotics. Despite several literature evaluations of the soft robotics subject, there seems to be a lack of systematic research on its intellectual structure and development despite the rising number of articles. This article gives an in-depth overview of the existing knowledge base on damage resistance and self-healing materials' fundamental structure and classifications. Current uses, problems with future implementation, and solutions to those problems are all included in this overview. Also discussed are potential applications and future directions for self-repairing soft robots.

Bio-inspired soft pneumatic actuator based on a kresling-like pattern with a rigid skeleton

INTRODUCTION

Biomimetic soft pneumatic actuators (SPA) with Kresling origami patterns have unique advantages over conventional rigid robots, owing to their adaptability and safety.

OBJECTIVES

Inspired by cloning and moving behaviors observed from salps, we proposed an SPA based on a Kresling-like pattern with a rigid skeleton. The elongation and output force were tested, and the effectiveness of the applications with the SPA was evaluated.

METHODS

The proposed SPA consists of rigid skeletons and a soft skin. The rigid skeletons are constructed using layers of Kresling-like patterns, while a novel extensible inserting structure is devised to replace the folds found in conventional Kresling patterns. This innovative approach ensures that the SPA exhibits axial contraction/expansion motion without any twisting movement. To mimic the bionic characteristics of swimming and ingesting progress of salps, the proposed SPA can perform an axial contraction motion without twisting and a controllable bending motion based on multi-layered Kresling-like patterns; to mimic the cloning and releasing life phenomena of salps, the number of layers of Kresling-like patterns is changeable by adding or reducing skeleton components according to the practical needs.

RESULTS

The experimental elongation results on the SPA with multiple layers of Kresling-like patterns show that the elongation can increase to above 162% by adding layers; the experimental output force results show that the three-layer SPA can provide 6.36 N output force at an air flow rate of 10 L/min, and the output force will continue to increase as the number of layers of Kresling-like pattern increases or the air flow rate increases. Further, we demonstrate the applications of the SPA in soft grippers, scissor grippers, claw grippers and pipe crawlers.

CONCLUSION

Our proposed SPA can avoid twisting in the radial contraction motion with high elongation and output force, and provide the practical guidance for bio-inspired soft robotic applications.

Soft Electromagnetic Motor and Soft Magnetic Sensors for Synchronous Rotary Motion

To create fully-soft robots, fully-soft actuators are needed. Currently, soft rotary actuator topologies described in the literature exhibit low rotational speeds, which limit their applicability. In this work, we describe a novel, fully-soft synchronous rotary electromagnetic actuator and soft magnetic contact switch sensor concept. In this study, the actuator is constructed using gallium indium liquid metal conductors, compliant permanent magnetic composites, carbon black powders, and flexible polymers. The actuator also operates using low voltages (<20 V, ≤10 A), has a bandwidth of 10 Hz, a stall torque of 2.5-3 mN·m, and no-load speed of up to 4000 rpm. These values show that the actuator rotates at over two orders-of-magnitude higher speed with at least one order-of-magnitude higher output power than previously developed soft rotary actuators. This unique soft rotary motor is operated in a manner similar to traditional hard motors, but is also able to stretch and deform to enable new soft robot functions. To demonstrate fully-soft actuator application concepts, the motor is incorporated into a fully-soft air blower, fully-soft underwater propulsion system, fully-soft water pump, and squeeze-based sensor for a fully-soft fan. Hybrid hard and soft applications were also tested, including a geared robotic car, pneumatic actuator, and hydraulic pump. Overall, this work demonstrates how the fully-soft rotary electromagnetic actuator can bridge the gap between the capabilities of traditional hard motors and novel soft actuator concepts.

Current and Future Advances in Surgical Therapy for Pituitary Adenoma

The vital physiological role of the pituitary gland, alongside its proximity to critical neurovascular structures, means that pituitary adenomas can cause significant morbidity or mortality. While enormous advancements have been made in the surgical care of pituitary adenomas, numerous challenges remain, such as treatment failure and recurrence. To meet these clinical challenges, there has been an enormous expansion of novel medical technologies (eg, endoscopy, advanced imaging, artificial intelligence). These innovations have the potential to benefit each step of the patient's journey, and ultimately, drive improved outcomes. Earlier and more accurate diagnosis addresses this in part. Analysis of novel patient data sets, such as automated facial analysis or natural language processing of medical records holds potential in achieving an earlier diagnosis. After diagnosis, treatment decision-making and planning will benefit from radiomics and multimodal machine learning models. Surgical safety and effectiveness will be transformed by smart simulation methods for trainees. Next-generation imaging techniques and augmented reality will enhance surgical planning and intraoperative navigation. Similarly, surgical abilities will be augmented by the future operative armamentarium, including advanced optical devices, smart instruments, and surgical robotics. Intraoperative support to surgical team members will benefit from a data science approach, utilizing machine learning analysis of operative videos to improve patient safety and orientate team members to a common workflow. Postoperatively, neural networks leveraging multimodal datasets will allow early detection of individuals at risk of complications and assist in the prediction of treatment failure, thus supporting patient-specific discharge and monitoring protocols. While these advancements in pituitary surgery hold promise to enhance the quality of care, clinicians must be the gatekeepers of the translation of such technologies, ensuring systematic assessment of risk and benefit prior to clinical implementation. In doing so, the synergy between these innovations can be leveraged to drive improved outcomes for patients of the future.

A stiffness-tunable soft actuator inspired by helix for medical applications

PURPOSE

This paper introduces the stiffness-tunable soft actuator (STSA), a novel device that combines a silicone body with a thermoplastic resin structure (TPRS). The STSA's design allows for the variable stiffness of soft robots, significantly increasing their potential for use in medical scenarios such as minimally invasive surgeries (MIS). By adjusting the stiffness of the STSA, it is possible to enhance the robot's dexterity and adaptability, making it a promising tool for performing complex tasks in narrow and delicate spaces.

METHODS

The stiffness of the STSA can be modulated by altering the temperature of the TPRS, which has been inspired by the helix and is integrated into the soft actuator to achieve a broad range of stiffness modulation while maintaining flexibility. The STSA has been designed with both diagnostic and therapeutic functions in mind, with the hollow area of the TPRS serving as an instrument channel for delivering surgical instruments. Additionally, the STSA features three uniformly arranged pipelines for actuation by air or tendon, and can be expanded with more functional chambers for endoscopy, illumination, water injection, and other purposes.

RESULTS

Experimental results show that the STSA can achieve a maximum 30-fold stiffness tuning, providing a significant improvement in load capacity and stability when compared to pure soft actuators (PSAs). Of particular importance, the STSA is capable of achieving stiffness modulation below 45 °C, thereby ensuring a safe entry into the human body and creating an environment conducive to the normal operation of surgical instruments such as endoscope.

CONCLUSION

The experimental findings indicate that the soft actuator with TPRS can achieve a broad range of stiffness modulation while retaining flexibility. Moreover, the STSA can be designed to have a diameter of 8-10 mm, which satisfies the diameter requirements of a bronchoscope. Furthermore, the STSA has the potential to be utilized for clamping and ablation in a laparoscopic scenario, thereby demonstrating its potential for clinical use. Overall, these results suggest that the STSA has significant promise for use in medical applications, particularly in the context of minimally invasive surgeries.

Toward a novel soft robotic system for minimally invasive interventions

PURPOSE

During minimally invasive surgery, surgeons maneuver tools through complex anatomies, which is difficult without the ability to control the position of the tools inside the body. A potential solution for a substantial portion of these procedures is the efficient design and control of a pneumatically actuated soft robot system.

METHODS

We designed and evaluated a system to control a steerable catheter tip. A macroscale 3D printed catheter tip was designed to have two separately pressurized channels to induce bending in two directions. A motorized hand controller was developed to allow users to control the bending angle while manually inserting the steerable tip. Preliminary characterization of two catheter tip prototypes was performed and used to map desired angle inputs into pressure commands.

RESULTS

The integrated robotic system allowed both a novice and a skilled surgeon to position the steerable catheter tip at the location of cylindrical targets with sub-millimeter accuracy. The novice was able to reach each target within ten seconds and the skilled surgeon within five seconds on average.

CONCLUSION

This soft robotic system enables its user to simultaneously insert and bend the pneumatically actuated catheter tip with high accuracy and in a short amount of time. These results show promise concerning the development of a soft robotic system that can improve outcomes in minimally invasive interventions.

Bioinspired rotary flight of light-driven composite films

Light-driven actuators have great potential in different types of applications. However, it is still challenging to apply them in flying devices owing to their slow response, small deflection and force output and low frequency response. Herein, inspired by the structure of vine maple seeds, we report a helicopter-like rotary flying photoactuator (in response to 0.6 W/cm2 near-infrared (NIR) light) with ultrafast rotation (~7200 revolutions per minute) and rapid response (~650 ms). This photoactuator is operated based on a fundamentally different mechanism that depends on the synergistic interactions between the photothermal graphene and the hygroscopic agar/silk fibroin components, the subsequent aerodynamically favorable airscrew formation, the jet propulsion, and the aerodynamics-based flying. The soft helicopter-like photoactuator exhibits controlled flight and steering behaviors, making it promising for applications in soft robotics and other miniature devices.

Angle-programmed tendril-like trajectories enable a multifunctional gripper with ultradelicacy, ultrastrength, and ultraprecision

Achieving multicapability in a single soft gripper for handling ultrasoft, ultrathin, and ultraheavy objects is challenging due to the tradeoff between compliance, strength, and precision. Here, combining experiments, theory, and simulation, we report utilizing angle-programmed tendril-like grasping trajectories for an ultragentle yet ultrastrong and ultraprecise gripper. The single gripper can delicately grasp fragile liquids with minimal contact pressure (0.05 kPa), lift objects 16,000 times its own weight, and precisely grasp ultrathin, flexible objects like 4-μm-thick sheets and 2-μm-diameter microfibers on flat surfaces, all with a high success rate. Its scalable and material-independent design allows for biodegradable noninvasive grippers made from natural leaves. Explicitly controlled trajectories facilitate its integration with robotic arms and prostheses for challenging tasks, including picking grapes, opening zippers, folding clothes, and turning pages. This work showcases soft grippers excelling in extreme scenarios with potential applications in agriculture, food processing, prosthesis, biomedicine, minimally invasive surgeries, and deep-sea exploration.

Artificial intelligence meets medical robotics

Artificial intelligence (AI) applications in medical robots are bringing a new era to medicine. Advanced medical robots can perform diagnostic and surgical procedures, aid rehabilitation, and provide symbiotic prosthetics to replace limbs. The technology used in these devices, including computer vision, medical image analysis, haptics, navigation, precise manipulation, and machine learning (ML) , could allow autonomous robots to carry out diagnostic imaging, remote surgery, surgical subtasks, or even entire surgical procedures. Moreover, AI in rehabilitation devices and advanced prosthetics can provide individualized support, as well as improved functionality and mobility (see the figure). The combination of extraordinary advances in robotics, medicine, materials science, and computing could bring safer, more efficient, and more widely available patient care in the future. -Gemma K. Alderton.

Control method for bio-actuators based on muscle contraction model. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023;2023:1-6. [PMID: 38083034 DOI: 10.1109/embc40787.2023.10341011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

For the practical application of bio-actuators, it is desired to develop a precise control method for skeletal muscles. In this study, a novel model-based control method has been proposed. The control method enables skeletal muscles to exert an arbitrary magnitude of contraction force, rather than just the conventional on/off control. First, we proposed a control system to obtain the optimized electrical stimulation voltage, that can reproduce reference force. In order to actually apply the method, a bio-actuator consisting of a skeletal muscle of a frog was manufactured for a verification experiment. First, muscle contraction model parameters that could reproduce the contractile response of the gastrocnemius muscle were identified from the experimental data. Next, based on this model, the proposed control method was used to calculate the stimulation voltage to exert the reference force. The voltage was applied to the bio-actuator to control the contraction force. As a results, the output of the actuator was able to follow the stepwise reference force. Our proposed control method demonstrates the feasibility of precise control of bio-actuators.Clinical Relevance- If skeletal muscles could be used as actuators for power-assistive suits, it would be possible to develop power-assistive suits that are more compatible with people and reduce the burden on caregivers in the field of nursing care. The method proposed in this study will enable the control of skeletal muscle contraction force by electrical stimulation, bringing skeletal muscle actuators closer to practical application.

A Magnetic Bio-Inspired Soft Carrier as a Temperature-Controlled Gastrointestinal Drug Delivery System

Currently, gastrointestinal bleeding in the colon wall and the small bowel is diagnosed and treated with endoscopes. However, the locations of this condition are often problematic to treat using traditional flexible and tethered tools. New studies commonly consider untethered devices for solving this problem. However, there still exists a gap in the extant literature, and more research is needed to diagnose and deliver drugs in the lower gastrointestinal tract using soft robotic carriers. This paper discusses the development of an untethered, magnetically-responsive bio-inspired soft carrier. A molding process is utilized to produce prototypes from Diisopropylidene-1,6-diphenyl-1,6-hexanediol-based Polymer with Ethylene Glycol Dimethacrylate (DiAPLEX) MP-3510 - a shape memory polymer with a low transition temperature to enable the fabrication of these carriers. The soft carrier design is validated through simulation results of deformation caused by magnetic elements embedded in the carrier in response to an external field. The thermal responsiveness of the fabricated prototype carriers is assessed ex vivo and in a phantom. The results indicate a feasible design capable of administering drugs to a target inside a phantom of a large intestine. The soft carrier introduces a method for the controlled release of drugs by utilizing the rubbery modulus of the polymer and increasing the recovery force through magnetic actuation.

Research on the Comparison Properties of PDMS Specimens Demolding Processes and the Mechanical Performance of Hollow-Solid Ratios of Flexible Telescopic Rods

The main motivation of this work was to demonstrate a hollow telescopic rod structure that could be used for minimally invasive surgery. The telescopic rods were fabricated using 3D printing technology to make mold flips. During fabrication, differences in biocompatibility, light transmission, and ultimate displacement were compared between telescopic rods fabricated via different processes, so as to select the appropriate process. To achieve these goals, flexible telescopic rod structures were designed and 3D-printed molds were fabricated using Fused Deposition Modeling (FDM) and Stereolithography (SLA) techniques. The results showed that the three molding processes had no impact on the doping of the PDMS specimens. However, the FDM molding process had lower surface flatness accuracy compared to SLA. The SLA mold flip fabrication exhibited superior surface accuracy and light transmission compared to the other methods. The sacrificial template method and the use of HTL direct demolding technique had no significant impact on cellular activity and biocompatibility, but the mechanical properties of the PDMS specimens were weakened after swelling recovery. The height and radius of the hollow rod were found to have a significant impact on the mechanical properties of the flexible hollow rod. The hyperelastic model was fitted appropriately with the mechanical test results, and the ultimate elongation increased with an increase in hollow-solid ratios under the uniform force.

Design improvement of the conversion mechanism from balloon inflation to bending motion for inflatable film actuators

Various soft actuators have been investigated to overcome the drawbacks of conventional solid machines and explore the applications of soft robotics. In particular, and because they are expected to be applicable in minimally invasive medicine because of their safety, soft inflatable microactuators using an actuation conversion mechanism from balloon inflation to bending motion have been proposed for high-output bending motion. These microactuators could be applied to create an operation space by safely moving organs and tissues; however, the conversion efficiency could be further improved. This study aimed to improve conversion efficiency by investigating the design of the conversion mechanism. The contact conditions between the inflated balloon and conversion film were examined to improve the contact area for force transmission, with the contact area dependent on the length of the contact arc between the balloon and force conversion mechanism and on the amount of balloon deformation. In addition, surface contact friction between the balloon and film, which affects actuator performance, was also investigated. The generated force of the improved device is 1.21 N at 80 kPa when it bends 10 mm, which is 2.2 times the generated force of the previous design. This improved soft inflatable microactuator is expected to assist in performing operations in a limited space, such as in endoscopic or laparoscopic operations.

A Millimeter-Scale Soft Robot for Tissue Biopsy Procedures

While interest in soft robotics as surgical tools has grown due to their inherently safe interactions with the body, their feasibility is limited in the amount of force that can be transmitted during procedures. This is especially apparent in minimally invasive procedures where millimeter-scale devices are necessary for reaching the desired surgical site, such as in interventional bronchoscopy. To leverage the benefits of soft robotics in minimally invasive surgery, a soft robot with integrated tip steering, stabilization, and needle deployment capabilities is proposed for lung tissue biopsy procedures. Design, fabrication, and modeling of the force transmission of this soft robotic platform allows for integration into a system with a diameter of 3.5 mm. Characterizations of the soft robot are performed to analyze bending angle, force transmission, and expansion during needle deployment. In-vitro experiments of both the needle deployment mechanism and fully integrated soft robot validate the proposed workflow and capabilities in a simulated surgical setting.

Hyperelastic Modeling and Validation of Hybrid-Actuated Soft Robot with Pressure-Stiffening

Soft robots have gained popularity, especially in intraluminal applications, because their soft bodies make them safer for surgical interventions than flexures with rigid backbones. This study investigates a pressure-regulating stiffness tendon-driven soft robot and provides a continuum mechanics model for it towards using that in adaptive stiffness applications. To this end, first, a central single-chamber pneumatic and tri-tendon-driven soft robot was designed and fabricated. Afterward, the classic Cosserat's rod model was adopted and augmented with the hyperelastic material model. The model was then formulated as a boundary-value problem and was solved using the shooting method. To identify the pressure-stiffening effect, a parameter-identification problem was formulated to identify the relationship between the flexural rigidity of the soft robot and internal pressure. The flexural rigidity of the robot at various pressures was optimized to match theoretical deformation and experiments. The theoretical findings of arbitrary pressures were then compared with the experiment for validation. The internal chamber pressure was in the range of 0 to 40 kPa and the tendon tensions were in the range of 0 to 3 N. The theoretical and experimental findings were in fair agreement for tip displacement with a maximum error of 6.40% of the flexure's length.

Adaptive control of a soft pneumatic actuator using experimental characterization data

Fiber reinforced soft pneumatic actuators are hard to control due to their non-linear behavior and non-uniformity introduced by the fabrication process. Model-based controllers generally have difficulty compensating non-uniform and non-linear material behaviors, whereas model-free approaches are harder to interpret and tune intuitively. In this study, we present the design, fabrication, characterization, and control of a fiber reinforced soft pneumatic module with an outer diameter size of 12 mm. Specifically, we utilized the characterization data to adaptively control the soft pneumatic actuator. From the measured characterization data, we fitted mapping functions between the actuator input pressures and the actuator space angles. These maps were used to construct the feedforward control signal and tune the feedback controller adaptively depending on the actuator bending configuration. The performance of the proposed control approach is experimentally validated by comparing the measured 2D tip orientation against the reference trajectory. The adaptive controller was able to successfully follow the prescribed trajectory with a mean absolute error of 0.68° for the magnitude of the bending angle and 3.5° for the bending phase around the axial direction. The data-driven control method introduced in this paper may offer a solution to intuitively tune and control soft pneumatic actuators, compensating for their non-uniform and non-linear behavior.

Self-folding soft-robotic chains with reconfigurable shapes and functionalities

Magnetic continuum soft robots can actively steer their tip under an external magnetic field, enabling them to effectively navigate in complex in vivo environments and perform minimally invasive interventions. However, the geometries and functionalities of these robotic tools are limited by the inner diameter of the supporting catheter as well as the natural orifices and access ports of the human body. Here, we present a class of magnetic soft-robotic chains (MaSoChains) that can self-fold into large assemblies with stable configurations using a combination of elastic and magnetic energies. By pushing and pulling the MaSoChain relative to its catheter sheath, repeated assembly and disassembly with programmable shapes and functions are achieved. MaSoChains are compatible with state-of-the-art magnetic navigation technologies and provide many desirable features and functions that are difficult to realize through existing surgical tools. This strategy can be further customized and implemented for a wide spectrum of tools for minimally invasive interventions.

A variable-stiffness and healable pneumatic actuator

Pneumatic-powered actuators are receiving increasing attention due to their widespread applications. However, their inherent low stiffness makes them incompetent in tasks requiring high load capacity or high force output. On the other hand, soft pneumatic actuators are susceptible to damage caused by over-pressuring or punctures by sharp objects. In this work, we designed and synthesized a coordination adaptable network (PETMP-AIM-Cu) with high mechanical rigidity (Young's modulus of 1.9 GPa and elongation <2% before fracturing) as well as excellent variable stiffness property (soft-rigid switching ability σ as high as 3 268 000 when ΔT = 90 °C). Combining PETMP-AIM-Cu with a self-healing elastomer based on dynamic disulfide bonds (LP-PDMS), we fabricated a new pneumatic actuator which shows high load capacity at room temperature, but can also easily deform upon heating and thus can be actuated pneumatically. Benefiting from the excellent self-healing ability of PETMP-AIM-Cu and LP-PDMS, the entire pneumatic actuator can still be actuated after being cut and healed. Such a variable-stiffness and healable pneumatic actuator would be useful for complex environmental applications.

Continuously-deformable and stiffness-tunable soft manipulator achieving unmanned COVID-19 pandemic sampling

In recent years, COVID-19 has spread across the whole world, and manpowered collection of pharyngeal samples undoubtedly increases the possibility of cross-infections. In this article, based on our previous fabricated soft manipulator (Cell Reports Physical Science, 2021, 2, 100600), we performed the COVID-19 sampling on real human volunteers by exploiting a pre-programmed unmanned system. The unmanned sampling system mainly includes a soft manipulator and a rigid motion platform, which are adjusted by pneumatic control box and the motor control modules, respectively. Drawn on the lead-through teaching method, the unmanned sampling of COVID-19 is realized by recording the applied pressure in soft manipulator and the feed motion of rigid platform. This research provides a potential approach for unmanned COVID-19 sampling, solving the risk of cross-infection during manual collection.

A multi-module soft robotic arm with soft actuator for minimally invasive surgery

BACKGROUND

Compared to traditional rigid robotic arms, soft robotic arms are flexible, environmentally adaptable and biocompatible. Recently, most minimally invasive cardiac procedures still rely on traditional rigid surgical tools. However, rigid tools lack sufficient bending angles, which are high-risk in terms of contact with tissues and organs.

METHODS

A soft robotic arm with multiple degrees of freedom was designed to repair atrial septal defects in cardiac surgery. The developed multi-module soft robotic arm consists of four different units, including a bending unit, a turning unit, a stretching unit and gripper units. The three movement units can reach the specified position, and the gripper units can hold a surgical tool stably, such as a suture needle in cardiac surgery.

RESULTS

A cardiac surgery to repair an atrial septal defect has been completed, validating the reliability and functionality of the developed multi-module soft robotic arm.

CONCLUSIONS

The multi-module flexible soft robotic arm for minimally invasive surgery proposed in this paper can reach the designated surgical area during surgery to repair Atrial Septal Defects. Meanwhile, the design of the actuator of the robot arm was used a completely soft silicone material replacing the rigid material, which releases the contact trauma of the organs during the surgery.

Neuron-Inspired Soft Robot Teams and Their Non-Contact Electric Signal Transmission Based on Electromagnetic Induction

Transmission of electric signal among robots enables them to construct a team to behave beyond capabilities of the individuals. However, such a signal transmission is elusive so far for soft robots due to the employment of soft materials, rather than traditionally rigid electronic units. In this study, we demonstrate neuron-inspired soft robots (NISRs) with an electromagnetic induced signal transmission system. The prototype 15-cm-long NISRs can not only be moved driven by a manually moving magnet but also transmit signals to others in a noncontact type based on the electromagnetic induction through their tentacle units. Owing to the motion and special signal transmission mode, three NISRs can form diverse signal transport pathways to light up light emitting diodes in different positions. Furthermore, an alternative current (AC) signal can be generated when applying an interval loading/unloading compressive force with the velocity of 800 mm·min^-1 on the head of NISR integrated a magnet and a coil (named it NISR-plus). Such an AC signal can be immediately sensed by neighboring NISRs, indicating the construction of a signal transmission network among the NISR team. Our results open perspectives to realize signal transmission of soft robots via wireless electromagnetic induction and favor the development of soft robot teams.

Energy-shaping control of a muscular octopus arm moving in three dimensions

Flexible octopus arms exhibit an exceptional ability to coordinate large numbers of degrees of freedom and perform complex manipulation tasks. As a consequence, these systems continue to attract the attention of biologists and roboticists alike. In this article, we develop a three-dimensional model of a soft octopus arm, equipped with biomechanically realistic muscle actuation. Internal forces and couples exerted by all major muscle groups are considered. An energy-shaping control method is described to coordinate muscle activity so as to grasp and reach in three-dimensional space. Key contributions of this article are as follows: (i) modelling of major muscle groups to elicit three-dimensional movements; (ii) a mathematical formulation for muscle activations based on a stored energy function; and (iii) a computationally efficient procedure to design task-specific equilibrium configurations, obtained by solving an optimization problem in the Special Euclidean group SE ( 3 ) . Muscle controls are then iteratively computed based on the co-state variable arising from the solution of the optimization problem. The approach is numerically demonstrated in the physically accurate software environment Elastica . Results of numerical experiments mimicking observed octopus behaviours are reported.

Multifunctional ferromagnetic fiber robots for navigation, sensing, and treatment in minimally invasive surgery

Small-scale robots capable of remote active steering and navigation offer great potential for biomedical applications. However, the current design and manufacturing procedure impede their miniaturization and integration of various diagnostic and therapeutic functionalities. Here, we present a robotic fiber platform for integrating navigation, sensing, and therapeutic functions at a submillimeter scale. These fiber robots consist of ferromagnetic, electrical, optical, and microfluidic components, fabricated with a thermal drawing process. Under magnetic actuation, they can navigate through complex and constrained environments, such as artificial vessels and brain phantoms. Moreover, we utilize Langendorff mouse hearts model, glioblastoma microplatforms, and in vivo mouse models to demonstrate the capabilities of sensing electrophysiology signals and performing localized treatment. Additionally, we demonstrate that the fiber robots can serve as endoscopes with embedded waveguides. These fiber robots provide a versatile platform for targeted multimodal detection and treatment at hard-to-reach locations in a minimally invasive and remotely controllable manner.

Neural Network-Based Active Load-Sensing Scheme and Stiffness Adjustment for Pneumatic Soft Actuators for Minimally Invasive Surgery Support

To provide a stable surgical view in Minimally Invasive Surgery (MIS), it is necessary for a flexible endoscope applied in MIS to have adjustable stiffness to resist different external loads from surrounding organs and tissues. Pneumatic soft actuators are expected to fulfill this role, since they could feed the endoscope with an internal access channel and adjust their stiffness via an antagonistic mechanism. For that purpose, it is essential to estimate the external load. In this study, we proposed a neural network (NN)-based active load-sensing scheme and stiffness adjustment for a soft actuator for MIS support with antagonistic chambers for three degrees of freedom (DoFs) of control. To deal with the influence of the nonlinearity of the soft actuating system and uncertainty of the interaction between the soft actuator and its environment, an environment exploration strategy was studied for improving the robustness of sensing. Moreover, a NN-based inverse dynamics model for controlling the stiffness of the soft actuator with different flexible endoscopes was proposed too. The results showed that the exploration strategy with different sequence lengths improved the estimation accuracy of external loads in different conditions. The proposed method for external load exploration and inverse dynamics model could be used for in-depth studies of stiffness control of soft actuators for MIS support.