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Haptic feedback of gripping forces during robotassisted surgery can benefit the surgical outcome by means of reduced forces applied to the tissue. A custom-designed haptic user interface allows to control four degrees of freedom of the instrument’s endeffector and to display gripping forces. System-centered evaluation is performed to assess its capability of displaying feedback with high mechanical bandwidth. In addition, the perception of gripping forces is evaluated using task-centered methods. Two tasks were performed by ten participants to assess the perceived feedback regarding size and stiffness of grasped objects. Maximum feedback forces of 4.3N and a mechanical bandwidth of 73.5 Hz are achieved. Tests with participants showed promising results regarding the discrimination of size and stiffness of grasped objects.

Increasing patient safety during operations is an inevitable topic in anaesthesiology. The cockpit strategy presented by Vogelsang et al. addresses this issue with elements such as closed loop communication and the use of checklists. In this paper, the use of checklists is taken up further. An AR application is presented that augments checklists for anaesthesia induction into the user’s field of view. The application is to be implemented in teaching and help prospective physicians to internalise the workflows in anaesthesiology more quickly and sustainably. A working prototype has been created and loaded onto the HoloLens 2. The prototype is being assessed and evaluated by an anaesthetist. The feedback will be included into the following development steps. The application will be further adapted to the needs and requirements of the users. In order to evaluate the usability and the user experience, students and medical professionals should test and evaluate the application repeatedly.

The global shortage of healthcare staff has led to high workloads and subsequent risks to patient well-being. One of the professions affected is that of the scrub nurse. Robotic scrub nurse systems have the potential to reduce workload and to assist in handling surgical instruments. Existing approaches mostly use two-finger grippers or electromagnetic grippers. However, it is assumed that a granular jamming gripper is more suitable for handling various surgical instruments, regardless of material and shape. A gripping unit based on a granular jamming gripper and attached to a robotic arm is presented. For evaluation, six surgical instruments were repeatedly gripped and transported. The granular jamming gripper was found to be suitable for picking up and transferring most instruments, however, handling very flat instruments turned out to be challenging.

In conventional laparoscopy, the field of view of the surgeon is limited. Angled laparoscopes enable the observation of surrounding structures, however, to change the viewing perspective on a specific object, permanent repositioning and rotation of the shaft is required. In this paper, a demonstrator of a steerable flexible laparoscope is presented, enabling the user to intuitively adjust the perspective onto an object by means of a single control element. The laparoscope provides a viewing angle of ± 50° at 50 mm working distance. In first tests, the presented laparoscope showed advantages regarding intuitiveness of the control, easier handling, and improved depth perception.

During laparoscopic procedures, the surgeon's view of the situs, and thus her or his performance, is dependent on the skills of the camera assistant. The surgeon lacks control over his own field of view and there is a high potential for reducing mental load and workflow issues. In this paper, a research setup of a 360° laparoscopic imaging system is presented and evaluated. The system consists of a 360° camera and a head-mounted display, through which the surgeon can inspect the situs. In a user test, the system showed advantages over a conventional laparoscope regarding orientation in the situs, intuitiveness of operation, and faster task completion.

Accurate measurement of interaction forces during robot-assisted surgery requires compact force sensing modalities in the surgical tools, thus might add considerable cost to the setup. Measuring the motor current to estimate gripping forces, is an advantageous approach since no expensive force sensor is needed. In this paper, a mechanical interface is presented, which allows actuating conventional articulated instruments for robot-assisted surgery. The interface features the estimation of static gripping forces at the instrument’s tip based on the motor current. The evaluation shows reproducible results, and the current-based approach seems to be a cost-efficient way to estimate gripping forces.

In robotic telemanipulation for minimally-invasive surgery, lack of haptic sensation and non-congruent movement of input device and manipulator are major drawbacks. Input devices based on cable-driven parallel mechanisms have the potential to be a stiff alternative to input devices based on rigid parallel or serial kinematics by offering low inertia and a scalable workspace. In this paper, the haptic user interface of a cable-driven input device and its technical specifications are presented and assessed. The haptic user interface allows to intuitively control the gripping movement of the manipulator’s end effector by providing a two-finger precision grasp. By design, the interface allows to command input angles between 0° and 45°. Furthermore, interaction forces from the manipulator’s end effector can be displayed to the user’s twofinger grasp in a range from 0 N to 6 N with a frequency bandwidth of 17 Hz.

A twisted string actuator (TSA) is a small, strong, lightweight, and low-cost gear, transforming rotation into a linear pulling movement. The TSA consists of two or more strings that are twisted along their common longitudinal axis. The helix formed in this process becomes shorter the further the bundle is twisted. A possible application is a tendon-based endoscopic robot. To control the movement of the endoscope, a precise contraction of the tendon is necessary. Since the strings of the TSA show an elastic behaviour, position feedback is needed to determine the exact movement of the TSA. In this paper, a TSA with a closed-loop position control by a low-cost displacement sensor is presented.

Access to systems for robot-assisted surgery is limited due to high costs. To enable widespread use, numerous issues have to be addressed to improve and/or simplify their components. Current systems commonly use universal linkage-based input devices, and only a few applicationoriented and specialized designs are used. A versatile virtual reality controller is proposed as an alternative input device for the control of a seven degree of freedom articulated robotic arm. The real-time capabilities of the setup, replicating a system for robot-assisted teleoperated surgery, are investigated to assess suitability. Image-based assessment showed a considerable system latency of 81.7 ± 27.7 ms. However, due to its versatility, the virtual reality controller is a promising alternative to current input devices for research around medical telemanipulation systems.

Microscopy enables fast and effective diagnostics. However, in resource-limited regions microscopy is not accessible to everyone. Smartphone-based low-cost microscopes could be a powerful tool for diagnostic and educational purposes. In this paper, the imaging quality of a smartphone-based microscope with four different optical parameters is presented and a systematic overview of the resulting diagnostic applications is given. With the chosen configuration, aiming for a reasonable trade-off, an average resolution of 1.23 μm and a field of view of 1.12 mm2 was achieved. This enables a wide range of diagnostic applications such as the diagnosis of Malaria and other parasitic diseases.

Microscopy is an essential tool in research and science. However, it is relatively resource consuming regarding cost, time of usage, and consumable supplies. Current low-cost approaches provide good imaging quality but struggle in terms of versatility or applicability to varying setups. In this paper, a Compact Microscope Module for versatile application in custom-made setups or research projects is presented. As a first application and proof of concept, the use of the module in a High-Throughput Microscope for screening of samples in microtiter plates is shown. The Compact Microscope Module allows for simple and resource-efficient microscopy in various applications while still enabling relatively good imaging qualities.

Robotic assistance in surgical interventions has been shown to improve both the surgical outcome and the surgeon’s performance. However, cost-efficient implementation of such systems in an operating room workflow is not yet resolved. Most of the current approaches use highly specialized and purpose-built robotic components, resulting in large costs. This paper presents an investigation into the usage of off-the-shelf robots as cost-efficient basis for teleoperated surgery. In addition, the modifications required of the robot and/or operating environment to make it suitable for the medical setting are assessed. The considered systems are found via a literature search and the MERODA-database, specifically focusing on systems designed for teleoperated surgery which use industrial robots. Among the 126 telemanipulated systems found, only 10 use industrial robots for surgical procedures. Overall, due to the better availability, reduced costs, and increased performance, current industrial robots should be further considered for new and versatile lowcost approaches to teleoperated surgery.

Microscopy enables fast and effective diagnostics. However, its functionality is not accessible to everyone. Smartphone-based low-cost microscopes could be a powerful tool for diagnostics and educational purposes. Current smartphone-based microscopy approaches struggle with high cost, poor image quality and/or insufficient smartphone compatibility. In this paper, a very feasible and effective lowcost microscope is presented which addresses these issues. To minimize cost, a monolithic foldable structure is designed for production by injection molding. The design has a high order of functional integration, minimizing the number of components, while still enabling a micrometer focusing accuracy.

In developing countries airborne micro-organisms are one of the most common causes of surgical wound infection. In the operating room low-turbulence displacementflow has been shown to reduce the influence of airborne bacteria. However, due to complexity and cost, current systems are not accessible to all potential users. In this paper a low-cost ventilation system is presented that provides lowturbulence displacement-flow over a surgical operating environment. A stand-alone, simple to assemble, mobile airflow system was developed using the principle of speed compensation for laminar airflow. From visual inspection and measurements, the system was seen to generate a continuous downwards displacement of air over the protected area around the situs. The entire system can be assembled quickly with minimal standard tools, making it very suitable for mobile use, such as in disaster areas. Future work is required to achieve the vertical dimension of a laminar flow field required by the DIN 1946-4. Overall, the low-cost and simple system could provide many potential users access to the technology and thus improving hygiene conditions in their operating environment.