Design and Integration of a Parallel, Soft Robotic End-Effector for Extracorporeal Ultrasound

A fully autonomous robotic ultrasound system for thyroid scanning

The current thyroid ultrasound relies heavily on the experience and skills of the sonographer and the expertise of the radiologist, and the process is physically and cognitively exhausting. In this paper, we report a fully autonomous robotic ultrasound system, which is able to scan thyroid regions without human assistance and identify malignant nod- ules. In this system, human skeleton point recognition, reinforcement learning, and force feedback are used to deal with the difficulties in locating thyroid targets. The orientation of the ultrasound probe is adjusted dynamically via Bayesian optimization. Experimental results on human participants demonstrated that this system can perform high-quality ultrasound scans, close to manual scans obtained by clinicians. Additionally, it has the potential to detect thyroid nodules and provide data on nodule characteristics for American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) calculation.

Toward Development of Novel Remote Ultrasound Robotic System Using Soft Robotics Technology

This paper reports on the development of a novel soft robotic system for remote ultrasound applications. Direct contact of the ultrasound probe with the patient's body represents a safety risk and therefore control of the probe's positioning and applied force is a crucial task. The proposed robot uses a passive control system that provides safe interaction between the robot and the patient by leveraging soft robotics technology. The soft robot's structure can be considered as a nonlinear spring which can be designed to exert a safe force within the robot's workspace to guarantee the safety of human-robot interaction. The literature suggests that effective ultrasound imaging of both the heart and abdomen requires six degrees-of-freedom. These degrees-of-freedom consist of three translational motions, which are achieved using a novel hybrid soft cable-driven parallel robot, and three wrist motions, which is based on a universal joint design. The experimental results show that the robot can achieve all these six degrees-of-freedom, and its blocking force can be engineered to generate a uniform force within the workspace.

Advancements in materials, manufacturing, propulsion and localization: propelling soft robotics for medical applications

Soft robotics is an emerging field showing immense potential for biomedical applications. This review summarizes recent advancements in soft robotics for in vitro and in vivo medical contexts. Their inherent flexibility, adaptability, and biocompatibility enable diverse capabilities from surgical assistance to minimally invasive diagnosis and therapy. Intelligent stimuli-responsive materials and bioinspired designs are enhancing functionality while improving biocompatibility. Additive manufacturing techniques facilitate rapid prototyping and customization. Untethered chemical, biological, and wireless propulsion methods are overcoming previous constraints to access new sites. Meanwhile, advances in tracking modalities like computed tomography, fluorescence and ultrasound imaging enable precision localization and control enable in vivo applications. While still maturing, soft robotics promises more intelligent, less invasive technologies to improve patient care. Continuing research into biocompatibility, power supplies, biomimetics, and seamless localization will help translate soft robots into widespread clinical practice.

SAPM: Self-Adaptive Parallel Manipulator with Pose and Force Adjustment for Robotic Ultrasonography

Robotic ultrasonography potentially acts as an essential aid to medical diagnosis. To overcome the limitations in robotic ultrasonography, in this paper, we proposed a novel self-adaptive parallel manipulator (SAPM) that can automatically adjust the ultrasound (US) probe pose to adapt to various contours of scanned areas, provide approximate constant operating forces/torques, achieve mechanical measurement, and cushion undesired produced forces. A novel parallel adjustment mechanism is proposed to attain automatic pose adjustment with 3 degrees of freedom (DOFs). This mechanism enables the US probe to adapt to different scanned areas and to perform the scanning with approximate constant forces and torques. Besides, we present a mechanical measurement and safety protection method that can be integrated into the SAPM and used as operation status monitoring and early warning during scanning procedures by capturing operating forces and torques. Experiments were carried out to calibrate the measurement and buffer units and evaluate the performance of the SAPM. Experimental results show the ability of the SAPM to provide 3-DoFs motion and operating force/torque measurement and automatically adjust the US probe pose to capture US images of equally good quality compared to a manual sonographer scan. Moreover, it has characteristics similar to soft robots that could significantly improve operation safety, and could be extended to some other engineering or medical applications.

A review on tele-manipulators for remote diagnostic procedures and surgery

With modern medicine and healthcare services improving in leaps and bounds, the integration of telemedicine has helped in expanding these specialised healthcare services to remote locations. Healthcare telerobotic systems form a component of telemedicine, which allows medical intervention from a distance. It has been nearly 40 years since a robotic technology, PUMA 560, was introduced to perform a stereotaxic biopsy in the brain. The use of telemanipulators for remote surgical procedures began around 1995, with the Aesop, the Zeus, and the da Vinci robotic surgery systems. Since then, the utilisation of robots has steadily increased in diverse healthcare disciplines, from clinical diagnosis to telesurgery. The telemanipulator system functions in a master–slave protocol mode, with the doctor operating the master system, aided by audio-visual and haptic feedback. Based on the control commands from the master, the slave system, a remote manipulator, interacts directly with the patient. It eliminates the requirement for the doctor to be physically present in the spatial vicinity of the patient by virtually bringing expert-guided medical services to them. Post the Covid-19 pandemic, an exponential surge in the utilisation of telerobotic systems has been observed. This study aims to present an organised review of the state-of-the-art telemanipulators used for remote diagnostic procedures and surgeries, highlighting their challenges and scope for future research and development.

Soft Robotics: A Systematic Review and Bibliometric Analysis

In recent years, soft robotics has developed considerably, especially since the year 2018 when it became a hot field among current research topics. The attention that this field receives from researchers and the public is marked by the substantial increase in both the quantity and the quality of scientific publications. In this review, in order to create a relevant and comprehensive picture of this field both quantitatively and qualitatively, the paper approaches two directions. The first direction is centered on a bibliometric analysis focused on the period 2008-2022 with the exact expression that best characterizes this field, which is "Soft Robotics", and the data were taken from a series of multidisciplinary databases and a specialized journal. The second direction focuses on the analysis of bibliographic references that were rigorously selected following a clear methodology based on a series of inclusion and exclusion criteria. After the selection of bibliographic sources, 111 papers were part of the final analysis, which have been analyzed in detail considering three different perspectives: one related to the design principle (biologically inspired soft robotics), one related to functionality (closed/open-loop control), and one from a biomedical applications perspective.

Singularity analysis of 3-DOF planar parallel continuum robots with constant curvature links

This paper presents the singularity analysis of 3-DOF planar parallel continuum robots (PCR) with three identical legs. Each of the legs contains two passive conventional rigid 1-DOF joints and one actuated planar continuum link, which bends with a constant curvature. All possible PCR architectures featuring such legs are enumerated and the kinematic velocity equations are provided for each of them. Afterwards, a singularity analysis is conducted based on the obtained Jacobian matrices, providing a geometrical understanding of singularity occurences. It is shown that while loci and occurrences of type II singularities are mostly analogous to conventional parallel kinematic mechanisms (PKM), type I singularity occurences for the PCR studied in this work are quite different from conventional PKM and less geometrically intuitive. The study provided in this paper can promote further investigations on planar parallel continuum robots, such as structural design and control.

A Novel Ultrasound Robot with Force/torque Measurement and Control for Safe and Efficient Scanning

Medical ultrasound is of increasing importance in medical diagnosis and intraoperative assistance and possesses great potential advantages when integrated with robotics. However, some concerns, including the operation efficiency, operation safety, image quality, and comfort of patients, remain after introducing robotics into medical ultrasound. In this paper, an ultrasound robot integrating a force control mechanism, force/torque measurement mechanism, and online adjustment method, is proposed to overcome the current limitations. The ultrasound robot can measure operating forces and torques, provide adjustable constant operating forces, eliminate great operating forces introduced by accidental operations, and achieve various scanning depths based on clinical requirements. The proposed ultrasound robot would potentially facilitate sonographers to find the targets quickly, improve operation safety and efficiency, and decrease patients' discomfort. Simulations and experiments were carried out to evaluate the performance of the ultrasound robot. Experimental results show that the proposed ultrasound robot is able to detect operating force in the z-direction and torques around the x- and y- directions with errors of 3.53% F.S., 6.68% F.S., and 6.11% F.S., respectively, maintain the constant operating force with errors of less than 0.57N, and achieve various scanning depths for target searching and imaging. This proposed ultrasound robot has good performance and would potentially be used in medical ultrasound.

Characterization of the Workspace and Limits of Operation of Laser Treatments for Vascular Lesions of the Lower Limbs

The increase of the aging population brings numerous challenges to health and aesthetic segments. Here, the use of laser therapy for dermatology is expected to increase since it allows for non-invasive and infection-free treatments. However, existing laser devices require doctors' manually handling and visually inspecting the skin. As such, the treatment outcome is dependent on the user's expertise, which frequently results in ineffective treatments and side effects. This study aims to determine the workspace and limits of operation of laser treatments for vascular lesions of the lower limbs. The results of this study can be used to develop a robotic-guided technology to help address the aforementioned problems. Specifically, workspace and limits of operation were studied in eight vascular laser treatments. For it, an electromagnetic tracking system was used to collect the real-time positioning of the laser during the treatments. The computed average workspace length, height, and width were 0.84 ± 0.15, 0.41 ± 0.06, and 0.78 ± 0.16 m, respectively. This corresponds to an average volume of treatment of 0.277 ± 0.093 m³. The average treatment time was 23.2 ± 10.2 min, with an average laser orientation of 40.6 ± 5.6 degrees. Additionally, the average velocities of 0.124 ± 0.103 m/s and 31.5 + 25.4 deg/s were measured. This knowledge characterizes the vascular laser treatment workspace and limits of operation, which may ease the understanding for future robotic system development.

Teleoperated Probe Manipulator for Prone-Position Echocardiography Examination

Echocardiography probe manipulation is a strenuous task. During a procedure, the operator must hold the probe, extend their arm, bend their elbow, and monitor the resulting image simultaneously, which causes strain and introduces variability to the measurement. We propose a teleoperated probe manipulation robot to reduce the burden of handling the probe and minimize the infection risk during the COVID pandemic. The proposed robot utilizes prone position scanning that could enlarge the cardiac windows for easier scanning and eliminate the risk of the robot pressing down on the patient. We derived the robot's requirements based on a real clinical scenario. Initial evaluation showed that the robot could achieve the required range of motion, force, and control. The robot's functionality was tested by a non-clinician, in which the tester could obtain heart images of a volunteer in under one minute.

Damian D. Hyperelastic Membrane Actuators: Analysis of Toroidal and Helical Multifunctional Configurations

Technologies that provide mechanical assistance are required in the medical field, such as implants that regenerate tissue through elongation and stimulation. One of the challenges is to develop actuators that combine the benefits of high axial extension at low pressures, modularity, multifunction, and load-bearing capabilities into one design while maintaining their shape and softness. Overcoming such a challenge will provide implants with enhanced capacity for mechanical assistance to induce tissue regeneration. We introduce two novel actuators (M2H) built of stacked Hyperelastic Ballooning Membrane Actuators (HBMAs) that can be realized using helical and toroidal configurations. By restraining the HBMA expansion deterministically using a semisoft exoskeleton, the actuators are endowed with axial extension and radial expansion capabilities. These actuators are thus built of modules that can be configured to different therapeutical needs and multifunctionality, to provide anatomically congruent stimulation. We present the design, fabrication, testing, and numerical and experimental validation of the M2H-HBMAs. They can axially extend up to 41% and 32% in their helical and toroidal configurations at input pressures as low as 26 and 24 kPa, respectively. If the axial extension module is used separately, its extension capacity reaches >170%. The M2H-HBMAs can perform independent and simultaneous expansion and extension motions with negligible intraluminal deformation as well as stand at least 1 kg of axial force without collapsing. The M2H-HBMAs overcome the limitations of hyperexpanding machines that show low resistance to load. We envisage M2H-HBMAs as promising tools to perform tissue regeneration procedures.

Telerobotic Sonography for Remote Diagnostic Imaging: Narrative Review of Current Developments and Clinical Applications

Access to sonographers and sonologists is limited in many communities around the world. Telerobotic sonography (robotic ultrasound) is a new technology to increase access to sonography, providing sonographers and sonologists the ability to manipulate an ultrasound probe from a distant location and remotely perform ultrasound examinations. This narrative review discusses the development of telerobotic ultrasound systems, clinical studies evaluating the feasibility and diagnostic accuracy of telerobotic sonography, and emerging use of telerobotic sonography in clinical settings. Telerobotic sonography provides an opportunity to provide real-time ultrasound examinations to underserviced rural and remote communities to increase equity in the delivery of diagnostic imaging.

Toward a Common Framework and Database of Materials for Soft Robotics

To advance the field of soft robotics, a unified database of material constitutive models and experimental characterizations is of paramount importance. This will facilitate the use of finite element analysis to simulate their behavior and optimize the design of soft-bodied robots. Samples from seventeen elastomers, namely Body Double™ SILK, Dragon Skin™ 10 MEDIUM, Dragon Skin 20, Dragon Skin 30, Dragon Skin FX-Pro, Dragon Skin FX-Pro + Slacker, Ecoflex™ 00-10, Ecoflex 00-30, Ecoflex 00-50, Rebound™ 25, Mold Star™ 16 FAST, Mold Star 20T, SORTA-Clear™ 40, RTV615, PlatSil® Gel-10, Psycho Paint®, and SOLOPLAST 150318, were subjected to uniaxial tensile tests according to the ASTM D412 standard. Sample preparation and tensile test parameters are described in detail. The tensile test data are used to derive parameters for hyperelastic material models using nonlinear least-squares methods, which are provided to the reader. This article presents the mechanical characterization and the resulting material properties for a wide set of commercially available hyperelastic materials, many of which are recognized and commonly applied in the field of soft robotics, together with some that have never been characterized. The experimental raw data and the algorithms used to determine material parameters are shared on the Soft Robotics Materials Database GitHub repository to enable accessibility, as well as future contributions from the soft robotics community. The presented database is aimed at aiding soft roboticists in designing and modeling soft robots while providing a starting point for future material characterizations related to soft robotics research.

Force Feedback Assistance in Remote Ultrasound Scan Procedures

In this contribution, we approached a new aspect in robotic applications. We investigated human–machine modeling for remote ultrasound scan equipment. While robotic systems for ultrasound scan applications with remote operations have been widely studied, in this research, remote force-feedback control was tested. The goal is for the human operator to receive, as physical input, the correct force perception transmitted by the remote ultrasound scan equipment in analyzing the body of the patient. Two principal aspects were investigated. The first was an artificial body model to receive the control signals from the remote equipment. The second aspect was to study a suitable feedback control law that attempts to compensate for the uncertainty between the artificial body and the patient’s body, while also taking into account the transmission delay. Therefore, the task was to give the operator relevant information while considering the force effect; thus, providing a reliable and efficient platform in order to work in remote conditions with ultrasound scan equipment.