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Background: Combining the strengths of surgical robotics and minimally invasive surgery (MIS) holds the potential to revolutionize surgical interventions. The MIS advantages for the patients are obvious, but the use of instrumentation suitable for MIS often translates in limiting the surgeon capabilities (eg, reduction of dexterity and maneuverability and demanding navigation around organs). To overcome these shortcomings, the application of soft robotics technologies and approaches can be beneficial. The use of devices based on soft materials is already demonstrating several advantages in all the exploitation areas where dexterity and safe interaction are needed. In this article, the authors demonstrate that soft robotics can be synergistically used with traditional rigid tools to improve the robotic system capabilities and without affecting the usability of the robotic platform., Materials and Methods: A bioinspired soft manipulator equipped with a miniaturized camera has been integrated with the Endoscopic Camera Manipulator arm of the da Vinci Research Kit both from hardware and software viewpoints. Usability of the integrated system has been evaluated with nonexpert users through a standard protocol to highlight difficulties in controlling the soft manipulator., Results and Conclusion: This is the first time that an endoscopic tool based on soft materials has been integrated into a surgical robot. The soft endoscopic camera can be easily operated through the da Vinci Research Kit master console, thus increasing the workspace and the dexterity, and without limiting intuitive and friendly use.

Abstract: The development of active locomotion approaches for endoscopic capsules – as opposed to the passive traversal of the gastrointestinal (GI) tract by natural peristalsis, which is the current clinical practice – is expected to significantly enhance the diagnostic and therapeutic functionalities of these devices. Exploitation of external magnetic fields as locomotion strategy currently represents the most promising approach for the active guidance of endoscopic capsules. In addition, the use of capsule vibrations is currently under investigation, in order to further enhance the maneuverability of the capsule by reducing its friction with the GI tissues. Towards this end, we present here the development of a capsule prototype, which integrates permanent magnets with a vibrating motor and a triaxial accelerometer, along with an electronic module allowing remote control of the motor and wireless transmission of the inertial data to a host PC. Ex vivo tests confirm both the efficacy of vibrations for reducing friction, as well as the adequacy of the inertial sensing scheme in capturing the characteristics of the capsule vibrations. It is expected that these findings could be exploited for the on-the-fly adjustment of the vibratory motor frequency, based on the accelerometer data, in order to adaptively minimize the capsule friction during the entire endoscopic procedure. [Copyright &y& Elsevier]

Background: Despite being considered the most effective method for colorectal cancer diagnosis, colonoscopy take-up as a mass-screening procedure is limited mainly due to invasiveness, patient discomfort, fear of pain, and the need for sedation. In an effort to mitigate some of the disadvantages associated with colonoscopy, this work provides a preliminary assessment of a novel endoscopic device consisting in a softly tethered capsule for painless colonoscopy under robotic magnetic steering. Methods: The proposed platform consists of the endoscopic device, a robotic unit, and a control box. In contrast to the traditional insertion method (i.e., pushing from behind), a 'front-wheel' propulsion approach is proposed. A compliant tether connecting the device to an external box is used to provide insufflation, passing a flexible operative tool, enabling lens cleaning, and operating the vision module. To assess the diagnostic and treatment ability of the platform, 12 users were asked to find and remove artificially implanted beads as polyp surrogates in an ex vivo model. In vivo testing consisted of a qualitative study of the platform in pigs, focusing on active locomotion, diagnostic and therapeutic capabilities, safety, and usability. Results: The mean percentage of beads identified by each user during ex vivo trials was 85 ± 11%. All the identified beads were removed successfully using the polypectomy loop. The mean completion time for accomplishing the entire procedure was 678 ± 179 s. No immediate mucosal damage, acute complications such as perforation, or delayed adverse consequences were observed following application of the proposed method in vivo. Conclusions: Use of the proposed platform in ex vivo and preliminary animal studies indicates that it is safe and operates effectively in a manner similar to a standard colonoscope. These studies served to demonstrate the platform's added advantages of reduced size, front-wheel drive strategy, and robotic control over locomotion and orientation. [ABSTRACT FROM AUTHOR]