Medical Robotics Research Articles

Bacterial outer membrane vesicle nanorobot

Autonomous nanorobots represent an advanced tool for precision therapy to improve therapeutic efficacy. However, current nanorobotic designs primarily rely on inorganic materials with compromised biocompatibility and limited biological functions. Here, we introduce enzyme-powered bacterial outer membrane vesicle (OMV) nanorobots. The immobilized urease on the OMV membrane catalyzes the decomposition of bioavailable urea, generating effective propulsion for nanorobots. This OMV nanorobot preserves the unique features of OMVs, including intrinsic biocompatibility, immunogenicity, versatile surface bioengineering for desired biofunctionalities, capability of cargo loading and protection. We present OMV-based nanorobots designed for effective tumor therapy by leveraging the membrane properties of OMVs. These involve surface bioengineering of robotic body with cell-penetrating peptide for tumor targeting and penetration, which is further enhanced by active propulsion of nanorobots. Additionally, OMV nanorobots can effectively safeguard the loaded gene silencing tool, small interfering RNA (siRNA), from enzymatic degradation. Through systematic in vitro and in vivo studies using a rodent model, we demonstrate that these OMV nanorobots substantially enhanced siRNA delivery and immune stimulation, resulting in the utmost effectiveness in tumor suppression when juxtaposed with static groups, particularly evident in the orthotopic bladder tumor model. This OMV nanorobot opens an inspiring avenue to design advanced medical robots with expanded versatility and adaptability, broadening their operation scope in practical biomedical domains.

Robot-assisted treatment of simple renal cysts

BACKGROUND: The gold standard in the surgical treatment of simple renal cysts is laparoscopic cyst fenestration. However, laparoscopic procedures have disadvantages which include poor ergonomics of the instruments hindering surgeon's work in children's small abdomen. Robot-assisted surgery has the potential to make surgeon's work easier and to improve surgical outcomes in patients with kidney cysts for the instruments have seven degrees of freedom, hand tremor is filtered. It also promotes comfortable console positioning for the surgeon, and three-dimensional wide-angle imaging of the surgical field. AIM: To present the first experience of applying robot-assisted surgery for fenestration (decortication) of the outer portion of the cyst and argon-plasma coagulation of its inner lining. METHODS: The author's present retrospective data of all patients with simple renal cysts operated on with robot-assisted approach at the Irkutsk State Regional Children's Clinical Hospital. The diagnosis was put after ultrasound examination of kidneys and after computed tomography with intravenous contrast agent. Surgery was performed using a new model of the Versius robotic system manufactured by Cambridge Medical Robotics (UK). RESULTS: Patients' mean age at the time of surgery was (13±5.3) years (median 15 [11; 16] years), mean weight — (46.7±17.2) kg (median 54 [40.5; 56.5] kg), smallest body weight — 27 kg, size of cysts — (1.8±2.4) cm (median 0.4 [0.4; 2.5] cm). Cystic formations in all patients were located on the left: in the upper pole in 2 patients, in the lower pole in 1 patient. During the surgical intervention, there were no complications in the form of bleeding from the kidney parenchyma or damage to neighbouring organs. Histological analysis revealed that the lining of the cyst wall contained transitional epithelium without signs of malignancy. Duration of surgery was (136.7±72.2) min (median 95 [95; 157] min), duration of patients' stay in the intensive care unit — (19.9±2.5) hours (median21.3 [19.1; 21.4] hours), duration of hospital stay — (9.3±2.3) days (median 8 [8; 10] days). Ultrasound examination made in 1, 3 and 6 months after the surgery revealed no signs of disease recurrence in the form of residual accumulation of fluid associated with kidney parenchyma. CONCLUSION: The experience described in the article is encouraging and confirms the reasonability and safety of robot-assisted procedures in pediatric urology.

A review of robot-assisted ultrasound examination: Systems and technology.

At present, the number and overall level of ultrasound (US) doctors cannot meet the medical needs, and the medical ultrasound robots will largely solve the shortage of medical resources. According to the degree of automation, the handheld, semi-automatic and automatic ultrasound examination robot systems are summarised. Ultrasound scanning path planning and robot control are the keys to ensure that the robot systems can obtain high-quality images. Therefore, the ultrasound scanning path planning and control methods are summarised. The research progress and future trends are discussed. A variety of ultrasound robot systems have been applied to various medical works. With the continuous improvement of automation, the systems provide high-quality ultrasound images and image guidance for clinicians. Although the development of medical ultrasound robot still faces challenges, with the continuous progress of robot technology and communication technology, medical ultrasound robot will have great development potential and broad application space.

The geometry and mechanics of the Chinese finger trap

We investigate the kinematics and mechanical mechanisms of cylindrically woven straps with a plain twill pattern, which form a tubular structure known as the Chinese Finger Trap. Our findings, derived from a combination of analytical, experimental, and numerical methods, demonstrate that when subjected to axial tension, the straps within the structure undergo reconfiguration, resulting in radial contraction. The geometry of the straps influences this contraction. As the structure compacts, the linear axial force transforms into an exponential force, resulting in a catenary-like profile in woven tubes due to the axially symmetric distribution of straps. Our study of this tension-induced contraction strategy proposes a straightforward approach to manufacturing morphable structures capable of efficiently converting axial elongation into radial contraction. This technique holds potential for medical, architecture, and soft robotics applications, offering accessible and controlled engagement and disengagement capabilities.

Design of Medical Assistant Robot (AIDO-Bot) using Internet of Things

Design of Medical Assistant Robot (AIDO-Bot) using Internet of Things

Closed-Form Kinematics Solutions for Redundant Medical Robots with Joint Limits and Singularity Avoidance

Closed-form forward and inverse position, velocity and acceleration kinematics problems solutions are developed for a redundant medical robot family. Developed solutions allow one to choose a specific joint as a set one. Solutions work in constant time, suitable for real-time operation. Methods for joint limit and singularity avoidance are proposed. Simulation experiments are performed on simulated KUKA MED 14 r820 robot.

Cross‐Species Segmentation of Animal Prostate Using a Human Prostate Dataset and Limited Preoperative Animal Images: A Sampled Experiment on Dog Prostate Tissue

ABSTRACTIn the development of medical devices and surgical robot systems, animal models are often used for evaluation, necessitating accurate organ segmentation. Deep learning‐based image segmentation provides a solution for automatic and precise organ segmentation. However, a significant challenge in this approach arises from the limited availability of training data for animal models. In contrast, human medical image datasets are readily available. To address this imbalance, this study proposes a fine‐tuning approach that combines a limited set of animal model images with a comprehensive human image dataset. Various postprocessing algorithms were applied to ensure that the segmentation results met the positioning requirements for the evaluation of a medical robot under development. As one of the target applications, magnetic resonance images were used to determine the position of the dog's prostate, which was then used to determine the target location of the robot under development. The MSD TASK5 dataset was used as the human dataset for pretraining, which involved a modified U‐Net network. Ninety‐nine pretrained backbone networks were tested as encoders for U‐Net. The cross‐training validation was performed using the selected network backbone. The highest accuracy, with an IoU score of 0.949, was achieved using the independent validation set from the MSD TASK5 human dataset. Subsequently, fine‐tuning was performed using a small set of dog prostate images, resulting in the highest accuracy of an IoU score of 0.961 across different cross‐validation groups. The processed results demonstrate the feasibility of the proposed approach for accurate prostate segmentation.

BiAIT*: Symmetrical Bidirectional Optimal Path Planning With Adaptive Heuristic

Adaptively Informed Trees (AIT*) is an algorithm that uses the problem-specific heuristic to avoid unnecessary searches, which significantly improves its performance, especially when collision checking is expensive. However, the heuristic estimation in AIT* consumes lots of computational resources, and its asymmetric bidirectional searching strategy cannot fully exploit the potential of the bidirectional method. In this article, we propose an extension of AIT* called BiAIT*. Unlike AIT*, BiAIT* uses symmetrical bidirectional search for both the heuristic and space searching. The proposed method allows BiAIT* to find the initial solution faster than AIT*, and update the heuristic with less computation when a collision occurs. We evaluated the performance of BiAIT* through simulations and experiments, and the results show that BiAIT* can find the solution faster than state-of-the-art methods. We also analyze the reasons for the different performances between BiAIT* and AIT*. Furthermore, we discuss two simple but effective modifications to fully exploit the potential of the adaptively heuristic method. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Note to Practitioners</i> —This work is inspired by the adaptively heuristic method and the symmetrical bidirectional searching method. The article introduces a novel algorithm that uses the symmetrical bidirectional method to calculate the adaptive heuristic and efficiently search the state space. The problem-specific heuristic in BiAIT* is derived from a lazy-forward tree and a lazy-reverse tree, which are constructed without collision checking. The lazy-forward and lazy-reverse trees are enabled to meet in the middle, thus generating the effective and accurate heuristic. In BiAIT*, the lazy-forward and lazy-reverse trees share heuristic information and jointly guide the growth of the forward and reverse trees, which conduct collision checking and guarantee the feasibility of their edges. Compared with state-of-the-art methods, BiAIT* finds the initial heuristic and updates the heuristic more quickly. The proposed algorithm can be applied to industrial robots, medical robots, or service robots to achieve efficient path planning. The implementation of BiAIT* is available at https://github.com/Licmjy-CU/BiAITstar.

Towards Localization of Miniaturized Medical Robots With Microwaves

Towards Localization of Miniaturized Medical Robots With Microwaves

Designing Socially Assistive Robots Exploring Israeli and German Designers’ Perceptions

Socially assistive robots (SARs) are becoming more prevalent in everyday life, emphasizing the need to make them socially acceptable and aligned with users’ expectations. Robots’ appearance impacts users’ behaviors and attitudes toward them. Therefore, product designers choose visual qualities to give the robot a character and to imply its functionality and personality. In this work, we sought to investigate the effect of cultural differences on Israeli and German designers’ perceptions of SARs’ roles and appearance in four different contexts: a service robot for an assisted living/retirement residence facility, a medical assistant robot for a hospital environment, a COVID-19 officer robot, and a personal assistant robot for domestic use. The key insight is that although Israeli and German designers share similar perceptions of visual qualities for most of the robotics roles, we found differences in the perception of the COVID-19 officer robot’s role and, by that, its most suitable visual design. This work indicates that context and culture play a role in users’ perceptions and expectations; therefore, they should be taken into account when designing new SARs for diverse contexts.

Transforming urology: exploring the innovations and utilizations of robotic systems

Robot-assisted surgery represents the pinnacle of minimally invasive surgical techniques, surpassing laparoscopic surgery in its efficacy. This study aimed to evaluate the current status of robotic surgery in urological practice, examining its advantages and disadvantages. A literature review was conducted using PUBMED and the pertinent articles in the field of urology selected. Various single-port and multiport robotic platforms, such as Da Vinci, Versius, Hugo RAS, Revo-I, Senhance, Mantra, Avatera, hinotori, and MicroSurge, are discussed along with their respective pros and cons. Details of the 4 robotic platforms used in our centers are also included. With an influx of diverse medical surgical robots entering the market and a competitive drive to establish the next standard of care in robotic surgery, it is inevitable that robotic surgery will soon become economically comparable to laparoscopic procedures.

Monolithic integrated optoelectronic chip for vector force detection

Sensors with a small footprint and real-time detection capabilities are crucial in robotic surgery and smart wearable equipment. Reducing device footprint while maintaining its high performance is a major challenge and a significant limitation to their development. Here, we proposed a monolithic integrated micro-scale sensor, which can be used for vector force detection. This sensor combines an optical source, four photodetectors, and a hemispherical silicone elastomer component on the same sapphire-based AlGaInP wafer. The chip-scale optical coupling is achieved by employing the laser lift-off techniques and the flip-chip bonding to a processed sapphire substrate. This hemispherical structure device can detect normal and shear forces as low as 1 mN within a measurement range of 0–220 mN for normal force and 0–15 mN for shear force. After packaging, the sensor is capable of detecting forces over a broader range, with measurement capabilities extending up to 10 N for normal forces and 0.2 N for shear forces. It has an accuracy of detecting a minimum normal force of 25 mN and a minimum shear force of 20 mN. Furthermore, this sensor has been validated to have a compact footprint of approximately 1.5 mm2, while maintaining high real-time response. We also demonstrate its promising potential by combining this sensor with fine surface texture perception in the fields of compact medical robot interaction and wearable devices.

A new industrially magnetic capsule MedRobot integrated with smart motion controller

Capsule medical robots with unique application advantages have broad prospects for gastrointestinal detection, targeted drug delivery, medical assistance, and other fields. However, due to the complexity of the gastrointestinal environment and the limitations of the space magnetic field, robust motion control of capsule robots is still a challenge. Using a permanent magnet (NdFeB) as a space magnetic source, a capsule robot manipulation instrument with an integrated motion intelligent control approach is proposed in this work. First of all, a steering fixture controlling a permanent magnet is designed, and a manipulation instrument capable of five degrees of motion freedom is built with low cost and high accuracy. Furthermore, an integrated motion control approach, consisting of a primary motion subsystem and an auxiliary motion subsystem, is presented, where the motion route of the capsule robot is planned. A parallel optimization strategy is adopted to improve the traditional Gray Wolf Optimization Algorithm, the improved version of which is utilized to tune the parameters of controllers. Finally, some experiments of the designed capsule robot are carried out in different planes and slopes, as well as simulated stomach and real pig stomach, respectively. The results show that the motion characteristics are continuous and stable, and the average position error is 4.2 mm, which meets the application requirements.

Real-Time Remote-Controlled Human Manipulation Medical Robot Using IoT Module

INTRODUCTION: Innovative robotics and advanced computer vision technology converge in the Human Manipulation-Controlled Robot, utilized for medical applications. The robot operates through human gestures, and includes a camera module for real-time visual feedback, enhancing its functionality and user interaction. OBJECTIVES: The primary goal of the research was to harness the natural expressiveness of human gestures to provide a more intuitive and engaging method of controlling medical robots. The focus is on enabling precise control through programmed responses to specific gestures, ensuring effective interaction with medical tasks. METHODS: The robot’s hardware configuration consists of a mobile platform with motorized components, an ESP32 module, gesture recognition sensors and a camera modules. The ESP32 module interprets signals from gesture recognition sensors to execute precise commands for the robot's movements and actions. Simultaneously, the camera module captures live footage, providing visual feedback through an intuitive interface for seamless interaction. RESULTS: The Human Manipulation-Controlled Robot has been successfully developed, featuring a fetch arm capable of autonomous movement and object manipulation. This research address critical needs in medical centers, demonstrating the feasibility of using only minimalistic EEG electrode wireless transmission to operate a robot effectively. CONCLUSION: Through the provision of a more intuitive and engaging method of controlling and interacting with medical robots, this innovation has the potential to significantly improve user experience. It represents a most important development in medical robotic vehicles, enhancing user experience and operational efficiency through advanced human-robot interaction techniques.

IPFS-blockchain-based delegation model for internet of medical robotics things telesurgery system

The concept of the Internet of Medical Robotics Things (IoMRT) is where intelligent robots assess surrounding events, combine information from their sensors, use both local and dispersed intelligence to determine the best course of action, and move or command objects. Telesurgery is one application of IoMRT (TS). With 5G-enabled Tactile Internet (TI) enabling telesurgery (TS), there is ample opportunity to provide exceptional, accurate, ultra-responsive, and real-time virtual surgical procedures. The potential for accurate surgical diagnosis involving the exchange of patient electronic medical records (EMR) with several doctors using an assistant robot (AR) could be greatly useful in the medical field. As a part of this, permission delegation has emerged as a novel approach for data sharing in TI. Robust control of access guidelines combined with a configurable permission scheme promise secure EMR exchange. The present research proposes a multi-hop permission delegation strategy for EMR exchange based on blockchain technology and with configurable delegation depth. Furthermore, the original EMRs are stored on the interplanetary file system (IPFS). Permission delegation uses smart contracts and proxy re-encryption technology. Attribute-based encryption, which offers fine-grained management of access, is used to guarantee data security. Blockchain is also utilized to accomplish immutability and traceability. Delegators may regulate the depth of delegation by using smart contracts. The suggested approach satisfies the intended aims, according to analysis of the protocol. Lastly, the Ethereum test chain is used to assess and put the suggested method into practice. The outcomes of the conducted experiments demonstrate that the suggested protocol operates better than the competitors.

Tactile Sensing and Grasping Through Thin‐Shell Buckling

Soft and lightweight grippers have greatly enhanced the performance of robotic manipulators in handling complex objects with varying shape, texture, and stiffness. However, the combination of universal grasping with passive sensing capabilities still presents challenges. To overcome this limitation, a fluidic soft gripper is introduced based on the buckling of soft, thin hemispherical shells. Leveraging a single fluidic pressure input, the soft gripper can grasp slippery and delicate objects while passively providing information on this physical interaction. Guided by analytical, numerical, and experimental tools, the novel grasping principle of this mechanics‐based soft gripper is explored. First, the buckling behavior of a free hemisphere is characterized as a function of its geometric parameters. Inspired by the free hemisphere's two‐lobe mode shape ideal for grasping purposes, it is demonstrated that the gripper can perform dexterous manipulation and gentle gripping of fragile objects in confined spaces and underwater environments. Last, the soft gripper's embedded capability of detecting contact, grasping, and release conditions during the interaction with an unknown object is proved. This simple buckling‐based soft gripper opens new avenues for the design of adaptive gripper morphologies with tactile sensing capabilities for applications ranging from medical and agricultural robotics to space and underwater exploration.

Development of a novel two-way 3D printed flexible spiral composite actuator based on shape memory alloy wire and its control

Soft robotics find its applications across numerous of scientific and industrial fields, spanning from medicine and surgery to gripper technology, assistive devices, and exploration in underwater and space. The study introduces a soft actuator design for soft robotics, produced using 3D printing technology, offering an efficient alternative to traditional molding and curing methods. A shape memory alloy wire is integrated to the spiral body printed using a flexible filament. The spiral enhances the actuation stroke (AS) to 2 cm for a wire of 189 mm in length, while actuation in the literature is typically accomplished through an axial AS of 3%–5% of the wire’s length. Four types of spirals with increasing gaps are prepared to observe the cooling effect. Their performances are evaluated in terms of AS and time through image processing in order to determine the optimal configuration. An electrical current constraint is established to prevent potential damage, and spiral control is attained using a proportional–integral–derivative controller. Moreover, a pick and place operation showcases the spiral’s ability to autonomously lift a gripped object weighing 6.5 g, achieving a specific displacement of 6.5 mm. Subsequently, the object is lifted down to its initial position using a two-way actuator that utilizes the stored energy within the spiral’s structure and elastic effect. The proposed actuator has the potential to be widely applied across various soft robotic applications, including medical robots, delicate gripping robots, and bioinspired robots.

Designing Actuated Medical Robots for Safe Human Interaction – A Real Challenge

Abstract The paper studies the influence of human factor and clinical constraints specific to mechanical devices for medical purpose. environment (with a limited workspace, inside or outside the patient body). A medical robot is usually a complex system including mechanical structure, human-machine interface (HMI), electronic components, and software controller. All these components are integrated to perform various tasks for daily medical applications. Because any failure may become very critical, medical robots must function safely and with high reliability, so that designing medical robots for safe human interaction can be considered a real challenge. In order to respect the clinical constrains, a safety real-time controller has been designed.

Coordinating Obstacle Avoidance of a Redundant Dual-Arm Nursing-Care Robot.

Collision safety is an essential issue for dual-arm nursing-care robots. However, for coordinating operations, there is no suitable method to synchronously avoid collisions between two arms (self-collision) and collisions between an arm and the environment (environment-collision). Therefore, based on the self-motion characteristics of the dual-arm robot's redundant arms, an improved motion controlling algorithm is proposed. This study introduces several key improvements to existing methods. Firstly, the volume of the robotic arms was modeled using a capsule-enveloping method to more accurately reflect their actual structure. Secondly, the gradient projection method was applied in the kinematic analysis to calculate the shortest distances between the left arm, right arm, and the environment, ensuring effective avoidance of the self-collision and environment-collision. Additionally, distance thresholds were introduced to evaluate collision risks, and a velocity weight was used to control the smooth coordinating arm motion. After that, experiments of coordinating obstacle avoidance showed that when the redundant dual-arm robot is holding an object, the coordinating operation was completed while avoiding self-collision and environment-collision. The collision-avoidance method could provide potential benefits for various scenarios, such as medical robots and rehabilitating robots.

A review on legal issues of medical robots.

This paper examines the legal challenges associated with medical robots, including their legal status, liability in cases of malpractice, and concerns over patient data privacy and security. And this paper scrutinizes China's nuanced response to these dilemmas. An analysis of Chinese judicial practices and legislative actions reveals that current denial of legal personality to AI at this stage is commendable. To effectively control the financial risks associated with medical robots, there is an urgent need for clear guidelines on responsibility allocation for medical accidents involving medical robots, the implementation of strict data protection laws, and the strengthening of industry standards and regulations.