A Smart, Textile-Driven, Soft Exosuit for Spinal Assistance.

Work-related musculoskeletal disorders (WMSDs) are often caused by repetitive lifting, making them a significant concern in occupational health. Although wearable assist devices have become the norm for mitigating the risk of back pain, most spinal assist devices still possess a partially rigid structure that impacts the user's comfort and flexibility. This paper addresses this issue by presenting a smart textile-actuated spine assistance robotic exosuit (SARE), which can conform to the back seamlessly without impeding the user's movement and is incredibly lightweight. To detect strain on the spine and to control the smart textile automatically, a soft knitting sensor that utilizes fluid pressure as a sensing element is used. Based on the soft knitting hydraulic sensor, the robotic exosuit can also feature the ability of monitoring and rectifying human posture. The SARE is validated experimentally with human subjects (N = 4). Through wearing the SARE in stoop lifting, the peak electromyography (EMG) signals of the lumbar erector spinae are reduced by 22.8% ± 12 for lifting 5 kg weights and 27.1% ± 14 in empty-handed conditions. Moreover, the integrated EMG decreased by 34.7% ± 11.8 for lifting 5 kg weights and 36% ± 13.3 in empty-handed conditions. In summary, the artificial muscle wearable device represents an anatomical solution to reduce the risk of muscle strain, metabolic energy cost and back pain associated with repetitive lifting tasks.

A Wearable Soft Fabric Sleeve for Upper Limb Augmentation.

Soft actuators (SAs) have been used in many compliant robotic structure and wearable devices, due to their safe interaction with the wearers. Despite advances, the capability of current SAs is limited by scalability, high hysteresis, and slow responses. In this paper, a new class of soft, scalable, and high-aspect ratio fiber-reinforced hydraulic SAs is introduced. The new SA uses a simple fabrication process of insertion where a hollow elastic rubber tube is directly inserted into a constrained hollow coil, eliminating the need for the manual wrapping of an inextensible fiber around a long elastic structure. To provide high adaptation to the user skin for wearable applications, the new SAs are integrated into flexible fabrics to form a wearable fabric sleeve. To monitor the SA elongation, a soft liquid metal-based fabric piezoresistive sensor is also developed. To capture the nonlinear hysteresis of the SA, a novel asymmetric hysteresis model which only requires five model parameters in its structure is developed and experimentally validated. The new SAs-driven wearable robotic sleeve is scalable, highly flexible, and lightweight. It can also produce a large amount of force of around 23 N per muscle at around 30% elongation, to provide useful assistance to the human upper limbs. Experimental results show that the soft fabric sleeve can augment a user's performance when working against a load, evidenced by a significant reduction on the muscular effort, as monitored by electromyogram (EMG) signals. The performance of the developed SAs, soft fabric sleeve, soft liquid metal fabric sensor, and nonlinear hysteresis model reveal that they can effectively modulate the level of assistance for the wearer. The new technologies obtained from this work can be potentially implemented in emerging assistive applications, such as rehabilitation, defense, and industry.

Soft robotic artificial left ventricle simulator capable of reproducing myocardial biomechanics.

The heart's intricate myocardial architecture has been called the Gordian knot of anatomy, an impossible tangle of intricate muscle fibers. This complexity dictates equally complex cardiac motions that are difficult to mimic in physical systems. If these motions could be generated by a robotic system, then cardiac device testing, cardiovascular disease studies, and surgical procedure training could reduce their reliance on animal models, saving time, costs, and lives. This work introduces a bioinspired soft robotic left ventricle simulator capable of reproducing the minutiae of cardiac motion while providing physiological pressures. This device uses thin-filament artificial muscles to mimic the multilayered myocardial architecture. To demonstrate the device's ability to follow the cardiac motions observed in the literature, we used canine myocardial strain data as input signals that were subsequently applied to each artificial myocardial layer. The device's ability to reproduce physiological volume and pressure under healthy and heart failure conditions, as well as effective simulation of a cardiac support device, were experimentally demonstrated in a left-sided mock circulation loop. This work also has the potential to deliver faithful simulated cardiac motion for preclinical device and surgical procedure testing, with the potential to simulate patient-specific myocardial architecture and motion.

Soft Fibrous Syringe Architecture for Electricity-Free and Motorless Control of Flexible Robotic Systems.

Flexible robotic systems (FRSs) and wearable user interfaces (WUIs) have been widely used in medical fields, offering lower infection risk and shorter recovery, and supporting amiable human-machine interactions (HMIs). Recently, soft electric, thermal, magnetic, and fluidic actuators with enhanced safety and compliance have innovatively boosted the use of FRSs and WUIs across many sectors. Among them, soft hydraulic actuators offer great speed, low noise, and high force density. However, they currently require bulky electric motors/pumps, pistons, valves, rigid accessories, and complex controllers, which inherently result in high cost, low adaptation, and complex setups. This paper introduces a novel soft fibrous syringe architecture (SFSA) consisting of two or more hydraulically connected soft artificial muscles that enable electricity-free actuation, motorless control, and built-in sensing ability for use in FRSs and WUIs. Its capabilities are experimentally demonstrated with various robotic applications including teleoperated flexible catheters, cable-driven continuum robotic arms, and WUIs. In addition, its sensing abilities to detect passive and active touch, surface texture, and object stiffness are also proven. These excellent results demonstrate a high feasibility of using a current-free and motor-less control approach for the FRSs and WUIs, enabling new methods of sensing and actuation across the robotic field.

Bio-SHARPE: Bioinspired Soft and High Aspect Ratio Pumping Element for Robotic and Medical Applications.

The advent of soft robots has solved many issues posed by their rigid counterparts, including safer interactions with humans and the capability to work in narrow and complex environments. While much work has been devoted to developing soft actuators and bioinspired mechatronic systems, comparatively little has been done to improve the methods of actuation. Hydraulically soft actuators (HSAs) are emerging candidates to control soft robots due to their fast responses, low noise, and low hysteresis compared to compressible pneumatic ones. Despite advances, current hydraulic sources for large HSAs are still bulky and require high power availability to drive the pumping plant. To overcome these challenges, this work presents a new bioinspired soft and high aspect ratio pumping element (Bio-SHARPE) for use in soft robotic and medical applications. This new soft pumping element can amplify its input volume to at least 8.6 times with a peak pressure of at least 40 kPa. The element can be integrated into existing hydraulic pumping systems like a hydraulic gearbox. Naturally, an amplification of fluid volume can only come at the sacrifice of pumping pressure, which was observed as a 19.1:1 reduction from input to output pressure. The new concept enables a large soft robotic body to be actuated by smaller fluid reservoirs and pumping plant, potentially reducing their power and weight, and thus facilitating drive source miniaturization. The high amplification ratio also makes soft robotic systems more applicable for human-centric applications such as rehabilitation aids, bioinspired untethered soft robots, medical devices, and soft artificial organs. Details of the fabrication and experimental characterization of the Bio-SHARPE and its associated components are given. A soft robotic squid and an artificial heart ventricle are introduced and experimentally validated.

Advanced Soft Robotic System for In Situ 3D Bioprinting and Endoscopic Surgery.

Three-dimensional (3D) bioprinting technology offers great potential in the treatment of tissue and organ damage. Conventional approaches generally rely on a large form factor desktop bioprinter to create in vitro 3D living constructs before introducing them into the patient's body, which poses several drawbacks such as surface mismatches, structure damage, and high contamination along with tissue injury due to transport and large open-field surgery. In situ bioprinting inside a living body is a potentially transformational solution as the body serves as an excellent bioreactor. This work introduces a multifunctional and flexible in situ 3D bioprinter (F3DB), which features a high degree of freedom soft printing head integrated into a flexible robotic arm to deliver multilayered biomaterials to internal organs/tissues. The device has a master-slave architecture and is operated by a kinematic inversion model and learning-based controllers. The 3D printing capabilities with different patterns, surfaces, and on a colon phantom are also tested with different composite hydrogels and biomaterials. The F3DB capability to perform endoscopic surgery is further demonstrated with fresh porcine tissue. The new system is expected to bridge a gap in the field of in situ bioprinting and support the future development of advanced endoscopic surgical robots.

Smart textiles using fluid-driven artificial muscle fibers.

The marriage of textiles with artificial muscles to create smart textiles is attracting great attention from the scientific community and industry. Smart textiles offer many benefits including adaptive comfort and high conformity to objects while providing active actuation for desired motion and force. This paper introduces a new class of programmable smart textiles created from different methods of knitting, weaving, and sticking fluid-driven artificial muscle fibers. Mathematical models are developed to describe the elongation-force relationship of the knitting and weaving textile sheets, followed by experiments to validate the model effectiveness. The new smart textiles are highly flexible, conformable, and mechanically programmable, enabling multimodal motions and shape-shifting abilities for use in broader applications. Different prototypes of the smart textiles are created with experimental validations including various shape-changing instances such as elongation (up to 65%), area expansion (108%), radial expansion (25%), and bending motion. The concept of reconfiguring passive conventional fabrics into active structures for bio-inspired shape-morphing structures is also explored. The proposed smart textiles are expected to contribute to the progression of smart wearable devices, haptic systems, bio-inspired soft robotics, and wearable electronics.

Twisting and Braiding Fluid-Driven Soft Artificial Muscle Fibers for Robotic Applications.

Research on soft artificial muscles (SAMs) is rapidly growing, both in developing new actuation ideas and improving existing structures with multifunctionality. The human body has more than 600 muscles that drive organs and joints to achieve desired functions. Inspired by the human muscles, this article presents a new type of SAM fiber formed from twisting and braiding soft hydraulic filament artificial muscles with high aspect ratio, high strain, and high energy efficiency. We systematically investigated the relationship between input pressure and output elongation as well as contraction force of the new muscles using different configurations in terms of an array of single and multiple muscles arranged in nontwisting (or straight), twisting, and braiding variants. Experimental results revealed that the twisting and braiding configurations greatly enhanced the muscle elongation and generated force compared with their nontwisting/braiding counterparts. To demonstrate the new muscles' usability, we implemented several muscle variants to bidirectionally manipulate 3D-printed human fingers and elbow, mimicking the human upper limb with a full range of motion. We also created a bioinspired growing soft tubular muscle that could simultaneously exert longitudinal and radial expansion upon pressurization, similar to that of auxetic metamaterial structures. The new growing soft tubular muscles were experimentally validated and the results showed that they could be potentially implemented in several emerging applications, including smart compression garments, stent-like supporting devices, and tubular grippers for medical use.

Two Magnetic Sensor Based Real-Time Tracking of Magnetically Inflated Swallowable Intragastric Balloon.

This paper presents a two magnetic sensor based tracking method for a magnetically inflated intragastric balloon capsule (MIBC) which is used for obesity treatment. After the MIBC is swallowed, it is designed to be inflated inside the stomach by approaching a permanent magnet (PM) externally near the abdomen. However, if the balloon inflation is accidentally triggered while the MIBC is still in the esophagus, the esophagus will be damaged. Therefore, to safely inflate the MIBC, we aim to track the MIBC's position along the esophagus and confirm the MIBC passes through. Typically, magnetic sensor based tracking systems tend to be bulky and costly since they involve computationally intensive optimization with many magnetic sensors. To solve those problems, we develop an algorithm that estimates the position of the PM inside the MIBC by using the grid search combined with the dynamically confined search range and search threshold modulation. Our tracking method achieved an average 1D position error of 3.48 mm which is comparable to the up to 4 mm average error for the other magnetic sensor based tracking systems that require more sensors and computational power compared to our system.

Smart surgical sutures using soft artificial muscles.

Wound closure with surgical sutures is a critical challenge for flexible endoscopic surgeries. Substantial efforts have been introduced to develop functional and smart surgical sutures to either monitor wound conditions or ease the complexity of knot tying. Although research interests in smart sutures by soft robotic technologies have emerged for years, it is challenging to develop a soft robotic structure that possesses a similar physical structure as conventional sutures while offering a self-tightening knot or anchor to close the wound. This paper introduces a new concept of smart sutures that can be programmed to achieve desired and uniform tension distribution while offering self-tightening knots or automatically deploying secured anchors. The core technology is a soft hydraulic artificial muscle that can be elongated and contracted under applied fluid pressure. Each suture is equipped with a pressure locking mechanism to hold its temporary elongated state and to induce self-shrinking ability. The puncturing and holding force for the smart sutures with anchors are examined. Ex-vivo experiments on fresh porcine stomach and colon demonstrate the usefulness of the new smart sutures. The new approaches are expected to pave the way for the further development of smart sutures that will benefit research, training, and commercialization in the surgical field.

EndoPil: A Magnetically Actuated Swallowable Capsule for Weight Management: Development and Trials.

Intragastric balloons (IGBs), by occupying the stomach space and prolonging satiety, is a promising method to treat obesity and consequently improves its associated comorbidities, e.g. coronary heart disease, diabetes, and cancer. However, existing IGBs are often tethered with tubes for gas or liquid delivery or require endoscopic assistance for device delivery or removal, which are usually uncomfortable, costly, and may cause complications. This paper presents a novel tetherless, magnetically actuated capsule (EndoPil) which can deploy an IGB inside the stomach after being swallowed and being activated by an external magnet. The external magnet attracts a small magnet inside the EndoPil to open a valve, triggering the chemical reaction of citric acid and potassium bicarbonate to produce carbon dioxide gas, which inflates a biocompatible balloon (around 120 mL). A prototype, 13 mm in diameter and 35 mm in length, was developed. Simulations and bench-top tests were conducted to test the force capability of the magnetic actuation mechanism, the required force to activate the valve, and the repeatability of balloon inflation. Experiments on animal and human were successfully conducted to demonstrate the safety and feasibility of inflating a balloon inside the stomach by an external magnet.

A Temperature-Dependent, Variable-Stiffness Endoscopic Robotic Manipulator with Active Heating and Cooling.

In flexible endoscopy, the endoscope needs to be sufficiently flexible to go through the tortuous paths inside the human body and meanwhile be stiff enough to withstand external payloads without unwanted tip bending during operation. Thus, an endoscope whose stiffness can be adjusted on command is needed. This paper presents a novel variable-stiffness manipulator. The manipulator (Ø15 mm) has embedded thermoplastic tubes whose stiffness is tunable through temperature. Temperature is adjusted through joule heat generated by the electrical current supplied to the stainless steel coils and an active air-cooling mechanism. Tests and modeling were conducted to characterize the performance of the design. The manipulator has a high stiffness-changing ratio (22) between rigid and flexible states while that of its commercial Olympus counterpart is only 1.59. The active cooling time is 11.9 s while that of passive ambient cooling is 100.3 s. The thermal insulation layer (Aerogel) keeps the temperature of the outer surface within the safe range (below 41 °C). The models can describe the heating and cooling processes with root mean square errors ranging from 0.6 to 1.3 °C. The results confirm the feasibility of a variable-stiffness endoscopic manipulator with high stiffness-changing ratio, fast mode-switching, and safe thermal insulation.

An Integrated Sensor-Model Approach for Haptic Feedback of Flexible Endoscopic Robots.

Haptic feedback for flexible endoscopic surgical robots is challenging due to space constraints for sensors and shape-dependent force hysteresis of tendon-sheath mechanisms (TSMs). This paper proposes (1) a single-axis fiber Bragg grating (FBG)-based force sensor for a TSM of a robotic arm and (2) an integrated sensor-model approach to estimate forces on other TSMs of that arm. With a robust and simple structure, a temperature-compensated sensor can be mounted on the distal sheath to measure forces applied by the TSM. This proposed sensor was integrated with a Ø4.2 mm articulated robotic arm driven by six TSMs, with a measurement error of 0.37 N in this work. The measurement from the single sensor was used to identify parameters in the force-transmission models of all other TSMs in the robot, realizing a one-sensor-for-all-distal-forces measurement method. The sensor-model approach could accurately estimate the distal force with an RMSE of 0.65 N. An animal study was carried out to demonstrate the sensor's feasibility in real-life surgery. The sensor-model approach presented a robust, space-saving, and cost-effective solution for haptic feedback of endoscopic robots without any assumption on the shapes of the robot.