Thermally Drawn Shape and Stiffness Programmable Fibers for Medical Devices

Despite the significant advantages of Shape Memory Polymers (SMPs), material processing and production challenges have limited their applications. Recent advances in fiber manufacturing offer a novel approach to processing polymers, broadening the functions of fibers beyond optical applications. In this study, a thermal drawing technique for SMPs to fabricate Shape Memory Polymer Fibers (SMPFs) tailored for medical applications, featuring programmable stiffness and shape control is developed. Rheological and differential scanning calorimetry analyses are conducted to assess SMP's compatibility with the proposed thermal drawing process and applications, leading to the production of multilumen, multimaterial SMPFs activated at body temperature. Different properties of SMPFs are investigated in three medical devices: stiffness-adjustable catheters, softening neural interface, and shape-programmable cochlear implants. Comprehensive characterization of these devices demonstrates the potential of thermally drawn SMPs to be employed in a wide range of applications demanding programmable mechanical properties.

Chain Friction and Lubrication Balanced Ultra-Tough Polyacrylates With Wide-Span Switchable Stiffness for Strain-Programmable Deformation

Natural mollusks perform complex mechanical actions through reversible large-strain deformation and stiffness switching, which are challenging to achieve simultaneously in synthetic materials. Herein, it is shown that a set of polyacrylates designed according to a chain friction and lubrication balanced strategy shows ultra-stretchability (λ up to 324), high resilience (near 100% recovery at strain ≥ 100), and wide-span stiffness switching (up to 2073 times). The typical emulsion polymerization method and casting technique are adopted to fabricate the polyacrylate films. Quaternary ammonium surfactants are used as the emulsifier and reserved in the polymer matrix to enhance the chain segment lubrication with their long alkyl group but improve the whole chain friction through the formation of nano-eutectics. These polyacrylates undergo multimodal mechanical responses, including temperature- or time-programmed deformation and load-bearing like artificial muscles. This molecular design principle and synthetic method provide a robust platform for the fabrication of ultra-tough polymers for soft robots with multiple customized functions.

An electropermanent magnet valve for the onboard control of multi-degree of freedom pneumatic soft robots

To achieve coordinated functions, fluidic soft robots typically rely on multiple input lines for the independent inflation and deflation of each actuator. Fluidic actuators are controlled by rigid electronic pneumatic valves, restricting the mobility and compliance of the soft robot. Recent developments in soft valve designs have shown the potential to achieve a more integrated robotic system, but are limited by high energy consumption and slow response time. In this work, we present an electropermanent magnet (EPM) valve for electronic control of pneumatic soft actuators that is activated through microsecond electronic pulses. The valve incorporates a thin channel made from thermoplastic films. The proposed valve (3 × 3 × 0.8 cm, 2.9 g) can block pressure up to 146 kPa and negative pressures up to -100 kPa with a response time of less than 1 s. Using the EPM valves, we demonstrate the ability to switch between multiple operation sequences in real time through the control of a six-DoF robot capable of grasping and hopping with a single pressure input. Our proposed onboard control strategy simplifies the operation of multi-pressure systems, enabling the development of dynamically programmable soft fluid-driven robots that are versatile in responding to different tasks.

Pioneering healthcare with soft robotic devices: A review

Recent advancements in soft robotics have been emerging as an exciting paradigm in engineering due to their inherent compliance, safe human interaction, and ease of adaptation with wearable electronics. Soft robotic devices have the potential to provide innovative solutions and expand the horizons of possibilities for biomedical applications by bringing robots closer to natural creatures. In this review, we survey several promising soft robot technologies, including flexible fluidic actuators, shape memory alloys, cable-driven mechanisms, magnetically driven mechanisms, and soft sensors. Selected applications of soft robotic devices as medical devices are discussed, such as surgical intervention, soft implants, rehabilitation and assistive devices, soft robotic exosuits, and prosthetics. We focus on how soft robotics can improve the effectiveness, safety and patient experience for each use case, and highlight current research and clinical challenges, such as biocompatibility, long-term stability, and durability. Finally, we discuss potential directions and approaches to address these challenges for soft robotic devices to move toward real clinical translations in the future.

Exceeding traditional curvature limits of concentric tube robots through redundancy resolution

Understanding elastic instability has been a recent focus of concentric tube robot research. Modeling advances have enabled prediction of when instabilities will occur and produced metrics for the stability of the robot during use. In this paper, we show how these metrics can be used to resolve redundancy to avoid elastic instability, opening the door for the practical use of higher curvature designs than have previously been possible. We demonstrate the effectiveness of the approach using a three-tube robot that is stabilized by redundancy resolution when following trajectories that would otherwise result in elastic instabilities. We also show that it is stabilized when teleoperated in ways that otherwise produce elastic instabilities. Lastly, we show that the redundancy resolution framework presented here can be applied to other control objectives useful for surgical robots, such as maximizing or minimizing compliance in desired directions.

A variable stiffness manipulator with multifunctional channels for endoscopic submucosal dissection

PURPOSE

Endoscopic submucosal dissection (ESD) has become the main treatment for early esophageal and gastric cancers, but the insufficient stiffness and large diameter of current devices increase the difficulty in operation. To address the above problems, this study proposes a variable stiffness manipulator with multifunctional channels for ESD.

METHODS

The proposed manipulator has a diameter of just 10 mm and highly integrates a CCD camera, two optical fibers, two channels for instruments, and one channel for water and gas. Additionally, a compact wire-driven variable stiffness mechanism is also integrated. The drive system of the manipulator is designed, and the kinematics and workspace are analyzed. The variable stiffness and practical application performance of the robotic system are tested.

RESULTS

The motion tests verify that the manipulator has sufficient workspace and motion accuracy. The variable stiffness tests show that the manipulator achieves 3.55 times of stiffness variation instantly. Further insertion tests and operation test demonstrates that the robotic system is safe and can satisfy the needs in motion, stiffness, channels, image, illumination, and injection.

CONCLUSION

The manipulator proposed in this study highly integrates six functional channels and a variable stiffness mechanism in a 10 mm diameter. After kinematic analysis and testing, the performance and application prospect of the manipulator are verified. The proposed manipulator can promote the stability and accuracy of ESD operation.

Research on Self-Stiffness Adjustment of Growth-Controllable Continuum Robot (GCCR) Based on Elastic Force Transmission

Continuum robots have good adaptability in unstructured and complex environments. However, affected by their inherent nature of flexibility and slender structure, there are challenges in high-precision motion and load. Thus, stiffness adjustment for continuum robots has consistently attracted the attention of researchers. In this paper, a stiffness adjustment mechanism (SAM) is proposed and built in a growth-controllable continuum robot (GCCR) to improve the motion accuracy in variable scale motion. The self-stiffness adjustment is realized by antagonism through cable force transmission during the length change of the continuum robot. With a simple structure, the mechanism has a scarce impact on the weight and mass distribution of the robot and required no independent actuators for stiffness adjustment. Following this, a static model considering gravity and end load is established. The presented theoretical static model is applicable to predict the shape deformations of robots under different loads. The experimental validations showed that the maximum error ratio is within 5.65%. The stiffness of the robot can be enhanced by nearly 79.6%.

Design and Experimental Validation of a 3D-Printed Embedded-Sensing Continuum Robot for Neurosurgery

A minimally-invasive manipulator characterized by hyper-redundant kinematics and embedded sensing modules is presented in this work. The bending angles (tilt and pan) of the robot tip are controlled through tendon-driven actuation; the transmission of the actuation forces to the tip is based on a Bowden-cable solution integrating some channels for optical fibers. The viability of the real-time measurement of the feedback control variables, through optoelectronic acquisition, is evaluated for automated bending of the flexible endoscope and trajectory tracking of the tip angles. Indeed, unlike conventional catheters and cannulae adopted in neurosurgery, the proposed robot can extend the actuation and control of snake-like kinematic chains with embedded sensing solutions, enabling real-time measurement, robust and accurate control of curvature, and tip bending of continuum robots for the manipulation of cannulae and microsurgical instruments in neurosurgical procedures. A prototype of the manipulator with a length of 43 mm and a diameter of 5.5 mm has been realized via 3D printing. Moreover, a multiple regression model has been estimated through a novel experimental setup to predict the tip angles from measured outputs of the optoelectronic modules. The sensing and control performance has also been evaluated during tasks involving tip rotations.

A Mixed-Reality-Based Unknown Space Navigation Method of a Flexible Manipulator

A hyper-redundant flexible manipulator is characterized by high degree(s) of freedom (DoF), flexibility, and environmental adaptability. It has been used for missions in complex and unknown spaces, such as debris rescue and pipeline inspection, where the manipulator is not intelligent enough to face complex situations. Therefore, human intervention is required to assist in decision-making and control. In this paper, we designed an interactive navigation method based on mixed reality (MR) of a hyper-redundant flexible manipulator in an unknown space. A novel teleoperation system frame is put forward. An MR-based interface was developed to provide a virtual model of the remote workspace and virtual interactive interface, allowing the operator to observe the real-time situation from a third perspective and issue commands to the manipulator. As for environmental modeling, a simultaneous localization and mapping (SLAM) algorithm based on an RGB-D camera is applied. Additionally, a path-finding and obstacle avoidance method based on artificial potential field (APF) is introduced to ensure that the manipulator can move automatically under the artificial command in the remote space without collision. The results of the simulations and experiments validate that the system exhibits good real-time performance, accuracy, security, and user-friendliness.

A Survey of Transoral Robotic Mechanisms: Distal Dexterity, Variable Stiffness, and Triangulation

Robot-assisted technologies are being investigated to overcome the limitations of the current solutions for transoral surgeries, which suffer from constrained insertion ports, lengthy and indirect passageways, and narrow anatomical structures. This paper reviews distal dexterity mechanisms, variable stiffness mechanisms, and triangulation mechanisms, which are closely related to the specific technical challenges of transoral robotic surgery (TORS). According to the structure features in moving and orienting end effectors, the distal dexterity designs can be classified into 4 categories: serial mechanism, continuum mechanism, parallel mechanism, and hybrid mechanism. To ensure adequate adaptability, conformability, and safety, surgical robots must have high flexibility, which can be achieved by varying the stiffness. Variable stiffness (VS) mechanisms based on their working principles in TORS include phase-transition-based VS mechanism, jamming-based VS mechanism, and structure-based VS mechanism. Triangulations aim to obtain enough workspace and create adequate traction and counter traction for various operations, including visualization, retraction, dissection, and suturing, with independently controllable manipulators. The merits and demerits of these designs are discussed to provide a reference for developing new surgical robotic systems (SRSs) capable of overcoming the limitations of existing systems and addressing challenges imposed by TORS procedures.

Static Modeling of a Class of Stiffness-Adjustable Snake-Like Robots with Gravity Compensation

Stiffness-adjustable snake-like robots have been proposed for various applications, including minimally invasive surgery. Based on a variable neutral-line mechanism, previous works proposed a class of snake-like robots that can adjust their stiffness by changing the driving cables’ tensions. A constant curvature hypothesis was used to formulate such robots’ kinematics and was further verified by our previous work via rigorous force analysis and ADAMS simulations. However, all these models and analyses have ignored the effect of the robot links’ gravity, resulting in significant errors in real systems. In this paper, a static model considering gravity compensation is proposed for the stiffness-adjustable snake-like robots. The proposed model adopts a nonlinear Gauss–Seidel iteration scheme and consists of two parts: gravity update and pose estimation. In each iteration, the former updates the payload of each link caused by gravity, and the latter estimates the pose of the robot by refreshing the angle and position values. This iteration stops when the change in the tip position is less than a pre-set error ϵ. During the above process, the only dependent information is each cable’s tension. Simulations and experiments are carried out to verify the effectiveness of the proposed model. The impact of gravity is found to increase with growing material densities in the simulations. The experimental results further indicate that compared with a model without gravity compensation, our model reduces the tip estimation error by 91.5% on average.

Endoscopic surgery robot that facilitates insertion of the curved colon and ensures positional stability against external forces: K-COLON

BACKGROUND

Although various endoscopic surgery robots developed in previous studies are versatile and have high lesion accessibility, they have limitations in terms of reaching the target lesion through the curved path in the large intestine and providing a stable tasking environment for the operator.

METHODS

An endoscopic surgery robot was developed for performing surgery in the large intestine. The robot was easily inserted into the target lesion in the curved colon through the mounted soft actuator and demonstrated high structural stiffness through the insertion of the sigmoidal auxiliary tendons.

RESULTS

The robot was able to access the target lesion in the curved colon through teleoperation alone. Further, it was confirmed that the high structural stiffness overtube improved the overall task performance in the user test.

CONCLUSIONS

The proposed robotic system demonstrated the possibility and potential of performing advanced endoscopic surgery in the large intestine.

From Two-Dimensional to Three-Dimensional: Diversified Bending Modality of a Cable-Driven Actuator and Its Grasping Characteristics

Cable-driven actuators are widely studied and utilized in soft robotics, and cable-driven is a traditional, advanced, and practical driving method. While limited by the uniaxial force transfer of the driving cable in previous researches, the cable-driven actuator can only bend in a two-dimensional (2D) plane. To further expand their scope of utilization, a new design scheme of an actuator is proposed to realize the transition from 2D bending to three-dimensional motion. A zigzag cable routing (ZCR) mode is presented to improve the helical motion. Compared with the straight cable routing mode, the ZCR actuator has better smooth movement characteristics and expanded functionality. Furthermore, we experimentally investigated the contact force and holding ability. The results show that the contact force is evenly acting on the cylinder target, and the grab weight is greater than 1950 g.

Hybrid Compliant Musculoskeletal System for Fast Actuation in Robots

A nature-inspired musculoskeletal system is designed and developed to examine the principle of nonlinear elastic energy storage-release for robotic applications. The musculoskeletal system architecture consists of elastically rigid segments and hyperelastic soft materials to emulate rigid-soft interactions in limbless vertebrates. The objectives are to (i) improve the energy efficiency of actuation beyond that of current pure soft actuators while (ii) producing a high range of motion similar to that of soft robots but with structural stability. This paper proposes a musculoskeletal design that takes advantage of structural segmentation to increase the system's degrees of freedom, which enhances the range of motion. Our findings show that rigid-soft interactions provide a remarkable increase in energy storage and release and, thus, an increase in the undulation speed. The energy efficiency achieved is approximately 68% for bending the musculoskeletal system from the straight configuration, compared to 2.5-30% efficiency in purely soft actuators. The hybrid compliance of the musculoskeletal system under investigation shows promise for alleviating the need for actuators at each joint in a robot.

Three-Dimensional Printable Ball Joints with Variable Stiffness for Robotic Applications Based on Soft Pneumatic Elastomer Actuators

This paper contributes to a new design of the three-dimensional printable robotic ball joints capable of creating the controllable stiffness linkage between two robot links through pneumatic actuation. The variable stiffness ball joint consists of a soft pneumatic elastomer actuator, a support platform, an inner ball and a socket. The ball joint structure, including the inner ball and the socket, is three-dimensionally printed using polyamide−12 (PA12) by selective laser sintering (SLS) technology as an integral mechanism without the requirement of assembly. The SLS technology can make the ball joint have the advantages of low weight, simple structure, easy to miniaturize and good MRI compatibility. The support platform is designed as a friction-based braking component to increase the stiffness of the ball joint while withstanding the external loads. The soft pneumatic elastomer actuator is responsible for providing the pushing force for the support platform, thereby modulating the frictional force between the inner ball, the socket and the support platform. The most remarkable feature of the proposed variable stiffness design is that the ball joint has ‘zero’ stiffness when no pressurized air is supplied. In the natural state, the inner ball can be freely rotated and twist inside the socket. The proposed ball joint can be quickly stiffened to lock the current position and orientation of the inner ball relative to the socket when the pressurized air is supplied to the soft pneumatic elastomer actuator. The relationship between the stiffness of the ball joint and the input air pressure is investigated in both rotating and twisting directions. The finite element analysis is conducted to optimize the design of the support platform. The stiffness tests are conducted, demonstrating that a significant stiffness enhancement, up to approximately 508.11 N·mm reaction torque in the rotational direction and 571.93 N·mm reaction torque in the twisting direction at the pressure of 400 kPa, can be obtained. Multiple ball joints can be easily assembled to form a variable stiffness structure, in which each ball joint has a relative position and an independent stiffness. Additionally, the degrees of freedom (DOF) of the ball joint can be readily restricted to build the single-DOF or two-DOFs variable stiffness joints for different robotic applications.

Equilibrium Conformation of a Novel Cable-Driven Snake-Arm Robot under External Loads

Based on the anti-parallelogram mechanism, an approximate cylindrical rolling joint is proposed to develop a novel cable-driven snake-arm robot with multiple degrees of freedom (DOF). Furthermore, the kinematics of the cable-driven snake-arm robot are established, and the mapping between actuator space and joint space is simplified by bending decoupling motion in the multiple segments. The workspace and bending configurations of the robot are obtained. The static model is established by the principle of minimum potential energy. Furthermore, the simplified cable constraints in the static model are proposed through Taylor expansion, which facilitates the equilibrium conformation analysis of the robot under different external forces. The cable-driven snake-arm robot prototype is developed to verify the feasibility of the robot design and the availability of the static model through the experiments of the free bending motion and the external load on the robot.

Stiffness-Tuneable Segment for Continuum Soft Robots with Vertebrae

In addition to high compliance to unstructured environments, soft robots can be further improved to gain the advantages of rigid robots by increasing stiffness. Indeed, realizing the adjustable stiffness of soft continuum robots can provide safer interactions with objects and greatly expand their application range. To address the above situation, we propose a tubular stiffening segment based on layer jamming. It can temporarily increase the stiffness of the soft robot in a desired configuration. Furthermore, we also present a spine-inspired soft robot that can provide support in tubular segments to prevent buckling. Theoretical analysis was conducted to predict the stiffness variation of the robot at different vacuum levels. Finally, we integrated the spine-inspired soft robot and tubular stiffening segment to obtain the tuneable-stiffness soft continuum robot (TSCR). Experimental tests were performed to evaluate the robot’s shape control and stiffness tuning effectiveness. Experimental results showed that the bending stiffness of the initial TSCR increased by more than 15× at 0°, 30× at 90°, and 60× in compressive stiffness.

Sigmoidal Auxiliary Tendon-Driven Mechanism Reinforcing Structural Stiffness of Hyper-Redundant Manipulator for Endoscopic Surgery

The overtube of an endoscopic surgery robot is fixed when performing tasks, unlike those of commercial endoscopes, and this overtube should have high structural stiffness after reaching the target lesion so that sufficient tension can be applied to the lesion tissue with the surgical tool and there are fewer changes in the field of view of the endoscopic camera from this reaction force. Various methods have been proposed to reinforce the structural stiffnesses of hyper-redundant manipulators. However, the safety, rapid response, space efficiency, and cost-effectiveness of these methods should be considered for use in actual clinical environments, such as the gastrointestinal tract. This study proposed a method to minimize the positional changes of the overtube end tip due to external forces using only auxiliary tendons in the optimized path without additional mechanical structures. Overall, the proposed method involved moving the overtube to the target lesion through the main driving tendon and applying tension to the auxiliary tendons to reinforce the structural stiffness. The complete system was analyzed in terms of energy, and the sigmoidal auxiliary tendons were verified to effectively reinforce the structural stiffness of the overtube consisting of rolling joints. In addition, the design guidelines of the overtube for actual endoscopic surgery were proposed considering hollowness, retroflexion, and high structural stiffness. The positional changes due to external forces were confirmed to be reduced by 60% over the entire workspace.

A review on structural development and recognition–localization methods for end-effector of fruit–vegetable picking robots

The excellent performance of fruit and vegetable picking robots is usually contributed by the reasonable structure of end-effector and recognition–localization methods with high accuracy. As a result, efforts are focused on two aspects, and diverse structures of end-effector, target recognition methods as well as their combinations are yielded continuously. A good understanding for the working principle, advantages, limitations, and the adaptability in respective fields is helpful to design picking robots. Therefore, depending on different grasping ways, separating methods, structures, materials, and driving modes, main characteristics existing in traditional schemes will be depicted firstly. According to technical routes, advantages, potential applications, and challenges, underactuated manipulators and soft manipulators representing future development are then summarized systematically. Secondly, partial recognition and localization methods are also demonstrated. Specifically, current recognition manners adopting the single-feature, multi-feature fusion and deep learning are explained in view of their advantages, limitations, and successful instances. In the field of 3D localization, active vision based on the structured light, laser scanning, time of flight, and radar is reflected through the respective applications. Also, another 3D localization method called passive vision is also evaluated by advantages, limitations, the degree of automation, reconstruction effects, and the application scenario, such as monocular vision, binocular vision, and multiocular vision. Finally portrayed from structural development, recognition, and localization methods, it is possible to develop future end-effectors for fruit and vegetable picking robots with superior characteristics containing the less driving element, rigid–flexible–bionic coupling soft manipulators, simple control program, high efficiency, low damage, low cost, high versatility, and high recognition accuracy in all-season picking tasks.

Snake Robots for Surgical Applications: A Review

Although substantial advancements have been achieved in robot-assisted surgery, the blueprint to existing snake robotics predominantly focuses on the preliminary structural design, control, and human–robot interfaces, with features which have not been particularly explored in the literature. This paper aims to conduct a review of planning and operation concepts of hyper-redundant serpentine robots for surgical use, as well as any future challenges and solutions for better manipulation. Current researchers in the field of the manufacture and navigation of snake robots have faced issues, such as a low dexterity of the end-effectors around delicate organs, state estimation and the lack of depth perception on two-dimensional screens. A wide range of robots have been analysed, such as the i²Snake robot, inspiring the use of force and position feedback, visual servoing and augmented reality (AR). We present the types of actuation methods, robot kinematics, dynamics, sensing, and prospects of AR integration in snake robots, whilst addressing their shortcomings to facilitate the surgeon’s task. For a smoother gait control, validation and optimization algorithms such as deep learning databases are examined to mitigate redundancy in module linkage backlash and accidental self-collision. In essence, we aim to provide an outlook on robot configurations during motion by enhancing their material compositions within anatomical biocompatibility standards.

Optimization-based Concurrent Control of a High Dexterity Robot for Vitreoretinal Surgery

Vitreoretinal surgery requires dexterity and force sensitivity from the clinician. A system to cooperatively control an integrated surgical robot for high dexterity manipulation within the eye's vitreous space was developed and validated in simulation. The system is composed of a 2 degrees of freedom (DoF) snake-like continuum manipulator that is attached to the end-effector of a 5-DoF rigid robot arm. It is capable of receiving position and orientation commands from a 5-DoF input device in real-time, as well as following pre-planned trajectories. The manipulator is moved to each target pose in real-time, using an optimization method to calculate the inverse kinematics solution. Constraints on the position and orientation ensure the target pose does not harm the patient within the vitreous space, enabling the robot to safely assist the clinician with vitreoretinal surgery when operating in real-time. The simulation demonstrates the system's feasibility and benefits over the existing non-dexterous system.

A Continuum Robotic Cannula with Tip Following Capability and Distal Dexterity for Intracerebral Hemorrhage Evacuation

OBJECTIVE

This paper aims to investigate a new continuum robot design and its motion implementation methods appropriate for a minimally invasive intracerebral hemorrhage (ICH) evacuation.

METHODS

We propose a continuum robotic cannula, consisting of a precurved body and a 2-degree-of-freedom (DoF) flexible tip, monolithically fabricated. Kinematics model with cable elongation model, and a dedicated design optimization and motion planning algorithm were developed to enable the follow-the-leader (FTL) motion of the cannula. A task-dependent Jacobian-based closed loop control was also designed to track the cannula motion during the insertion and its independent tip motion.

RESULTS

Comprehensive experiments were conducted to verify the kinematic model and submillimeter motion coupling between the cannula precurved body and its flexible tip. The cannula was also capable of achieving FTL motion within around 2.5 mm shape deviation and control performance within submillimeter errors. It was finally demonstrated to be capable of the nonlinear insertion and tip manipulation in the brain phantom.

CONCLUSION

The new cannula design, together with the proposed algorithms, provides the unique ability to access ICH in a nonlinear trajectory and dexterous tip motion.

SIGNIFICANCE

These motion capabilities of the robot in such a slender form factor will lead to more complete ICH evacuation and reduced trauma to the healthy brain tissues.

Design and Validation of a Novel Cable-Driven Hyper-Redundant Robot Based on Decoupled Joints

In most of the prior designs of conventional cable-driven hyper-redundant robots, the multiple degree-of-freedom (DOF) bending motion usually has bending coupling effects. It means that the rotation output of each DOF is controlled by multiple pairs of cable inputs. The bending coupling effect will increase the complexity of the driving mechanism and the risk of slack in the driving cables. To address these problems, a novel 2-DOF decoupled joint is proposed by adjusting the axes distribution of the universal joints. Based on the decoupled joint, a 4-DOF hyper-redundant robot with two segments is developed. The kinematic model of the robot is established, and the workspace is analyzed. To simplify the driving mechanism, a kinematic fitting approach is presented for both proximal and distal segments and the mapping between the actuator space and the joint space is significantly simplified. It also leads to the simplification of the driving mechanism and the control system. Furthermore, the cable-driven hyper-redundant robot prototype with multiple decoupled joints is established. The experiments on the robot prototype verify the advantages of the design.

An Integrated High-dexterity Cooperative Robotic Assistant for Intraocular Micromanipulation

Retinal surgeons are required to manipulate multiple surgical instruments in a confined intraocular space, while the instruments are constrained at the small incisions made on the sclera. Furthermore, physiological hand tremor can affect the precision of the instrument motion. The Steady-Hand Eye Robot (SHER), developed in our previous study, enables tremor-free tool manipulation by employing a cooperative control scheme whereby the surgeon and robot can co-manipulate the surgical instruments. Although SHER enables precise and tremor-free manipulation of surgical tools, its straight and rigid structure imposes certain limitations, as it can only approach a target on the retina from one direction. As a result, the instrument could potentially collide with the eye lens when attempting to access the anterior portion of the retina. In addition, it can be difficult to approach a target on the retina from a suitable direction when accessing its anterior portion for procedures such as vein cannulation or membrane peeling. Snake-like robots offer greater dexterity and allow access to a target on the retina from suitable directions, depending on the clinical task at hand. In this study, we present an integrated, high-dexterity, cooperative robotic assistant for intraocular micromanipulation. This robotic assistant comprises an improved integrated robotic intraocular snake (I2RIS) with a user interface (a tactile switch or joystick unit) for the manipulation of the snake-like distal end and the SHER, with a detachable end-effector to which the I2RIS can be attached. The integrated system was evaluated through a set of experiments wherein subjects were requested to touch or insert into randomly-assigned targets. The results indicate that the high-dexterity robotic assistant can touch or insert the tip into the same target from multiple directions, with no significant increase in task completion time for either user interface.

Design of a dexterous robotic surgical instrument with a novel bending mechanism

BACKGROUND

The robot-assisted minimally invasive surgery (RMIS) has developed rapidly in recent years, requiring highly articulated instruments to enable surgeons to perform complicated and precise procedures.

METHODS

A novel wrist-type surgical instrument was proposed for RMIS. The wrist consists of superelastic-wire-driven snake-like joints and universal joints, which could perform two deflections and one distal rotation. The bending mechanism and the kinematics of universal joints were analysed. The forward and inverse kinematics of the wrist were derived.

RESULTS

The performances of the instrument were evaluated using a prototype by experiments. The average motion deviation of the wrist's deflection was 0.15 ± 0.08 mm, and the maximum deviation was 0.52 mm. The maximum payload capability was 10 N. The suture task and ex vivo procedure verified the effectiveness of the instrument.

CONCLUSIONS

The proposed instrument has high dexterity and payload capability, which contributes to improving the quality of the RMIS procedures.

Improved Integrated Robotic Intraocular Snake

Retinal surgery can be performed only by surgeons possessing advanced surgical skills because of the small, confined intraocular space, and the restricted free motion of instruments in contact with the sclera. Snake-like robots could be essential for use in retinal surgery to overcome this problem. Such robots can approach from suitable directions and operate delicate tissues when performing retinal vein cannulation, epiretinal membrane peeling and so on. In this study, we propose an improved integrated robotic intraocular snake (I²RIS), which is a new version of our previous IRIS. This update focuses on the dexterous distal unit design and the drive unit design. The proposed dexterous distal unit consists of small elements with reduced contact stress. The proposed drive unit includes a new wire drive mechanism where the drive pulley is mounted at a right angle relative to the actuation direction (also, relative to the conventional direction). A geometric analysis and mechanical design show that the proposed drive mechanism is simpler and easier to assemble and yields higher accuracy than the conventional drive mechanism. Furthermore, considering clinical use, the instrument of the I²RIS is detachable from the motor unit for cleaning, sterilization, and attachment of various surgical tools. Weighing merely 31.3 g, the proposed mechanism is only one third of the weight of the conventional IRIS. The basic functions and effectiveness of the proposed mechanism are verified by experiments on 5:1 scaled-up models of the dexterous distal unit and actual-size models of the instrument and motor units.

Current Trends and Prospects in Compliant Continuum Robots: A Survey

Compliant continuum robots (CCRs) have slender and elastic bodies. Compared with a traditional serial robot, they have more degrees of freedom and can deform their flexible bodies to go through a constrained environment. In this paper, we classify CCRs according to basic transmission units. The merits, materials and potential drawbacks of each type of CCR are described. Drive systems depend on the basic transmission units significantly, and their advantages and disadvantages are reviewed and summarized. Variable stiffness and intrinsic sensing are desired characteristics of CCRs, and the methods of obtaining the two characteristics are discussed. Finally, we discuss the friction, buckling, singularity and twisting problems of CCRs, and emphasise the ways to reduce their effects, followed by several proposing perspectives, such as the collaborative CCRs.

Leveraging Geometry to Enable High-Strength Continuum Robots

Developing high-strength continuum robots can be challenging without compromising on the overall size of the robot, the complexity of design and the range of motion. In this work, we explore how the load capacity of continuum robots can drastically be improved through a combination of backbone design and convergent actuation path routing. We propose a rhombus-patterned backbone structure composed of thin walled-plates that can be easily fabricated via 3D printing and exhibits high shear and torsional stiffness while allowing bending. We then explore the effect of combined parallel and converging actuation path routing and its influence on continuum robot strength. Experimentally determined compliance matrices are generated for straight, translation and bending configurations for analysis and discussion. A robotic actuation platform is constructed to demonstrate the applicability of these design choices.

Improved Integrated Robotic Intraocular Snake: Analyses of the Kinematics and Drive Mechanism of the Dexterous Distal Unit

Retinal surgery can be performed only by surgeons possessing advanced surgical skills because of the small, confined intraocular space, and the restricted free motion of the instruments in contact with the sclera. Snake-like robots may be essential for use in retinal surgery to overcome this problem. Such robots can approach the target site from suitable directions and operate on delicate tissues during retinal vein cannulation, epiretinal membrane peeling, and so on. We propose an improved integrated robotic intraocular snake (I2RIS), which is a new version of our previous IRIS. This study focused on the analyses of the kinematics and drive mechanism of the dexterous distal unit. This unit consists of small elements with reduced contact stress achieved by changing wire-hole positions. The kinematic analysis of the dexterous distal unit shows that it is possible to control the bending angle and direction of the unit by using two pairs of drive wires. The proposed drive mechanism includes a new pull-and-release wire mechanism in which the drive pulley is mounted at a right angle relative to the actuation direction (also, relative to the conventional direction). Analysis of the drive mechanism shows that compared to the previous drive mechanism, the proposed mechanism is simpler and easier to assemble and yields higher accuracy and resolution. Furthermore, considering clinical use, the instrument of the I2RIS is detachable from the motor unit easily for cleaning, sterilization, and attachment of various surgical tools. Analyses of the kinematics and drive mechanism and the basic functions of the proposed mechanism were verified experimentally on actual-size prototypes of the instrument and motor units.

Recent Advances in Design and Actuation of Continuum Robots for Medical Applications

Traditional rigid robot application in the medical field is limited due to the limited degrees of freedom caused by their material and structure. Inspired by trunk, tentacles, and snakes, continuum robot (CR) could traverse confined space, manipulate objects in complex environment, and conform to curvilinear paths in space. The continuum robot has broad prospect in surgery due to its high dexterity, which can reach circuitous areas of the body and perform precision surgery. Recently, many efforts have been done by researchers to improve the design and actuation methods of continuum robots. Several continuum robots have been applied in clinic surgical interventions and demonstrated superiorities to conventional rigid-link robots. In this paper, we provide an overview of the current development of continuum robots, including the design principles, actuation methods, application prospect, limitations, and challenge. And we also provide perspective for the future development. We hope that with the development of material science, Engineering ethics, and manufacture technology, new methods can be applied to manufacture continuum robots for specific surgical procedures.

Roboticizing fabric by integrating functional fibers

Fabrics are ubiquitous materials that have conventionally been passive assemblies of interlacing, inactive fibers. However, the recent emergence of active fibers with actuation, sensing, and structural capabilities provides the opportunity to impart robotic function into fabric substrates. Here we present an implementation of robotic fabrics by integrating functional fibers into conventional fabrics using typical textile manufacturing techniques. We introduce a set of actuating and variable-stiffness fibers, as well as printable in-fabric sensors, which allows for robotic closed-loop control of everyday fabrics while remaining lightweight and maintaining breathability. Finally, we demonstrate the utility of robotic fabrics through their application to an active wearable tourniquet, a transforming and load-bearing deployable structure, and an untethered, self-stowing airfoil.

Suction-fixing surgical device for assisting liver manipulation with laparoscopic forceps

PURPOSE

Noninvasiveness and stability are significant issues in laparoscopic liver resection. Inappropriate grasping force can cause damage or serious bleeding to the liver. In addition, instability of grasping can result unsafe operations or wavered cutting. We propose a surgical device to improve stability of liver manipulation.

METHODS

A proposed device adheres to the liver surface with suction fixation, then tunes its stiffness to being hard and shapes like as a bulge on the liver surface to be grasped with laparoscopic forceps. It consists of two soft beams, a chamber sponge, membrane covering the device upper, suburb extrusion wing membrane, a vacuuming tube and to-be-grasped bars. The beams are designed as being non-stretchable and easy to bend. The device is connected to a medical vacuuming pump to vacuum air in the device and then gets hard to transfer forceps operation well. This stiffness tuning mechanism by pneumatic control features the device for achieving good liver shape followability and forceps operation propagation less invasively. The proposed device was tested with rubber phantoms and porcine livers on shape followability, stiffness transition, liver invasiveness and operational usability in the experiments.

RESULTS

Performance of the proposed device was assessed in experiments. The device showed good object-shape followability. It held the liver with 2.43-N force for vertical lifting and 4.90-N shear force with - 80 kPa vacuuming pressure. Invasiveness was reduced to acceptable level of liver damage. In usability test, the device grasped the liver stably and transferred surgical forceps operations to the liver surface well.

CONCLUSION

The proposed device showed effective performance to improve laparoscopic liver manipulation. It held the liver stably and less invasively and transferred forceps operation force to the liver surface well.

Toward Task Autonomy in Robotic Cardiac Ablation: Learning-Based Kinematic Control of Soft Tendon-Driven Catheters

The goal of this study was to propose and validate a control framework with level-2 autonomy (task autonomy) for the control of flexible ablation catheters. To this end, a kinematic model for the flexible portion of typical ablation catheters was developed and a 40-mm-long spring-loaded flexible catheter was fabricated. The feasible space of the catheter was obtained experimentally. Furthermore, a robotic catheter intervention system was prototyped for controlling the length of the catheter tendons. The proposed control framework used a support vector machine classifier to determine the tendons to be driven, and a fully connected neural network regressor to determine the length of the tendons. The classifier and regressors were trained with the data from the feasible space. The control system was implemented in parallel at user-interface and firmware and exhibited a 0.4-s lag in following the input. The validation studies were four trajectory tracking and four target reaching experiments. The system was capable of tracking trajectories with an error of 0.49 ± 0.32 and 0.62 ± 0.36 mm in slow and fast trajectories, respectively. Also, it exhibited submillimeter accuracy in reaching three preplanned targets and ruling out one nonfeasible target autonomously. The results showed improved accuracy and repeatability of the position control compared with the recent literature. The proposed learning-based approach could be used in enabling task autonomy for catheter-based ablation therapies.

Development of a Rigidity Tunable Flexible Joint Using Magneto-Rheological Compounds-Toward a Multijoint Manipulator for Laparoscopic Surgery

Laparoscopic surgery is a representative operative method of minimally invasive surgery. However, most laparoscopic hand instruments consist of rigid and straight structures, which have serious limitations such as interference by the instruments and limited field of view of the endoscope. To improve the flexibility and dexterity of these instruments, we propose a new concept of a multijoint manipulator using a variable stiffness mechanism. The manipulator uses a magneto-rheological compound (MRC) whose rheological properties can be tuned by an external magnetic field. In this study, we changed the shape of the electromagnet and MRC to improve the performance of the variable stiffness joint we previously fabricated; further, we fabricated a prototype and performed basic evaluation of the joint using this prototype. The MRC was fabricated by mixing carbonyl iron particles and glycerol. The prototype single joint was assembled by combining MRC and electromagnets. The configuration of the joint indicates that it has a closed magnetic circuit. To examine the basic properties of the joint, we conducted preliminary experiments such as elastic modulus measurement and rigidity evaluation. We confirmed that the elastic modulus increased when a magnetic field was applied. The rigidity of the joint was also verified under bending conditions. Our results confirmed that the stiffness of the new joint changed significantly compared with the old joint depending on the presence or absence of a magnetic field, and the performance of the new joint also improved.

Geometric constraint-based modeling and analysis of a novel continuum robot with Shape Memory Alloy initiated variable stiffness

Continuum robots exhibit promising adaptability and dexterity for soft manipulation due to their intrinsic compliance. However, this compliance may lead to challenges in modeling as well as positioning and loading. In this paper, a virtual work-based static model is established to describe the deformation and mechanics of continuum robots with a generic rod-driven structure, taking the geometric constraint of the drive rods into account. Following this, this paper presents a novel variable stiffness mechanism powered by a set of embedded Shape Memory Alloy (SMA) springs, which can make the drive rods become ‘locked’ on the body structure with different configurations. The resulting effects of variable stiffness are then presented in the static model by introducing tensions of the SMA and friction on the rods. Compared with conventional models, there is no need to predefine the actuation forces of the drive rods; instead, actuation displacements are used in this new mechanism system with stiffness being regulated. As a result, the phenomenon that the continuum robot can exhibit an S-shaped curve when subject to single-directional forces is observed and analyzed. Simulations and experiments demonstrated that the presented mechanism has stiffness variation of over 287% and further demonstrated that the mechanism and its model are achievable with good accuracy, such that the ratio of positioning error is less than 2.23% at the robot end-effector to the robot length.

A review of recent advancements in soft and flexible robots for medical applications

BACKGROUND

Soft and flexible robots for medical applications are needed to change their flexibility over a wide range to perform tasks adequately. The mechanism and theory of flexibility has been a scientific issue and is of interest to the community.

METHODS

Recent advancements of bionics, flexible actuation, sensing, and intelligent control algorithms as well as tunable stiffness have been referenced when soft and flexible robots are developed. The benefits and limitations of these relevant studies and how they affect the flexibility are discussed, and possible research directions are explored.

RESULTS

The bionic materials and structures that demonstrate the potential capabilities of the soft medical robot flexibility are the fundamental guarantee for clinical medical applications. Flexible actuation that used to provide power, intelligent control algorithms which are the exact executors, and the wide range stiffness of the soft materials are the three important influence factors for soft medical robots.

CONCLUSION

Some reasonable suggestions and possible solutions for soft and flexible medical robots are proposed, including novel materials, flexible actuation concepts with a built-in source of energy or power, programmable flexibility, and adjustable stiffness.

Positioning and stiffening of an articulated/continuum manipulator for implant delivery in minimally invasive surgery

BACKGROUND

Hollow, bendable manipulators can advance implant delivery in minimally invasive surgery, by circumventing the drawbacks of straight-line delivery and fostering single-port approaches. Variable stiffness manipulators are sought to be safe and effective.

METHODS

We designed and experimentally assessed a cable-driven articulated/continuum manipulator, devised for cardiac valve delivery. Positioning and stiffening were teleoperated, based on cable shortening. Stiffening was parameterized by using the leading tension (LT, ie, tension of the cables driving bending). We assessed positioning (repeatability/reversibility along eight/two bending directions) and stiffening (eight bent configurations).

RESULTS

We achieved good repeatability and reversibility (mean errors <1% and 1.5%, respectively, of the workspace characteristic length). Stiffening was effective (up to 9-fold increase, depending on pose). Stiffening was linearly correlated (R² = 0.92) with LT for all the considered configurations.

CONCLUSION

We accurately positioned and effectively stiffened the manipulator in several bent configurations. The proposed stiffness modulation strategy can be extended to other manipulators.

Inverse displacement analysis of a hyper-redundant bionic trunk-like robot

This article presents the inverse displacement analysis of a hyper-redundant bionic trunk-like robot. The hyper-redundant bionic trunk-like robot is constituted of some parallel mechanism modules in series. The mathematical model of the inverse displacement analysis of the hyper-redundant robot comprises a set of nonlinear consistent equations with a number of unknown variables that are more than given equations. It is impossible to find all solutions for the inverse displacement analysis since there are infinite solution possibilities. By planning the pose of distal moving platforms for robot modules, the problem of the inverse displacement analysis of the hyper-redundant robot is transformed into that of a parallel mechanism. The inverse velocity and acceleration computation are then implemented using a method of the numerical differentiation. A developed prototype of a hyper-redundant bionic trunk-like robot is presented. The approach can be applied to the hyper-redundant robot with man–machine interactive system in the unstructured environment.

Towards an ontology for soft robots: what is soft?

The advent of soft robotics represents a profound change in the forms robots will take in the future. However, this revolutionary change has already yielded such a diverse collection of robots that attempts at defining this group do not reflect many existing 'soft' robots. This paper aims to address this issue by scrutinising a number of descriptions of soft robots arising from a literature review with the intention of determining a coherent meaning for soft. We also present a classification of existing soft robots to initiate the development of a soft robotic ontology. Finally, discrepancies in prescribed ranges of Young's modulus, a frequently used criterion for the selection of soft materials, are explained and discussed. A detailed visual comparison of these ranges and supporting data is also presented.

A foldable manipulator with tunable stiffness based on braided structure

Minimally invasive surgery (MIS) has recently seen a surge in clinical applications due to its potential benefits over open surgery. In MIS, a long manipulator is placed through a tortuous human orifice to create a channel for surgical tools and provide support when they are operated. Currently the relative large profile and low stiffness of the manipulators limit the effectiveness and accuracy of MIS. Here we propose a new foldable manipulator with tunable stiffness. The manipulator takes a braided skeleton to enable radial folding, whereas membrane is used to seal the skeleton so as to adjust stiffness through creating negative pressure. We demonstrated experimentally, numerically, and analytically that, a flexible and a rigid state were obtained, and the ratio of bending stiffness in the rigid state to that in the flexible state reached 6.85. In addition, the manipulator achieved a radial folding ratio of 1.95. The proposed manipulator shows great potential in the design of surgical robots for MIS. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B, 2019.