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Copyright of Journal of Chengdu University (Social Science) is the property of Journal of Chengdu University (Social Science Edition) Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hyper-redundant manipulators (HRMs) have been applied to many robotic surgery platforms because they can be bent in various directions as they consist of many rigid segments and are operated in a cable-driven manner, allowing remote placement of actuators. However, due to the long kinematic chain and wire stretching when subjected to force, HRMs have disadvantages, including inaccurate positioning and difficulty in building physics-based models. These constraints pose challenges in realizing force feedback using HRMs. In this paper, we present a deep neural network (DNN) based estimation system for the external force exerted on the distal end of the HRMs using tensions and fixed positions of the cables as input data, which can be measured outside the human body. To generate a training dataset for DNN, a physics-based HRM model considering external forces, cable tensions, cable friction, and cable extension was developed. We also proposed the iterative optimization algorithm for the optimal configuration of the HRM. The training dataset was produced through simulation using the physics-based HRM model, and then the DNN-based force estimation model was trained. The HRM prototype was fabricated to verify the reliability of the training dataset and evaluate the performance of the DNN-based force estimation model. The estimated magnitude and angle errors of the external force were 4.8% and 10.4% on average, respectively. This demonstrates the feasibility of measuring the external force without force/torque sensors, which can help realize force feedback in HRMs. [ABSTRACT FROM AUTHOR]

Copyright of China Journal of Oral & Maxillofacial Surgery is the property of Shanghai Jiao Tong University, College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper presents the development of the hardware and software architecture of a sixdegrees of freedom (DOF) parallel robot (PARA-SILSROB) by illustrating all the stages undertaken to achieve the experimental model of the robot. Based on the experimental model, the control architecture is also presented, which is primarily based on a master–slave control system through which the surgeon controls the robot using the master console composed of commercial peripheral components (two 3D Space Mouse devices, computer, and keyboard) integrated with the solution developed in this study and presented in this paper. The robot was developed also according to the surgical protocol and surgeon's requirements, and for the functionality testing of the mechanical structure, two experimental stands were used. The first stand presented several surgical steps, such as manipulation, resection, and suture of experimental tissues (simulating real-life robot-assisted surgical maneuvers) using commercial instruments. The second stand presented a simulation of an esophagectomy for esophageal cancer and digestive reconstruction through a right intercostal approach. For this testing phase, the organs were created using 3D reconstruction, and their simplified models were 3D printed using PolyJet technology. Furthermore, the input trajectory generated using the master console was compared with the robot actuator's movements and the obtained results were used for validation of the proposed robot control system. [ABSTRACT FROM AUTHOR]

Surgical robot is the national strategic diagnostic and therapeutic equipment research focus, get a number of scientific research institutes, colleges and universities and enterprises pay extensive attention to the design and development of a variety of surgical robots, and registration declaration. This article explores the critical technologies of surgical robots and key areas for optimizing their performance, including kinematic positioning errors, pose errors, feedback model errors, image recognition positioning errors, path planning, and safety aspects. The findings not only provide a scientific basis for future standardization research on surgical robots but also offer significant theoretical and practical references for the research, manufacturing, and registration processes in the medical robotics industry.

In response to the compliant tracking of surgical intent and adherence to safety range constraints in semi-active knee arthroplasty robots, a model predictive impedance control (MPIC) algorithm is proposed. First, to enhance this algorithm’s operational efficiency, the Stirling interpolation method is employed to linearize the dynamics model of the robotic arm as the predictive model. This method offers computational simplicity and high-precision solving accuracy. Second, based on the impedance model, the force-compliant control mechanism is used to identify the surgeon’s force intention, thereby generating the desired motion trajectory for the robotic arm. To facilitate programming implementation, the impedance model is discretized. Third, leveraging the rolling optimization and feedback correction properties of model predictive control, a virtual state enhancement is designed to improve the explicit constraint handling capability of the MPIC algorithm. This enhancement addresses the infeasibility issues encountered by traditional model predictive control near state constraint boundaries in practical applications. Transforming the model predictive problem into a quadratic programming problem reduces the difficulty of solving the model predictive problem and increases problem-solving speed. Finally, MPIC is integrated as the lower-level position-tracking controller for the robotic arm, with the impedance model serving as the upper-level task planning controller, thus forming the MPIC controller. Comparative experiments with three-loop PID (Proportional integral derivative) control are conducted on the ROKAE seven-axis collaborative robot experimental platform, confirming that the MPIC algorithm achieves better trajectory tracking accuracy and response speed, effectively realizing the desired impedance dynamics and yielding superior compliance. Additionally, further validation is conducted by installing a six-axis force sensor between the end-effector and the wrist of the robotic arm to measure human–robot interaction forces, confirming that the MPIC algorithm exhibits better compliance than traditional position-tracking control methods. Drag experiments are designed to verify the active constraint effect of MPIC on mechanically coupled robotic arms with complex system parameter structures, demonstrating that the control algorithm can actively constrain the motion of the robotic arm when it is manually manipulated to exceed the set state constraint range. Overall, the MPIC algorithm achieves better compliance and meets the safety requirements for knee arthroplasty surgery compared to traditional three-loop PID control methods. This advancement holds promise for further development and adoption of semi-active surgical robots, reducing the complexity of using surgical robots as surgeons and accelerating the widespread adoption of domestically produced surgical robots in hospitals. This paper should promote the practical application of semi-active surgical robots.

Pancreatic cancer, a highly malignant digestive system tumor, presents significant challenges in surgical treatment and generally has a poor prognosis. Luckily, the rapid development of medical artificial intelligence has facilitated its application in areas related to pancreatic cancer, including preoperative imaging diagnostics, rapid pathological diagnosis, surgical robotic systems, and the training of pancreatic surgery specialists. In this paper, we review the latest advancements in the application of medical artificial intelligence in pancreatic cancer, aiming to promote the deep integration of artificial intelligence in the field of pancreatic cancer surgery.

Introduction: The use of robotic systems in the surgical domain has become groundbreaking for patients and surgeons in the last decades. While the annual number of robotic surgical procedures continues to increase rapidly, it is essential to provide the surgeon with innovative training courses along with the standard specialization path. To this end, simulators play a fundamental role. Currently, the high cost of the leading VR simulators limits their accessibility to educational institutions. The challenge lies in balancing highfidelity simulation with cost-effectiveness; however, few cost-effective options exist for robotic surgery training. Methods: This paper proposes the design, development and user-centered usability study of an affordable user interface to control a surgical robot simulator. It consists of a cart equipped with two haptic interfaces, a VR visor and two pedals. The simulations were created using Unity, which offers versatility for expanding the simulator to more complex scenes. An intuitive teleoperation control of the simulated robotic instruments is achieved through a high-level control strategy. Results and Discussion: Its affordability and resemblance to real surgeon consoles make it ideal for implementing robotic surgery training programs in medical schools, enhancing accessibility to a broader audience. This is demonstrated by the results of an usability study involving expert surgeons who use surgical robots regularly, expert surgeons without robotic surgery experience, and a control group. The results of the study, which was based on a traditional Peg-board exercise and Camera Control task, demonstrate the simulator's high usability and intuitive control across diverse user groups, including those with limited experience. This offers evidence that this affordable system is a promising solution for expanding robotic surgery training. [ABSTRACT FROM AUTHOR]

High-performance miniature surgical instruments play an important role in complicated minimally invasive surgery (MIS). Based on in-depth analysis of the requirements of MIS and the characteristics of the existing minimally invasive surgical instruments, a multiple degrees of freedom (DOF) robotic surgical instrument with decoupled pose was proposed. Firstly, the design concept of the pose decoupling instrument was described in detail, and its physical structure, transmission structure, and mechanical properties were designed and analyzed. A surgical instrument control algorithm based on the master–slave mode was established. Finally, a physical prototype was developed, and its motion ranges of joints, load capacity, and suture operation performance were comprehensively evaluated, which confirmed the effectiveness of the proposed minimally invasive robotic surgical instrument. [ABSTRACT FROM AUTHOR]

Background: Mandibular tumor surgery necessitates precise osteotomies based on tumor boundaries; however, conventional osteotomies often lack accuracy in predicting osteotomy positions and planes, potentially leading to excessive resection of normal bone tissues or residual tumors, thus compromising postoperative quality of life and clinical outcomes. Robotic-assisted surgery (RAS) augmented with artificial intelligence (AI) offers precise localization capabilities, aiding surgeons in achieving accurate osteotomy positioning. This study aimed to evaluate the feasibility and accuracy of a robotic magnetic navigation system for positioning and osteotomy in an intraoral surgical trial of a mandibular tumormodel. Methods: Patient computed tomography (CT) imaging data of mandibular chin and body tumors were utilized to create 3D printedmodels, serving as study subjects for mandibular tumor resection. Ten pairs of models were printed for the experimental and control groups. The experimental group (EG) underwent osteotomy using a robot-assisted surgical navigation system, performing osteotomy under robotic navigation following alignment based on preoperative design. The control group (CG) underwent traditional surgery, estimating osteotomy position empirically according to preoperative design. Postoperative CT scans were conducted on both models, and actual postoperative results were compared to preoperative design. Osteotomy accuracy was evaluated by positional and angular errors between preoperatively designed and actual osteotomy planes. Results: For ten randomly selected spots on the left and right sides, respectively, the EG group had mean distance errors of 0.338 mmand 0.941 mm. These values were obtained from the EG group. In the EG group, on the left side, the mean angular errors were 14.741 degrees, while on the right side, they were 13.021 degrees. For the 10 randomly selected spots on the left and right sides, respectively, the CG had mean distance errors of 1.776 mm and 2.320 mm. This is in contrast to the results obtained by the EG. It was determined that the left side had a mean angle error of 16.841 degrees, while the right side had an error of 18.416 degrees in the CG group. The above results indicated significantly lower point errors of bilateral osteotomy planes in the experimental group compared to the control group. Conclusion: This study demonstrates the feasibility of electromagnetic navigation robot-assisted intraoral osteotomy for mandibular tumors and suggests that this approach can enhance the precision of clinical surgery. [ABSTRACT FROM AUTHOR]

Reduction is a crucial stage in the surgical treatment of bone fractures. The detailed fracture information of the patient can be obtained from computed tomography (CT) scans before surgery and enable physicians to plan preoperative reduction, to reduce the operation time and thus increase the probability of getting satisfactory results. The primary purpose of this paper is to design a computer-aided automatic registration method of fracture point cloud data, so as to simplify the fracture reduction process. In this paper, we propose an integrated fracture reduction system was introduced. The system enables direct semi-automatic processing from CT images to fracture reduction. First, a 3D fracture models is reconstructed from CT images by using the modified Marching Cube (MC) algorithm and is discretized to generate a point cloud. Second, the K-dimensional (KD) tree algorithm is used to cluster and segment the point clouds to identify different fracture fragments. Last, through the combination algorithm of Normal Distributions Transform (NDT) and modified Iterative Closest Point (ICP), the coarse alignment and fine registration of point clouds are achieved step by step. This method has been successfully applied to the reduction of tibial fracture. In the tests performed, the processing time of each step, the point cloud and the 3D model after registration are displayed. The semi-automatic integrated system based on preoperative CT scanning is used to realize fracture reduction, which provides a feasible foundation for minimally invasive and accurate fracture reduction surgery. [ABSTRACT FROM AUTHOR]

This paper presents a minimally invasive surgical robot system for endoluminal gastrointestinal endoscopy through natural orifices. In minimally invasive gastrointestinal endoscopic surgery (MIGES), surgical instruments need to pass through narrow endoscopic channels to perform highly flexible tasks, imposing strict constraints on the size of the surgical robot while requiring it to possess a certain gripping force and flexibility. Therefore, we propose a novel minimally invasive robot system with advantages such as compact size and high precision. The system consists of an endoscope, two compact flexible continuum mechanical arms with diameters of 3.4 mm and 2.4 mm, respectively, and their driving systems, totaling nine degrees of freedom. The robot's driving system employs bidirectional ball-screw-driven motion of two ropes simultaneously, converting the choice of opening and closing of the instrument's end into linear motion, facilitating easier and more precise control of displacement when in position closed-loop control. By means of coordinated operation of the terminal surgical tools, tasks such as grasping and peeling can be accomplished. This paper provides a detailed analysis and introduction of the system. Experimental results validate the robot's ability to grasp objects of 3 N and test the system's accuracy and payload by completing basic operations, such as grasping and peeling, thereby preliminarily verifying the flexibility and coordination of the robot's operation in a master–slave configuration. [ABSTRACT FROM AUTHOR]

Purpose: Preoperative planning is critical for total knee arthroplasty (TKA) performed with surgical robots, as it involves establishing a coordinate system to calculate the angle values of the components. This coordinate system serves as a reference during the surgical planning stage. This study aimed to develop a newly custom coordinate system suitable for integration with a surgical robot system. Methods: The “Skywalker” surgical robot system was used to import computed tomography (CT) images of the entire lower extremities from 50 patients diagnosed with osteoarthritis. Three-dimensional reconstruction was subsequently performed. The TKA component was positioned at a fixed angle using the newly developed custom coordinate system. The angle values of the components, based on the standard CT coordinate system, were then recorded without altering their positioning. These values were analyzed to assess the differences between the two coordinate systems. Results: The mean and standard deviation values for the coronal, sagittal, and transverse plane positioning of the femoral component (absolute value of error) were 0.004° ± 0.020°, 0.006° ± 0.024°, and 0.158° ± 0.186°, respectively. Similarly, the mean and standard deviation values for the coronal, sagittal, and transverse plane positioning of the tibial component (absolute value of error) were 0.544° ± 0.452°, 0.042° ± 0.076°, and 0.348° ± 0.445°, respectively. Conclusion: This newly developed custom coordinate system can be employed for preoperative planning in Skywalker surgical robot system-assisted TKA, particularly for patients with significant positional abnormalities in their CT scans.

Objective Percutaneous CT‐guided radiofrequency ablation (CT‐RFA) is a widely accepted procedure for treatment of osteoid osteomas. However, the application of CT‐RFA was restricted as a result of some drawbacks, such as radiation exposure, and inconvenience in general anesthesia. The primary aim of this study is to evaluate the safety and efficacy of intra‐operative TiRobot‐assisted percutaneous RFA of osteoid osteomas. Methods We retrospectively reviewed 21 medical files of patients who were treated with percutaneous RFA of osteoid osteomas guided by the TiRobot system in our institution between March 2021 and April 2022. The three‐dimensional images obtained by a 3D C‐arm intra‐operatively were sent to the TiRobot system. The puncture point and trajectory were designed. Then the guide pin was positioned to the lesion with the assistance of TiRobot and the biopsy sheath was inserted into the lesion through the guide pin. The tumor was biopsied for pathological examination. Then the RFA needle was inserted into the nidus through the biopsy sheath for thermal ablation. Data were extracted on the associated complications, the reduction in pain at 1 month and 1 year postoperatively assessed by the visual analogue scale (VAS). A paired t‐test was used to compare the pre‐operative and post‐operative VAS scores. Results The patients included 17 males and four females with a mean age of 19.5 ± 10.4 years (range 3–45 years). Lesions were located on the femur in nine cases, on the tibia in nine cases, on the humerus in one case, on the calcaneus in one case, and on the acetabulum in one case. TiRobot‐assisted percutaneous RFA was successfully performed on all 21 patients. There was no intra‐operative or post‐operative complications observed. Pathological diagnosis of osteoid osteoma was obtained in 11 patients, but the other 10 cases were not pathologically diagnosed. The mean follow‐up time was 18.8 months (range: 12–26 months).Post‐operative VAS scores were reduced significantly in all cases. The mean VAS score decreased from 6.5 pre‐operatively to 0.5 at 1 month post‐operatively and to 0.1 at 1 year post‐operatively. Conclusion As a reliable technique for localizing and resection of nidus, TiRobot‐assisted percutaneous RFA is a safe and effective option for the treatment of osteoid osteomas.

In order to improve the safety and operational performance of surgical robots, a vertebral plate decompression surgery robot was used as a research object to conduct a user evaluation of its interactive interface. Hierarchical analysis was used to calculate the weights of the evaluation indexes for each dimension. A questionnaire survey with orthopedic surgeons was used to investigate the usefulness, practicability, comprehensibility, degree of balance, and overall rating of the keystrokes in the collection screen, the realtime grinding information, and the robot operation information. The weighted scores for each key and message within the interface were derived by weighted summation. The results show that the scores of the practicable operation buttons, the practicable and degree of balance of both operation buttons, and the robot operation information are low. The weighted rating of the operation buttons within the interface is higher than the mean, but the weighted scores for the real-time grinding and robot operation information are lower than the mean. It is concluded that the recognition of buttons and information within the interface needs to be more detailed in the future design of the surgical robot to avoid problems with confusing keys or messages. Also, unified interface language, the use of vocabulary in specialized medical fields, and adding interface tips or function descriptions are necessary designs to improve the safety and operational performance of surgical robots. [ABSTRACT FROM AUTHOR]

Objective: Percutaneous CT‐guided radiofrequency ablation (CT‐RFA) is a widely accepted procedure for treatment of osteoid osteomas. However, the application of CT‐RFA was restricted as a result of some drawbacks, such as radiation exposure, and inconvenience in general anesthesia. The primary aim of this study is to evaluate the safety and efficacy of intra‐operative TiRobot‐assisted percutaneous RFA of osteoid osteomas. Methods: We retrospectively reviewed 21 medical files of patients who were treated with percutaneous RFA of osteoid osteomas guided by the TiRobot system in our institution between March 2021 and April 2022. The three‐dimensional images obtained by a 3D C‐arm intra‐operatively were sent to the TiRobot system. The puncture point and trajectory were designed. Then the guide pin was positioned to the lesion with the assistance of TiRobot and the biopsy sheath was inserted into the lesion through the guide pin. The tumor was biopsied for pathological examination. Then the RFA needle was inserted into the nidus through the biopsy sheath for thermal ablation. Data were extracted on the associated complications, the reduction in pain at 1 month and 1 year postoperatively assessed by the visual analogue scale (VAS). A paired t‐test was used to compare the pre‐operative and post‐operative VAS scores. Results: The patients included 17 males and four females with a mean age of 19.5 ± 10.4 years (range 3–45 years). Lesions were located on the femur in nine cases, on the tibia in nine cases, on the humerus in one case, on the calcaneus in one case, and on the acetabulum in one case. TiRobot‐assisted percutaneous RFA was successfully performed on all 21 patients. There was no intra‐operative or post‐operative complications observed. Pathological diagnosis of osteoid osteoma was obtained in 11 patients, but the other 10 cases were not pathologically diagnosed. The mean follow‐up time was 18.8 months (range: 12–26 months).Post‐operative VAS scores were reduced significantly in all cases. The mean VAS score decreased from 6.5 pre‐operatively to 0.5 at 1 month post‐operatively and to 0.1 at 1 year post‐operatively. Conclusion: As a reliable technique for localizing and resection of nidus, TiRobot‐assisted percutaneous RFA is a safe and effective option for the treatment of osteoid osteomas. [ABSTRACT FROM AUTHOR]

Purpose: Common dense stereo simultaneous localization and mapping (SLAM) approaches in minimally invasive surgery (MIS) require high-end parallel computational resources for real-time implementation. Yet, it is not always feasible since the computational resources should be allocated to other tasks like segmentation, detection, and tracking. To solve the problem of limited parallel computational power, this research aims at a lightweight dense stereo SLAM system that works on a single-core CPU and achieves real-time performance (more than 30 Hz in typical scenarios). Methods: A new dense stereo mapping module is integrated with the ORB-SLAM2 system and named BDIS-SLAM. Our new dense stereo mapping module includes stereo matching and 3D dense depth mosaic methods. Stereo matching is achieved with the recently proposed CPU-level real-time matching algorithm Bayesian Dense Inverse Searching (BDIS). A BDIS-based shape recovery and a depth mosaic strategy are integrated as a new thread and coupled with the backbone ORB-SLAM2 system for real-time stereo shape recovery. Results: Experiments on in vivo data sets show that BDIS-SLAM runs at over 30 Hz speed on modern single-core CPU in typical endoscopy/colonoscopy scenarios. BDIS-SLAM only consumes around an additional 12 % time compared with the backbone ORB-SLAM2. Although our lightweight BDIS-SLAM simplifies the process by ignoring deformation and fusion procedures, it can provide a usable dense mapping for modern MIS on computationally constrained devices. Conclusion: The proposed BDIS-SLAM is a lightweight stereo dense SLAM system for MIS. It achieves 30 Hz on a modern single-core CPU in typical endoscopy/colonoscopy scenarios (image size around 640 × 480 ). BDIS-SLAM provides a low-cost solution for dense mapping in MIS and has the potential to be applied in surgical robots and AR systems. Code is available at https://github.com/JingweiSong/BDIS-SLAM. [ABSTRACT FROM AUTHOR]

In gynecologic surgery, a uterine manipulator is one of the instruments used to perform the laparoscopy. Throughout the past decade, a number of robotic technology applications used for uterine manipulation during surgery have been designed with the aim of increasing the efficiency, improving the precision, and reducing the workload of medical assistants. Although the RCM (Remote Center of Motion) mechanism is one of the key features in a Minimally Invasive Surgical (MIS) robot, the preliminary result in this study, in which the RCM mechanism was applied in a uterine manipulation robot, proved that this may cause unpleasant sensations such as irritation or harm to the nearby area during such manipulation. Therefore, a design of a non-RCM 2-DoF (Degree of Freedom) Robotic Uterine Manipulation System, in cooperation with an existing, reusable and tiltable-tip uterine manipulator, for laparoscopic gynecologic surgery has been proposed and evaluated via a mathematical model along with numerical analysis, a 3D uterus model, and a 1:1 uterus manikin model in order to demonstrate the use of the essential functions. According to the experimental results, the maximum load of 500 g has been handled well by the prototype, with the movement ranges of ±150° in the roll panel and ±90° in the pitch panel (0∼90° for anteversion and 0∼−90° for retroversion, if needed, which can be achieved by rotating the instrument to the other side). Furthermore, to verify this new design prior to its use on patients, and also in consideration of the ethics of human experimentation, through extensive testing on five donated soft-tissue cadavers, the proposed robot received positive feedback from all five surgeons performing the experiments and could offer effective uterine manipulation at the angular velocity of 4 °/s (0.67 RPM) with steady delineation of the vaginal fornices to create necessary motions in the pitch and roll panels of 30∼80° and ±15°, respectively, providing efficient visualization of the uterus. These features make this robot a valuable addition to the surgical instruments available to gynecologic surgeons. [ABSTRACT FROM AUTHOR]

Tribological interactions are one of the basic reactions affecting the course of the drive torque in surgical robot joints. It is interesting to test out what is the impact of friction on its dynamics because it gives the possibility to effective control. Inputs from two in vitro experiments on cardiovascular tissue were added to optimization model. For the optimal obtained geometry, a model of dynamics of driving torques was constructed by using the block diagram method, taking into the account the inertia tensors and the locations of masses centers. The electromechanical DC motor model was added to each joint. PID regulator models were also added to them and step response with optimal indicators of the regulation quality was received using gradient descent method. For a specific mechatronic system of the surgical robot, dynamic friction model was formulated based on the Lund-Grenoble model. [ABSTRACT FROM AUTHOR]

Objectives: This prospective clinical study aimed to evaluate the accuracy and 1‐year clinical follow‐up performance of dental implant placement with an autonomous dental implant robot (ADIR) system in full‐arch implant surgery. Materials and Methods: Twelve patients with edentulous arches or final dentition received 102 implants using the ADIR system. Global platform deviation, global apex deviation, and global angular deviation between the planned and actual implants were calculated after surgery. Data were statistically analyzed for factors including jaws, implant positions, patient sequences, implant systems, and implant length. Surgery duration was recorded. Patients were followed for 3 months and 1 year after surgery. Periodontal parameters, buccal bone thickness (BBT), and facial vertical bone wall peak (IP‐FC) were recorded. Results: Among the 102 implants, the mean (SD) global platform deviation, global apex deviation, and global angular deviation were 0.53 (0.19) mm, 0.58 (0.17) mm, and 1.83 (0.82)°, respectively. The deviation differences between the mandible and maxilla did not show statistical significance (p >.05). No statistically significant differences were found for the jaws, implant positions, patient sequences, implant systems, and implant length to the deviations (p >.05). The periodontal parameters, the BBT, and IP‐FC remained stable during 1‐year follow‐up. Conclusion: The ADIR system showed excellent positional accuracy. The 1‐year follow‐up after full‐arch implant surgery indicated that the ADIR system could achieve promising clinical performance. Additional clinical evidence is requisite to furnish guidelines for the implementation of the ADIR system in full‐arch implant surgery. [ABSTRACT FROM AUTHOR]

With advances in minimally invasive ophthalmic surgery (MIOS), novel vitreoretinal surgeries have been proposed to treat retinal diseases. Due to the limitations of manual techniques, surgical robots have been introduced for such surgeries. Among ophthalmic surgical robots, the remote center of motion (RCM) mechanism is widely used due to its unique advantages. In this paper, a novel RCM is proposed. Based on the configuration, the kinematics and singularity are analyzed. Subsequently, the planar workspace is analyzed based on ocular anatomy and the requirements of MIOS. The optimal configuration is selected according to the workspace coverage analysis, and the three-dimensional workspace is obtained. Finally, a prototype is built, and the motion is validated. When compared with the related prior RCM mechanisms, the resulting design has qualified workspace coverage, more concise kinematics, and reduced motion coupling with all actuators placed at the distal end of the base. The proposed RCM mechanism is suitable for common MIOS. Future research will further optimize the mechanical structure and control algorithm to improve the accuracy of the prototype. [ABSTRACT FROM AUTHOR]

Purpose: Surgical robots have significant research value and clinical significance in the field of percutaneous punctures. There have been numerous studies on ultrasound-guided percutaneous surgical robots; however, addressing the respiratory compensation problem of deep punctures remains a significant obstacle. Herein we propose a robotic system for percutaneous puncture with respiratory compensation. Methods: We proposed an online advance respiratory prediction model based on Bidirectional Gate Recurrent Unit (Bi-GRU) for the respiratory prediction requirements of surgical robot systems. By analyzing the main factors governing the accuracy of the respiratory motion prediction models, various parameters of the online advance prediction model were optimized. Subsequently, we integrated and developed ultrasound-guided percutaneous puncture robot software and a hardware platform to implement respiratory compensation, thus verifying the effectiveness and reliability of various key technologies in the system. Results: The proposed respiratory prediction model has a significantly reduced update time, with an average root mean square error (RMSE) of less than 0.4 mm. This represents a reduction of ~ 20% compared to the online training long short-term memory(LSTM). By conducting puncture experiments based on a respiratory phantom, the average puncture error was 2.71 ± 0.65 mm and the average single-round puncture time was 65.00 ± 6.67 s. Conclusion: Herein we proposed and optimized an online training respiratory prediction network model based on Bi-GRU. The stability and reliability of this system are verified by conducting puncture experiments on a respiratory phantom. [ABSTRACT FROM AUTHOR]

Copyright of University of Sharjah Journal of Law Sciences (JLS) is the property of University of Sharjah - Scientific Publishing Unit and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

IntroductionThe use of robotic systems in the surgical domain has become groundbreaking for patients and surgeons in the last decades. While the annual number of robotic surgical procedures continues to increase rapidly, it is essential to provide the surgeon with innovative training courses along with the standard specialization path. To this end, simulators play a fundamental role. Currently, the high cost of the leading VR simulators limits their accessibility to educational institutions. The challenge lies in balancing high-fidelity simulation with cost-effectiveness; however, few cost-effective options exist for robotic surgery training.MethodsThis paper proposes the design, development and user-centered usability study of an affordable user interface to control a surgical robot simulator. It consists of a cart equipped with two haptic interfaces, a VR visor and two pedals. The simulations were created using Unity, which offers versatility for expanding the simulator to more complex scenes. An intuitive teleoperation control of the simulated robotic instruments is achieved through a high-level control strategy.Results and DiscussionIts affordability and resemblance to real surgeon consoles make it ideal for implementing robotic surgery training programs in medical schools, enhancing accessibility to a broader audience. This is demonstrated by the results of an usability study involving expert surgeons who use surgical robots regularly, expert surgeons without robotic surgery experience, and a control group. The results of the study, which was based on a traditional Peg-board exercise and Camera Control task, demonstrate the simulator’s high usability and intuitive control across diverse user groups, including those with limited experience. This offers evidence that this affordable system is a promising solution for expanding robotic surgery training.

BackgroundMandibular tumor surgery necessitates precise osteotomies based on tumor boundaries; however, conventional osteotomies often lack accuracy in predicting osteotomy positions and planes, potentially leading to excessive resection of normal bone tissues or residual tumors, thus compromising postoperative quality of life and clinical outcomes. Robotic-assisted surgery (RAS) augmented with artificial intelligence (AI) offers precise localization capabilities, aiding surgeons in achieving accurate osteotomy positioning. This study aimed to evaluate the feasibility and accuracy of a robotic magnetic navigation system for positioning and osteotomy in an intraoral surgical trial of a mandibular tumor model.MethodsPatient computed tomography (CT) imaging data of mandibular chin and body tumors were utilized to create 3D printed models, serving as study subjects for mandibular tumor resection. Ten pairs of models were printed for the experimental and control groups. The experimental group (EG) underwent osteotomy using a robot-assisted surgical navigation system, performing osteotomy under robotic navigation following alignment based on preoperative design. The control group (CG) underwent traditional surgery, estimating osteotomy position empirically according to preoperative design. Postoperative CT scans were conducted on both models, and actual postoperative results were compared to preoperative design. Osteotomy accuracy was evaluated by positional and angular errors between preoperatively designed and actual osteotomy planes.ResultsFor ten randomly selected spots on the left and right sides, respectively, the EG group had mean distance errors of 0.338 mm and 0.941 mm. These values were obtained from the EG group. In the EG group, on the left side, the mean angular errors were 14.741 degrees, while on the right side, they were 13.021 degrees. For the 10 randomly selected spots on the left and right sides, respectively, the CG had mean distance errors of 1.776 mm and 2.320 mm. This is in contrast to the results obtained by the EG. It was determined that the left side had a mean angle error of 16.841 degrees, while the right side had an error of 18.416 degrees in the CG group. The above results indicated significantly lower point errors of bilateral osteotomy planes in the experimental group compared to the control group.ConclusionThis study demonstrates the feasibility of electromagnetic navigation robot-assisted intraoral osteotomy for mandibular tumors and suggests that this approach can enhance the precision of clinical surgery.

ObjectiveTo compare the therapeutic efficacy of robot-assisted and manual screw placement techniques for the treatment of pelvic fractures.MethodsThis study included patients with pelvic fractures admitted to our orthopedic department between January 2020 and January 2022. They were randomly assigned to either the robot-assisted group or the control group. Various parameters, including surgical duration, intraoperative bleeding, fluoroscopy frequency, postoperative pain, length of hospitalization, postoperative hematological indices, postoperative functional scores, and postoperative complications, were compared between the two groups.ResultsThere were no significant differences in age, sex, body mass index, and preoperative hematological parameters between the two groups. The robot-assisted group exhibited significantly shorter surgical duration, lower fluoroscopy frequencies, lower postoperative pain scores, and shorter length of hospitalization compared to the control group. At 3 and 6 months postoperatively, patients in the robot-assisted group demonstrated significantly higher Majeed functional scores in comparison to the control group. However, there were no significant differences in Majeed scores at 12 months postoperatively. Moreover, there were no significant differences in postoperative complications between the two groups.ConclusionRobot-assisted minimally invasive treatment of pelvic fractures using hollow screws effectively reduced surgical duration, mitigated intraoperative bleeding and postoperative pain, shortened hospital stays, and promoted faster functional recovery.

This paper presents the development of the hardware and software architecture of a sixdegrees of freedom (DOF) parallel robot (PARA-SILSROB) by illustrating all the stages undertaken to achieve the experimental model of the robot. Based on the experimental model, the control architecture is also presented, which is primarily based on a master–slave control system through which the surgeon controls the robot using the master console composed of commercial peripheral components (two 3D Space Mouse devices, computer, and keyboard) integrated with the solution developed in this study and presented in this paper. The robot was developed also according to the surgical protocol and surgeon’s requirements, and for the functionality testing of the mechanical structure, two experimental stands were used. The first stand presented several surgical steps, such as manipulation, resection, and suture of experimental tissues (simulating real-life robot-assisted surgical maneuvers) using commercial instruments. The second stand presented a simulation of an esophagectomy for esophageal cancer and digestive reconstruction through a right intercostal approach. For this testing phase, the organs were created using 3D reconstruction, and their simplified models were 3D printed using PolyJet technology. Furthermore, the input trajectory generated using the master console was compared with the robot actuator’s movements and the obtained results were used for validation of the proposed robot control system.

Quickly and accurately completing endoscopic submucosal dissection (ESD) operations within narrow lumens is currently challenging because of the environment's high flexibility, invisible collision, and natural tissue motion. This paper proposes a novel stereo visual servoing control for a dual-segment robotic endoscope (DSRE) for ESD surgery. Departing from conventional monocular-based methods, our DSRE leverages stereoscopic imaging to rapidly extract precise depth data, enabling quicker controller convergence and enhanced surgical accuracy. The system's dual-segment configuration enables agile maneuverability around lesions, while its compliant structure ensures adaptability within the surgical environment. The implemented stereo visual servo controller uses image features for real-time feedback and dynamically updates gain coefficients, facilitating rapid convergence to the target. In visual servoing experiments, the controller demonstrated strong performance across various tasks. Even when subjected to unknown external forces, the controller maintained robust performance in target tracking. The feasibility and effectiveness of the DSRE were further verified through ex vivo experiments. We posit that this novel system holds significant potential for clinical application in ESD surgeries. [ABSTRACT FROM AUTHOR]

A new configuration of continuum surgical robot is proposed, whose skeleton is composed of inner and outer layers. The outer layer is composed of miniature rotating modules connected in series and connected by orthogonal hinges, which can ensure the ability to resist unconventional torsion without losing the degree of freedom. The inner layer is a central support column with superelasticity. When bending, its superelasticity can make the overall configuration biased toward constant curvature bending, which is convenient for motion control and according to the new configuration, this paper establishes the kinematics model of the robot. Finally, the motion control experiment of the continuum robot is carried out. After the experiment, the average positioning error of the robot is 2.674 mm, and the average repetitive positioning error is 2.625 mm. Both are less than 2 % of the robot length, verifying the accuracy of the model. [ABSTRACT FROM AUTHOR]

Background and Objectives: The present systematic review and meta-analysis undertake a comparison of studies that examine the accuracy of robot-assisted dental implant placement in relation to static computer-assisted implant surgery (SCAIS), dynamic computer-assisted implant surgery (DCAIS), and freehand procedures. This study aims to provide a comprehensive understanding of the precision of robot-assisted dental implant placement and its comparative efficacy in relation to other placement techniques. Methods: The guidelines recommended by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were used to organize and compose this review. Four electronic databases (PubMed, Web of Science, Scopus, and Cochrane) were systematically searched for pertinent articles. Articles were selected following the inclusion and exclusion criteria. Qualitative and quantitative analyses of the selected articles were performed. Results: The initial electronic search resulted in 1087 hits. Based on the inclusion and exclusion criteria, five articles were selected for qualitative analysis, out of which three were considered for quantitative analysis. Three parameters were considered for accuracy evaluation (angular, coronal, and apical deviation). The mean angular deviation was −1.22 degrees (95% CI, −1.06–−1.39), the mean coronal deviation was −0.15 mm (95% CI, −0.24–−0.07), and the mean apical deviation was −0.19 mm (95% CI, −0.27–−0.10). Conclusions: The robotic implant system was found to have significantly lower angular deviations and insignificantly lower coronal and apical deviations compared to DCAIS. Within the limitations of this review, it can be concluded that robot-assisted implant placement in resin models permits higher accuracy compared to DCAIS and SCAIS systems. However, due to the limited number of comparative studies with high heterogeneity, the findings of this review should be interpreted with caution. Further research is necessary to confirm the clinical application of robotics in implant surgery. [ABSTRACT FROM AUTHOR]

The purpose of this study is to realize a grasp force measurement of forceps for robotic surgery systems. Generally, surgical robot forceps is actuated by traction wire, and we have suggested a newly force sensing system by measuring the wire expansion utilizing micro displacement sensors. For measuring the elongation of the wire, the white‐light interference principle has been utilized on sensor system, and the sensor consists of a tip‐tilted optical fiber, a Fizeau interferometer and a sensor holder. In this report, displacement sensor has been successfully fabricated and mounted onto the wire to measure the elongation of the wire under tension and discussed the experimental results. [ABSTRACT FROM AUTHOR]

In robot-assisted minimally invasive surgery, there is a risk of skin tissue damage or suture failure at the suture site owing to incomplete tension. To avoid these problems and improve the inaccuracy of tension prediction, this study proposes a suture-tension prediction method using spatio-temporal features that simultaneously utilizes visual information obtained from surgical suture images and robot state changes over time. The proposed method can assist in minimally invasive robotic surgical techniques by predicting suture-tension through a neural network with image and robot information as inputs, without additional equipment. The neural network structure of the proposed method was reconstructed using ShuffleNet V2plus and spatio-temporal long-short-term memory, which are suitable for tension prediction. To validate the constructed neural network, we performed suturing expferiments using biological tissue and created a training database. We trained the proposed model using the built database and found that the estimated suture-tension values were similar to the actual tension values. We also found that the estimated tension values performed better than those of the other neural network models. [ABSTRACT FROM AUTHOR]

Osteoarthritis (OA) is a degenerative disease frequently encountered clinically, which can lead to loss of joint function in the late stage and is associated with a high disability rate. There is still no available cure for OA. Therefore, early diagnosis and precise treatment are the key to improving the therapeutic effect. Being an interdisciplinary research focus, artificial intelligence (AI) has been increasingly used in the diagnosis and treatment of OA recently, as it improves the diagnostic accuracy as well as clinical treatment and prognosis of OA. We summarized and systematically reviewed the literature on the application of AI in the diagnosis and treatment of OA, in which the application potential in assisting imaging diagnosis, surgical treatment, progression prediction and postoperative rehabilitation of OA was indicated, yet some limitations including non-standardized data collection and unstable algorithmic system were also identified. In the future, it is expected to establish a standardized clinical sample database and continuously optimize the algorithmic model, so as to better incorporate AI technologies in the diagnosis and treatment process of OA.

Medical robots improve medical efficiency and reduce patients’ suffering that owns social significance and scientific research value.Focusing on the difficulties of medical robots, we propose the concept of parallel medical robotics based on the ACP (artificial societies, computational experiments, parallel execution)-based parallel system method.parallel medical robot is mainly composed of a physical medical robot and its virtual counterpart, through which we can realize the management and control for the overall system, conduct experiments and evaluation for the treatment process, and learning and training for doctors and patients.Parallel medical robotics is supported by robot simulation, biomechanism, 3D printing and knowledge automation techniques, and holds three core functions that are descrition, prediction and prescription when combined with parallel learning.We demonstrate the framework and its potential usages with a robotic trans-esophageal ultrasound system.

According to a World Health Organization survey report in 2021, 430 million people worldwide currently suffer from moderate or severe hearing impairment. Cochlear implant surgery is one of the most effective ways to restore hearing impairment, however, it can be very difficult for doctors. Therefore, surgery with the help of surgical robots has become a popular research topic. To meet the needs of surgery, there are strict requirements for the precision of surgical robots, such as the cochlear implant robot we designed in this paper. So we mainly design a complete precision evaluation theory for this cochlear implant robot in this paper. By analyzing the jacobian matrix of the manipulator, the surgical position and posture of the robot with optimal precision can be calculated based on this theory. This new computational theory enables the robot to meet surgical precision requirements within a limited area, and to make this theory more practical, we developed a vision-based system to assist doctors during preoperative positioning and ensure that the surgical area is in the robot’s optimal precision area. [ABSTRACT FROM AUTHOR]

Purpose: The current state of soft tissue surgery robots is surveyed, and the key technologies underlying their success are analyzed. State-of-the-art technologies are introduced, and future directions are discussed. Methods: Relevant literature is explored, analyzed, and summarized. Results: Soft tissue surgical robots had rapidly spread in the field of laparoscopic surgery based on the multi-degree-of-freedom movement of intra-abdominal surgical tools and stereoscopic imaging that are not possible in conventional surgery. The three key technologies that have made surgical robots successful are wire-driven mechanisms for multi-degree-of-freedom movement, master devices for intuitive remote control, and stereoscopic imaging technology. Recently, human-robot interaction technologies have been applied to develop user interfaces such as vision assistance and haptic feedback, and research on autonomous surgery has begun. Conclusion: Robotic surgery not only replaces conventional laparoscopic surgery but also allows for complex surgeries that are not possible with laparoscopic surgery. On the other hand, it is also criticized for its high cost and lack of clinical superiority or patient benefit compared to conventional laparoscopic surgery. As various robots compete in the market, the cost of surgical robots is expected to decrease. Surgical robots are expected to continue to evolve in the future due to the need to reduce the workload of medical staff and improve the level of care demanded by patients. [ABSTRACT FROM AUTHOR]

In recent years, the integration of robots in minimally invasive surgery has gained significant traction in clinical practice. However, conventional contact-based human-computer interaction poses the risk of bacterial infection, significantly limiting the role of robots in surgery. To address this limitation, we propose an innovative interaction method rooted in gestures and visual tags, allowing surgeons to control and fine-tune surgical robots without physical contact with the environment. By encoding the six gestures collected using LeapMotion, we can effectively control the surgical robot in a non-contact manner. Moreover, utilizing Aruco technology, we have accurately identified the 3D spatial position of the visual label, and developed 12 fine-tuning operations to refine surgical instruments. To evaluate the applicability of our proposed system in surgery, we designed a relevant experimental setup. In the experiment, we achieved enough precision. These results demonstrate that our system meets the clinical standard, providing doctors with a non-contact and flexible means of interacting with robots during surgery. [ABSTRACT FROM AUTHOR]

This paper presents the development of a 6-DOF (Degrees of Freedom) parallel robot for single-incision laparoscopic surgery (SILS). The concept of the robotic system is developed with respect to a medical protocol designed by the medical experts in the team targeting a SILS procedure in urology. The kinematic model of the robotic system was defined to determine the singularities that may occur during functioning. FEM analyses were performed to determine the components of the robotic structure that may compromise the rigidity of the robotic system, and these components were redesigned and integrated into the final design of the robot. To verify the kinematic model a series of numerical and graphical simulations were performed, while to test the functionality of the robotic system, a low-cost experimental model was developed. The accuracy of the experimental model was measured using an optical motion tracking system. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Purpose: The application of robotics in the field of minimally invasive surgery solves some shortcomings of traditional minimally invasive surgery. Preoperative planning is an important prerequisite for the successful completion of robot-assisted surgery. The optimization of surgical incision position and the initial location of surgical robot are two important parts of preoperative planning. In this paper, a novel structure and preoperative planning method of a three-axis intersection surgical manipulator are proposed. Methods: Firstly, a mathematical model of human abdominal wall was established. Three characteristic parameters between the lesion and the incision are defined and used to optimize the surgical incisions. Then, the spatial position relationship between the laparoscopic arm and the incision was analyzed to obtain the effective solution groups of each passive joint of the laparoscopic arm. Lastly, the optimal initial location of the laparoscopic arm was determined by taking the total joint variables of the telecentric mechanism as the optimization index. Results: According to a given set of lesion parameters and the position of laparoscopic arm base, the optimal incision position was obtained using the surgical incision characteristic parameters and the optimal triangle criterion, and the positioning angles of the laparoscopic arm were optimized by using the Total Joint Variable (TJV) as the evaluation index. Conclusions: The proposed preoperative planning method is verified by simulation. The proposed method can realize the preoperative planning process of the three axis intersection laparoscopic arm. The proposed method of preoperative planning will provide important reference to improve the intelligence of robot-assisted surgery. [ABSTRACT FROM AUTHOR]

Owing to the effect of the Coronavirus disease (COVID-19) pandemic, the use of surgical robots to reduce the risk of infection to medical staff has been gradually increasing. In surgeries involving a surgical robot, the surgeon adjusts the robot's arms and camera by operating an input interface with their hands and/or feet. However, owing to the diverse types of input information required for surgery, the necessity to match the operation between input information and the input interface is increasing. Thus, we propose a foot interface based on three-dimension (3D)- printer technology and verify its usefulness through a demonstration. First, the current level and direction of development of foot interfaces are reviewed through a detailed assessment of the foot interfaces used in surgical robots. Then, the hardware platform for the proposed interface is designed and fabricated using a 3D printer, and the necessary electronic systems are embedded in the hardware platform. Finally, the usefulness of this interface is demonstrated. In terms of the appropriateness of expanding the input function through the foot interface, similarities and differences in some tasks are discussed by conducting an experiment in which the same task as that of the hand interface is performed using the proposed foot interface. In addition, the ability to improve the usage of the foot interface through training is discussed. [ABSTRACT FROM AUTHOR]