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The advanced prostate biopsy robot system has broad application prospects in clinical practice, but due to the deformation and distortion between MR-TRUS (magnetic resonance transrectal ultrasound) images, it poses challenges in biopsy accuracy and safety. The study utilized an advanced prostate biopsy robot system based on MR-TRUS image flexible registration technology and conducted experiments on animal models. Retrospective analysis of the puncture accuracy of 12 animal experiments undergoing prostate puncture using MR-TRUS flexible registration technology from May 2022 to October 2023, and observation of intraoperative and 7-day postoperative complications. The study obtained MR-TRUS images and utilized image processing algorithms for registration to reduce image deformation and distortion. Then, precise positioning and operation are carried out through the robot system to execute the prostate biopsy program. The experimental results indicate that the advanced prostate biopsy robot system based on MR-TRUS image flexible registration technology has demonstrated good feasibility and safety in animal experiments. Image registration technology has successfully reduced image distortion and deformation, improving biopsy accuracy. The precise positioning and operation of robot systems play a crucial role in the biopsy process, reducing the occurrence of complications.

BackgroundSurgical robots are gaining increasing popularity because of their capability to improve the precision of pedicle screw placement. However, current surgical robots rely on unimodal computed tomography (CT) images as baseline images, limiting their visualization to vertebral bone structures and excluding soft tissue structures such as intervertebral discs and nerves. This inherent limitation significantly restricts the applicability of surgical robots. To address this issue and further enhance the safety and accuracy of robot-assisted pedicle screw placement, this study will develop a software system for surgical robots based on multimodal image fusion. Such a system can extend the application range of surgical robots, such as surgical channel establishment, nerve decompression, and other related operations.MethodsInitially, imaging data of the patients included in the study are collected. Professional workstations are employed to establish, train, validate, and optimize algorithms for vertebral bone segmentation in CT and magnetic resonance (MR) images, intervertebral disc segmentation in MR images, nerve segmentation in MR images, and registration fusion of CT and MR images. Subsequently, a spine application model containing independent modules for vertebrae, intervertebral discs, and nerves is constructed, and a software system for surgical robots based on multimodal image fusion is designed. Finally, the software system is clinically validated.DiscussionWe will develop a software system based on multimodal image fusion for surgical robots, which can be applied to surgical access establishment, nerve decompression, and other operations not only for robot-assisted nail placement. The development of this software system is important. First, it can improve the accuracy of pedicle screw placement, percutaneous vertebroplasty, percutaneous kyphoplasty, and other surgeries. Second, it can reduce the number of fluoroscopies, shorten the operation time, and reduce surgical complications. In addition, it would be helpful to expand the application range of surgical robots by providing key imaging data for surgical robots to realize surgical channel establishment, nerve decompression, and other operations.

This article proposes a flexible surgical robot featuring strong magnetic steering achieved by a hemispherical magnet array actuation, and high‐accuracy ultrasonic position sensing achieved by a beacon total focusing method (b‐TFM). The hemispherical magnet array with magnetic focusing is described and its array parameters are optimized through finite element analysis to increase the magnetic field for actuation. The magnetic field strength at 100 mm for the array with the same mass as the cylindrical magnet is about 1.8 times higher than that of the cylindrical magnet. Using the magnet array actuation, the flexible robot exhibits the capability of agile steering to navigate along a predefined trajectory. In addition, a 1 mm × 1 mm lead zirconate titanate (PZT) patch is embedded into the tip of the flexible robot as a beacon for b‐TFM ultrasonic imaging to detect the position of the robot. Therefore, the entire navigation process can be executed under the supervision of the ultrasonic position sensing system, and the maximum error is 0.8 mm when the steering radius is 100 mm.

Laparoscopic surgery (LS) has become an effective and widely accepted therapy for patients. However, performing LS requires advanced training and skills, as it demands high precision and dexterity due to visual feedback depending on the collaboration between the surgeon and endoscope assistant, restricted field of view, and limited dexterity inside the body. Thus, a flexible endoscope holder system with an automatic control scheme is proposed to assist LS performance, allowing the surgeon to perform solo LS. A DNA‐inspired helix‐based structure with wide‐angle and constant curvature bending is presented and made of printable nylon with selective laser sintering. The proposed flexible mechanism reduces the cost of manufacturing and assembling. Also, it has a hollow design for embedded sensing and actuation. Then, an optimization method is proposed, which provides a reference for the endoscope installation, robot placement, and pose selection. In addition, aiming at the misorientation problem, a pose‐constrained visual servoing control scheme for the endoscope system is developed. Both simulation and physical experiments are conducted to verify the effectiveness and feasibility of the proposed control scheme. Experimental results demonstrate that the proposed visual servoing scheme can maintain the optimized pose and reduce misorientation during automatic view steering.

Surgical robots have been used for many years in the field of medical sciences and engineering. With sophisticated technology governing the world in recent years, surgical robots have benefited from the addition of sensors, actuators, and intelligent control systems, allowing them to function at high precision along with more efficiency. The focus of this study is to present a brief review of sensors and components utilized in robotic surgery that have been studied in recent literature. In the present study, initially, a brief history of robotic surgery is presented, followed by a review on sensors and components in robotic surgery that can be informative for engineers or researchers while designing surgical robots for specific applications. Consequently, highlights of recent trends in the technological advancements in surgical robots have been presented. Further, the paper concludes with recent advances and new challenges in the development of surgical robots.

Minimally invasive endovascular procedures rely heavily on catheter devices. However, traditional catheters lack active steering requiring considerable skill on the surgeon’s part to accurately position the tip. While catheter tips could be made steerable using tendon-driven and Pneumatic Artificial Muscle (PAM) approaches, remote magnetic actuation is uniquely suited for this task due to its safety, controllability, and intrinsic miniaturization capabilities. Soft composite magnetic materials feature embedding distributed magnetic microparticles compared with attaching discrete permanent magnets proving beneficial in steerability and control. This work demonstrates the fabrication of a soft hollow magnetic tip that can be attached to a catheter to make the assembly steerable. The catheter tip is extensively characterized in terms of bending hysteresis, bending force, and dynamic response. The catheter showed average hysteresis between 5% and 10% and bending forces up to 0.8 N. It also showed a good dynamic response by changing its bending angle in

Preoperative planning and intra-operative system setup are crucial steps to successfully integrate robotically assisted surgical systems (RASS) into the operating room. Efficiency in terms of setup planning directly affects the overall procedural costs and increases acceptance of RASS by surgeons and clinical personnel. Due to the kinematic limitations of RASS, selecting an optimal robot base location and surgery access point for the patient is essential to avoid potentially critical complications due to reachability issues. To this end, this work proposes a novel versatile method for RASS setup and planning based on robot capability maps (CMAPs). CMAPs are a common tool to perform workspace analysis in robotics, as they are in general applicable to any robot kinematics. However, CMAPs have not been completely exploited so far for RASS setup and planning. By adapting global CMAPs to surgical procedure-specific tasks and constraints, a novel RASS capability map (RASSCMAP) is generated. Furthermore, RASSCMAPs can be derived to also comply with kinematic access constraints such as access points in laparoscopy. RASSCMAPs are versatile and applicable to any kind of surgical procedure; they can be used on the one hand for aiding in intra-operative experience-based system setup by visualizing online the robot’s capability to perform a task. On the other hand, they can be used to find the optimal setup by applying a multi-objective optimization based on a genetic algorithm preoperatively, which is then transfered to the operating room during system setup. To illustrate these applications, the method is evaluated in two different use cases, namely, pedicle screw placement in vertebral fixation procedures and general laparoscopy. The proposed RASSCMAPs help in increasing the overall clinical value of RASS by reducing system setup time and guaranteeing proper robot reachability to successfully perform the intended surgeries.

This paper presents the concept of a parallel medical robotic service system to assist in a surgical procedure involving precise exploratory trepanation holes in a patient’s skull. The target position and orientation of the trepanation tool in the cranial region is determined using a prior intracranial image analysis using an external medical imaging system. A trepanning actuation system is attached to the end-effector of the parallel robot. The end-effector will act as an accurate positioner for the trepanning drill in the medical intervention area. The conceptual design of the mechanical actuation subsystem of a trepanning robot was developed in the SolidWorks 2022 software environment. The virtual model of the kinematic chain of the robot and the assumed design parameters were used to analytically derive the equations describing the inverse kinematics task. An analysis of the forward kinematics task of the parallel manipulator was also carried out using analytical and numerical methods. A workspace analysis was performed using Matlab based on the kinematic model of the parallel robot. This paper significantly advances the field by presenting the conceptual design of the actuation subsystem, deriving the kinematics equations, conducting a thorough workspace analysis, and establishing a foundation for subsequent control-algorithm development.

In order to streamline and summarize the status quo of human–computer interaction (HCI) design research in minimally invasive surgery robots, and to inspire and promote in-depth design research in related fields, this study utilizes literature research methods, inductive summarizing methods, and comparative analysis methods to analyze and organize the usage scenarios, users, interaction content and form, and relevant design methods of minimally invasive surgery robots, with the purpose of arriving at a review. Through a summary method, this study will obtain outcomes such as design requirements, interaction information classification, and the advantages and disadvantages of different interaction forms, and then make predictions of future trends in this field. Research findings show that the HCI design in the relevant field display a highly intelligent, human-centered, and multimodal development trend through the application of cutting-edge technology, taking full account of work efficiency and user needs. However, meanwhile, there are problems such as the absence of guidance by a systematic user knowledge framework and incomplete design evaluation factors, which need to be supplemented and improved by researchers in related fields in the future.

Continuum manipulators, with their characteristics of flexibility and dexterity, have gained significant interest in various applications across industries such as inspection, manufacturing, space exploration, and medical surgery. However, because of their inherent compliance, handling payloads may prove challenging due to shape distortion and deflection. This demonstrates the need to optimize the manipulator’s stiffness. The primary objective of this work was to show the merits of sensitivity analysis in the design of flexible surgical manipulators. Such analysis can guide important design decisions and enable the more efficient use of available resources, contributing to designing more effective prototypes. A new sensitivity analysis framework based on a multi-model and a multi-method approach was proposed to achieve this. This framework was then demonstrated by studying a tendon-driven rolling contact joint hyper-redundant manipulator for transoral laser microsurgery. In this analysis, the effects of independent design parameters on the stiffness of the manipulator were examined. Then, scaled-up 3D-printed prototypes were used to validate the accuracy of the stiffness model experimentally, which enabled us to assess the outcome of the sensitivity analysis framework. The results demonstrated that only two out of five design parameters for the considered manipulator significantly impacted the device’s performance. This information could enable the designer to efficiently allocate resources toward correctly setting these two most important parameters to achieve the desired system. Overall, the proposed analysis framework is a general tool that can be applied to any design architecture, helping to develop optimal manipulators for various applications.

The development process of laparoscopic technology has proven the driving effect of technological progress on medicine, which overturns the methods of surgery, especially general surgery. With its widespread popularity, its limitations have gradually emerged. At the same time, da Vinci surgical robots have flourished after demonstrating enormous advantages, leading surgery from minimally invasive to intelligent. However, there remains huge development space for domestically produced surgical robots in areas such as modularity, single-port approach, and remote capabilities.

The field of magnetic robotics aims to obviate physical connections between the actuators and end‐effectors. Such tetherless control may enable new ultraminimally invasive surgical manipulations in clinical settings. While wireless actuation offers advantages in medical applications, the challenge of providing sufficient force to magnetic needles for tissue penetration remains a barrier to practical application. Applying sufficient force for tissue penetration is required for tasks such as biopsy, suturing, cutting, drug delivery, and accessing deep‐seated regions of complex structures in organs such as the eye. To expand the force landscape for such magnetic surgical tools, an impact force‐based suture needle capable of penetrating in vitro and ex vivo samples with 3‐degrees‐of‐freedom (DOF) planar motion is proposed. Using custom‐built 14 and 25 G needles, generation of 410 mN penetration force is demonstrated, a 22.7‐fold force increase with more than 20 times smaller volume compared with similar magnetically guided needles. With the Magnetic Pulse Actuated Collisions for Tissue‐penetrating (MPACT)‐Needle, gauze mesh suturing onto an agar gel is demonstrated. In addition, the tip size is reduced to 25 G, a typical needle size for eye interventions, to demonstrate ex vivo penetration in a rabbit eye towards corneal injections and transscleral drug delivery.

Risk classes defined by MDR and FDA for state-of-the-art surgical robots based on their intended use are not suitable as indicators for their hazard potential. While there is a lack of safety regulation for an increasing degree of automation as well as the degree of invasiveness into the patient’s body, adverse events have increased in the last decade. Thus, an outright identification of hazards as part of the risk analysis over the complete development process and life cycle of a surgical robot is crucial, especially when introducing new technologies. For this reason, we present a comprehensive approach for hazard identification in early phases of development. With this multi-perspective approach, the number of hazards identified can be increased. Furthermore, a generic catalogue of hazards for surgical robots has been established by categorising the results. The catalogue serves as a data pool for risk analyses and holds the potential to reduce hazards through safety measures already in the design process before becoming risks for the patient.

It is essential for seamlessly delivering intended hand motion to surgical robots while actively suppressing undesired hand tremor during microsurgery. To achieve this goal, we propose a novel method for predicting voluntary motion based on deep learning with the signal decomposition and ensemble approach. This approach can thus deal with various forms of voluntary signals, such as either highly stationary or rather highly cyclic at a low range of frequencies. The proposed method comprises a series of signal blocks to decompose complex hand motion into multiple sub-signals using deep neural networks upon their signal characteristics. The signal block yields parameterized sub-signal and predicted voluntary motion. In addition, an ensemble layer allows for accurately predicting future voluntary motion by combining predicted motion from each signal block with the optimal weight. These signal blocks are connected by a decomposition flow in series and also by a forecast flow in parallel to ensemble the prediction output of each block. Given real data sets, we evaluated the prediction performance of the proposed algorithm compared to other data-driven deep learning models. The generalizability of the proposed algorithm was also investigated by applying the trained models to new data sets from new tasks and a different subject, which had not been involved in training procedures. As a result, the proposed algorithm outperforms the other baseline models in terms of prediction error and accuracy. Furthermore, we explored whether the proposed method could suppress tremor via spectral analysis, which shows substantial tremor attenuation more than -10 dB in a frequency of interest, 6-14 Hz. It is also found that the proposed method has the predictive power for dealing with inevitable control delays, where prediction error increased only by 2% per one-time sample, approximately 4.2 ms.

Pre-existing surgical robotic systems are sold with electronics (sensors and controllers) that can prove difficult to retroactively improve when newly developed methods are proposed. Improvements must be somehow “imposed” upon the original robotic systems. What options are available for imposing performance from pre-existing, common systems and how do the options compare? Optimization often assumes idealized systems leading to open-loop results (lacking feedback from sensors), and this manuscript investigates utility of prefiltering, such other modern methods applied to non-idealized systems, including fusion of noisy sensors and so-called “fictional forces” associated with measurement of displacements in rotating reference frames. A dozen modern approaches are compared as the main contribution of this work. Four methods are idealized cases establishing a valid theoretical comparative benchmark. Subsequently, eight modern methods are compared against the theoretical benchmark and against the pre-existing robotic systems. The two best performing methods included one modern application of a classical approach (velocity control) and one modern approach derived using Pontryagin’s methods of systems theory, including Hamiltonian minimization, adjoint equations, and terminal transversality of the endpoint Lagrangian. The key novelty presented is the best performing method called prefiltered open-loop optimal + transport decoupling, achieving 1–3 percent attitude tracking performance of the robotic instrument with a two percent reduced computational burden and without increased costs (effort).

The literature on surgical robots (SRs) usually adopts the perspective of healthcare workers. However, research on potential patients’ perceptions and the publics’ points of view on SRs is scarce. This fact motivates our study, which assesses the factors inducing the SRs acceptance in the opinion of potential patients. We consider three variables, based on the unified theory of acceptance and the use of technology (UTAUT): the performance expectancy (PE), the effort expectancy (EE), and the social influence (SI); pleasure (PL), arousal (AR), and the perceived risk (PR). To deal with empirical data, we used the ordered logistic regression (OLR) and the fuzzy set comparative qualitative analysis (fsQCA). The OLR allowed us to check for a significant positive average influence of the UTAUT variables and PL, on the intention to undergo robotic surgery. However, the PR had a significant negative impact, and AR was not found to be significant. The FsQCA allowed the identification of the potential patient profiles, linked to acceptance of and resistance to SRs and confirmed that they are not symmetrical. The proposed input variables are presented as core conditions in at least one prime implicate robotic-assisted surgery acceptance. The exception to this statement is the PR, which is affirmed in some recipes and absent in others. The recipes explaining the resistance to SRs were obtained by combining the absence of PE, EE, SI, and PL (i.e., these variables have a negative impact on rejection) and the presence of the PR (i.e., the perceived risk has a positive impact on a resistance attitude toward SRs). Similarly, arousal played a secondary role in explaining the rejection.

Serve as the human-robot interface of laparoscopic surgical robot, the master device always plays a crucial role in terms of master-slave manipulation. Growing demands of robot-assisted surgery system also warrant more rational design and optimization for the master manipulator mechanism, which turn out to be important for improving the performance of surgical operations. In this paper, a novel 9 degrees of freedom (DOFs) haptic master manipulator applied to laparoscopic surgical robots is proposed. First of all, the mechanical configuration of the serial master manipulator is presented along with its corresponding kinematic analysis. The proposed strategy can decouple the posture and position completely and to a certain extent simplify the kinematics calculations. Then a mechanism optimization index which synthesizes the global kinematic performances, the global positioning accuracy and the structure length utilization of the manipulator mechanism is introduced. Finally, an improved particle swarm optimization algorithm is proposed to find the optimal mechanism design parameters. The optimization index and algorithm are verified by comparing the optimized parameters with the initial settings. Theoretical analysis and optimization results have demonstrated that the master manipulator can achieve better kinematic performances while maintaining 6 dimensions force feedback.

Techniques for the detection and recognition of objects have experienced continuous development over recent years, as their application and benefits are so very obvious. Whether they are involved in driving a car, environment surveillance and security, or assistive living for people with different disabilities, not to mention advanced robotic surgery, these techniques are almost indispensable. This article presents the research results of a distance assessment using object detection and recognition techniques. The first is a new technique based on low-cost photo cameras and special sign detection. The second is a classic approach based on a LIDAR sensor and an HQ photo camera. Its novelty, in this case, consists of the concept and prototype of the hardware subsystem for high-precision distance measurement, as well as fast and accurate object recognition. The experimentally obtained results are used for the motion control strategy (directional inverse kinematics) of the robotic arm (virtual prototype) component in special assistive devices designed for visually impaired persons. The advantages of the original technical solution, experimentally validated by a prototype system with modern equipment, are the precision and the short time required for the identification and recognition of objects at relatively short distances. The research results obtained, in both the real and virtual experiments, stand as a basis for the further development of the visually impaired mechatronic system prototype using additional ultrasonic sensors, stereoscopic or multiple cameras, and the implementation of machine-learning models for safety-critical tasks.

Redundancy resolution techniques have been widely used for the control of kinematically redundant robots. In this work, one of the redundancy resolution techniques is employed in the mechanical design optimization of a robot arm. Although the robot arm is non-redundant, the proposed method modifies robot arm kinematics by adding virtual joints to make the robot arm kinematically redundant. In the proposed method, a suitable objective function is selected to optimize the robot arm’s kinematic parameters by enhancing one or more performance indices. Then the robot arm’s end-effector is fixed at critical positions while the redundancy resolution algorithm moves its joints including the virtual joints because of the self-motion of a redundant robot. Hence, the optimum values of the virtual joints are determined, and the design of the robot arm is modified accordingly. An advantage of this method is the visualization of the changes in the manipulator’s structure during the optimization process. In this work, as a case study, a passive robotic arm that is used in a surgical robot system is considered and the task is defined as the determination of the optimum base location and the first link’s length. The results indicate the effectiveness of the proposed method.

The mechanical ability and usefulness of simulation systems can be improved by combining a tactile display with a remote control or medical simulation systems. In this study, a scissors-type haptic device containing magnetorheological fluid (MR fluid) in its fulcrum is developed. We evaluate the mechanical response to the applied voltage and realize the presence of mechanical stimuli when a subject grasps or cuts the corresponding objects. When the magnetic field around the MR fluid is controlled by an electric voltage of 150⁻500 mV, the torque linearly increases from 0.007 ± 0.000 to 0.016 ± 0.000 N m. The device can provide tactile stimuli with 0.1 s of resolution. We also determined the voltage profiles based on typical force profiles obtained during grasping/cutting processes and evaluated the torque using a mechanical evaluation system. Features of the force profiles related to the soft and sticky feels were reconstructed well.

This article presents a study about the use of industrial robots as assistants in laparoscopic surgeries. An analysis of laparoscopic surgical method and this procedure assisted by robots is presented. The problem of passing through the hole abdominal where surgical instruments are inserted is enligthed. This problem is solved through an optimization algorithm that yields the trajectories to be followed by elbow and wrist joint of an anthropomorphic robot. Two industrial robots (Puma of Unimation and PA10 of Mitsubishi) are studied and their respective simulated performances as potential assistants in such surgeries are discussed.