YoMo: Yoshimura Continuum Manipulator for MR Environment.

Origami robots have garnered attention due to their versatile deformation and potential applications, particularly for medical applications. In this article, we propose a Yoshimura continuum manipulator (YoMo) that can achieve accurate control of the tip position for the magnetic resonance (MR) environment. The YoMo made of a single piece of paper is cable-actuated to generate the bending and shortening deformation. The paper-based YoMo attached to an arc frame can readily function under different orientations in the MR environment. The design and fabrication of YoMo were formulated according to the Yoshimura folding pattern. The kinematics model based on constant curvature assumption was derived as a benchmark method to predict the tip position of the YoMo. The Koopman operator theory was applied to describe the relationship between the tip position and the length change under different orientations. The linear quadratic regulator integrated into the Koopman-based model (K-LQR) was adopted to achieve the trajectory tracking. Comprehensive experiments were carried out to examine the proposed YoMo, its modeling and control methods. The performance of the YoMo including stiffness and workspace was characterized via a customized test setup. The Koopman-based method demonstrates the superiority over the constant curvature-based model to predict the tip position. The K-LQR control method was examined with different trajectories, and the impact of the orientation, speed, and different trajectories were taken into consideration. The results demonstrate the YoMo is capable of achieving trajectory tracking with satisfied accuracy, indicating its potential for medical applications in the MR environment.

Untethered & Stiffness-Tunable Ferromagnetic Liquid Robots for Cleaning Thrombus in Complex Blood Vessels.

Thrombosis is a significant threat to human health. However, the existing clinical treatment methods have limitations. Magnetic soft matter is used in the biomedical field for years, and ferromagnetic liquids exhibit tunable stiffness and on-demand movement advantages under magnetic fields. In this study, a ferromagnetic liquid robot (FMLR) is developed and applied it to thrombus removal in complex blood vessels. The FMLR consisted of Fe3O4 magnetic nanoparticles and dimethyl silicone oil. The FMLR can pass through a narrow complex maze through shape deformation by tailoring the intensity and direction of the external magnetic field. Finite element simulation analysis is used to validate the mechanism of controllable FMLR movements. Importantly, the storage modulus of FMLR can be tuned from 0.1 to 2018 Pa by varying the external magnetic intensity, ensuring its effectiveness in removing rigid and stubborn thrombi present on the vascular walls. Toward medical robotic applications, FMLR can be used in telerobotic neurointerventional. Experiments demonstrating the capability of FMLR to remove thrombi in the ear veins of rabbits are conducted. This study introduces an efficient approach for thrombus elimination, broadening the utilization of FMLRs within the realm of clinical medicine.

Adaptive approach for tracking movements of biological targets: application to robot-based intervention for prostate cancer.

Introduction: In this paper, we introduce an advanced robotic system integrated with an adaptive optimization algorithm, tailored for Brachytherapy in prostate cancer treatment. The primary innovation of the system is the algorithm itself, designed to dynamically adjust needle trajectories in response to the real-time movements of the prostate gland during the local intervention. Methods: The system employs real-time position data extracted from Magnetic Resonance Imaging (MRI) to ensure precise targeting of the prostate, adapting to its constant motion and deformation. This precision is crucial in Brachytherapy, where the accurate placement of radioactive seeds directly impacts the efficacy of the treatment and minimizes damage to surrounding safe tissues. Results: Our results demonstrate a marked improvement in the accuracy of radiation seed placement, directly correlating to more effective radiation delivery. The adaptive nature of the algorithm significantly reduces the number of needle insertions, leading to a less invasive treatment experience for patients. This reduction in needle insertions also contributes to lower risks of infection and shorter recovery times. Discussion: This novel robotic system, enhanced by the adaptive optimization algorithm, improves the coverage of targets reached by a traditional combinatorial approach by approximately 15% with fewer required needles. The improved precision and reduced invasiveness highlight the potential of this system to enhance the overall effectiveness and patient experience in prostate cancer Brachytherapy.

Evaluation of a passive wearable arm ExoNET.

Wearable ExoNETs offer a novel, wearable solution to support and facilitate upper extremity gravity compensation in healthy, unimpaired individuals. In this study, we investigated the safety and feasibility of gravity compensating ExoNETs on 10 healthy, unimpaired individuals across a series of tasks, including activities of daily living and resistance exercises. The direct muscle activity and kinematic effects of gravity compensation were compared to a sham control and no device control. Mixed effects analysis revealed significant reductions in muscle activity at the biceps, triceps and medial deltoids with effect sizes of -3.6%, -4.5%, and -7.2% rmsMVC, respectively, during gravity support. There were no significant changes in movement kinematics as evidenced by minimal change in coverage metrics at the wrist. These findings reveal the potential for the ExoNET to serve as an alternative to existing bulky and encumbering devices in post-stroke rehabilitation settings and pave the way for future clinical trials.

A prostate seed implantation robot system based on human-computer interactions: Augmented reality and voice control.

The technology of robot-assisted prostate seed implantation has developed rapidly. However, during the process, there are some problems to be solved, such as non-intuitive visualization effects and complicated robot control. To improve the intelligence and visualization of the operation process, a voice control technology of prostate seed implantation robot in augmented reality environment was proposed. Initially, the MRI image of the prostate was denoised and segmented. The three-dimensional model of prostate and its surrounding tissues was reconstructed by surface rendering technology. Combined with holographic application program, the augmented reality system of prostate seed implantation was built. An improved singular value decomposition three-dimensional registration algorithm based on iterative closest point was proposed, and the results of three-dimensional registration experiments verified that the algorithm could effectively improve the three-dimensional registration accuracy. A fusion algorithm based on spectral subtraction and BP neural network was proposed. The experimental results showed that the average delay of the fusion algorithm was 1.314 s, and the overall response time of the integrated system was 1.5 s. The fusion algorithm could effectively improve the reliability of the voice control system, and the integrated system could meet the responsiveness requirements of prostate seed implantation.

Magnetic Soft Catheter Robot System for Minimally Invasive Treatments of Articular Cartilage Defects.

Articular cartilage defects are among the most common orthopedic diseases, which seriously affect patients' health and daily activities, without prompt treatment. The repair biocarrier-based treatment has shown great promise. Total joint injection and open surgery are two main methods to deliver functional repair biocarriers into the knee joint. However, the exhibited drawbacks of these methods hinder their utility. The repair effect of total joint injection is unstable due to the low targeting rate of the repair biocarriers, whereas open surgery causes serious trauma to patients, thereby prolonging the postoperative healing time. In this study, we develop a magnetic soft catheter robot (MSCR) system to perform precise in situ repair of articular cartilage defects with minimal incision. The MSCR processes a size of millimeters, allowing it to enter the joint cavity through a tiny skin incision to reduce postoperative trauma. Meanwhile, a hybrid control strategy combining neural network and visual servo is applied to sequentially complete the coarse and fine positioning of the MSCR on the cartilage defect sites. After reaching the target, the photosensitive hydrogel is injected and anchored into the defect sites through the MSCR, ultimately completing the in situ cartilage repair. The in vitro and ex vivo experiments were conducted on a 3D printed human femur model and an isolated porcine femur, respectively, to demonstrate the potential of our system for the articular cartilage repair.

Body-Mounted MR-Conditional Robot for Minimally Invasive Liver Intervention.

MR-guided microwave ablation (MWA) has proven effective in treating hepatocellular carcinoma (HCC) with small-sized tumors, but the state-of-the-art technique suffers from sub-optimal workflow due to the limited accuracy provided by the manual needle insertions. This paper presents a compact body-mounted MR-conditional robot that can operate in closed-bore MR scanners for accurate needle guidance. The robotic platform consists of two stacked Cartesian XY stages, each with two degrees of freedom, that facilitate needle insertion pose control. The robot is actuated using 3D-printed pneumatic turbines with MR-conditional bevel gear transmission systems. Pneumatic valves and control mechatronics are located inside the MRI control room and are connected to the robot with pneumatic transmission lines and optical fibers. Free-space experiments indicated robot-assisted needle insertion error of 2.6 ± 1.3 mm at an insertion depth of 80 mm. The MR-guided phantom studies were conducted to verify the MR-conditionality and targeting performance of the robot. Future work will focus on the system optimization and validations in animal trials.

Toward certifiable optimal motion planning for medical steerable needles.

Medical steerable needles can follow 3D curvilinear trajectories to avoid anatomical obstacles and reach clinically significant targets inside the human body. Automating steerable needle procedures can enable physicians and patients to harness the full potential of steerable needles by maximally leveraging their steerability to safely and accurately reach targets for medical procedures such as biopsies. For the automation of medical procedures to be clinically accepted, it is critical from a patient care, safety, and regulatory perspective to certify the correctness and effectiveness of the planning algorithms involved in procedure automation. In this paper, we take an important step toward creating a certifiable optimal planner for steerable needles. We present an efficient, resolution-complete motion planner for steerable needles based on a novel adaptation of multi-resolution planning. This is the first motion planner for steerable needles that guarantees to compute in finite time an obstacle-avoiding plan (or notify the user that no such plan exists), under clinically appropriate assumptions. Based on this planner, we then develop the first resolution-optimal motion planner for steerable needles that further provides theoretical guarantees on the quality of the computed motion plan, that is, global optimality, in finite time. Compared to state-of-the-art steerable needle motion planners, we demonstrate with clinically realistic simulations that our planners not only provide theoretical guarantees but also have higher success rates, have lower computation times, and result in higher quality plans.

Image-guided prostate biopsy robots: A review.

At present, the incidence of prostate cancer (PCa) in men is increasing year by year. So, the early diagnosis of PCa is of great significance. Transrectal ultrasonography (TRUS)-guided biopsy is a common method for diagnosing PCa. The biopsy process is performed manually by urologists but the diagnostic rate is only 20%-30% and its reliability and accuracy can no longer meet clinical needs. The image-guided prostate biopsy robot has the advantages of a high degree of automation, does not rely on the skills and experience of operators, reduces the work intensity and operation time of urologists and so on. Capable of delivering biopsy needles to pre-defined biopsy locations with minimal needle placement errors, it makes up for the shortcomings of traditional free-hand biopsy and improves the reliability and accuracy of biopsy. The integration of medical imaging technology and the robotic system is an important means for accurate tumor location, biopsy puncture path planning and visualization. This paper mainly reviews image-guided prostate biopsy robots. According to the existing literature, guidance modalities are divided into magnetic resonance imaging (MRI), ultrasound (US) and fusion image. First, the robot structure research by different guided methods is the main line and the actuators and material research of these guided modalities is the auxiliary line to introduce and compare. Second, the robot image-guided localization technology is discussed. Finally, the image-guided prostate biopsy robot is summarized and suggestions for future development are provided.

Flexible Pressure Sensors Based on Microcrack Structure and Composite Conductive Mechanism for Medical Robotic Applications.

With the advancement of intelligent medical robot technology, machine touch utilizing flexible sensors has emerged as a prominent research area. In this study, a flexible resistive pressure sensor was designed incorporating a microcrack structure with air pores and a composite conductive mechanism of silver/carbon. The aim was to achieve enhanced stability and sensitivity with the inclusion of macro through-holes (1-3 mm) to expand the sensitive range. This technology solution was specifically applied to the machine touch system of the B-ultrasound robot. Through meticulous experimentation, it was determined that the optimal approach involved uniformly blending ecoflex and nano carbon powder at a mass ratio of 5:1, and subsequently combining the mixture with an ethanol solution of silver nanowires (AgNWs) at a mass ratio of 6:1. This combination of components resulted in the fabrication of a pressure sensor with optimal performance. Under the pressure testing condition of 5 kPa, a comparison of the resistance change rate was conducted among samples using the optimal formulation from the three processes. It was evident that the sample of ecoflex-C-AgNWs/ethanol solution exhibited the highest sensitivity. Its sensitivity was increased by 19.5% compared to the sample (ecoflex-C) and by 11.3% compared to the sample (ecoflex-C-ethanol). The sample (ecoflex-C-AgNWs/ethanol solution), which only incorporated internal air pore microcracks without through-holes, exhibited sensitive response to pressures below 5 N. However, with the addition of through-holes, the measurement range of its sensitive response increased to 20 N, representing a 400% increase in the measurement range.

[Feasibility analysis of puncture robot technology for the application of acupuncture robot].

The difficulties such as how to accurately locate acupoints and safely insert needles are presented in acupuncture robot. The puncture robot with high technological similarity to acupuncture robot is getting mature, and a large number of human trials and animal experiments have been conducted for the development of puncture robot. Through comparing the similarities and differences between puncture robot and acupuncture robot in the aspects of through-skin puncture, needle insertion and needle removal, the valuable technology of puncture robot is analyzed for the development of acupuncture robot, and the crucial direction of technology migration is determined. ①Integrating the mechanical feedback and medical imaging technology and utilizing the multi-modal perception to achieve the safety of acupuncture operation. ②Emphasizing the integration of the existing designs of chest puncture robot to realize the acupuncture operation with inhalation and exhalation involved. ③Focusing on the development of relevant technology of automatic needle removal through conducting the actual scenario of treatment with acupuncture robot in patients under non-anaesthetic condition.

Path Planning for Obstacle Avoidance of Robot Arm Based on Improved Potential Field Method.

In medical and surgical scenarios, the trajectory planning of a collaborative robot arm is a difficult problem. The artificial potential field (APF) algorithm is a classic method for robot trajectory planning, which has the characteristics of good real-time performance and low computing consumption. There are many variants of the APF algorithm, among which the most widely used variants is the velocity potential field (VPF) algorithm. However, the traditional VPF algorithm has inherent defects and problems, such as easily falling into local minimum, being unable to reach the target, poor dynamic obstacle avoidance ability, and safety and efficiency problems. Therefore, this work presents the improved velocity potential field (IVPF) algorithm, which considers direction factors, obstacle velocity factor, and tangential velocity. When encountering dynamic obstacles, the IVPF algorithm can avoid obstacles better to ensure the safety of both the human and robot arm. The IVPF algorithm also does not easily fall into a local problem when encountering different obstacles. The experiments informed the RRT* algorithm, VPF algorithm, and IVPF algorithm for comparison. Compared with the informed RRT* and VPF algorithm, the result of experiments indicate that the performances of the IVPF algorithm have significant improvements when dealing with different obstacles. The main aim of this paper is to provide a safe and efficient path planning algorithm for the robot arm in the medical field. The proposed algorithm can ensure the safety of both the human and the robot arm when the medical and surgical robot arm is working, and enables the robot arm to cope with emergencies and perform tasks better. The application of the proposed algorithm could make the collaborative robots work in a flexible and safe condition, which could open up new opportunities for the future development of medical and surgical scenarios.

CochleRob: Parallel-Serial Robot to Position a Magnetic Actuator around a Patient's Head for Intracochlear Microrobot Navigation.

Our work introduces a new robotic solution named CochleRob, which is used for the administration of super-paramagnetic antiparticles as drug carriers into the human cochlea for the treatment of hearing loss caused by damaged cochlea. This novel robot architecture presents two key contributions. First, CochleRob has been designed to meet specifications pertaining to ear anatomy, including workspace, degrees of freedom, compactness, rigidity, and accuracy. The first objective was to develop a safer mathod to administer drugs to the cochlea without the need for catheter or CI insertion. Secondly, we aimed at developing and validating the mathemathical models, including forward, inverse, and dynamic models, to support the robot function. Our work provides a promising solution for drug administration into the inner ear.

Suppression of Clothing-Induced Acoustic Attenuation in Robotic Auscultation.

For patients who are often embarrassed and uncomfortable when exposing their breasts and having them touched by physicians of different genders during auscultation, we are developing a robotic system that performs auscultation over clothing. As the technical issue, the sound obtained through the clothing is often attenuated. This study aims to investigate clothing-induced acoustic attenuation and develop a suppression method for it. Because the attenuation is due to the loss of energy as sound propagates through a medium with viscosity, we hypothesized that the attenuation is improved by compressing clothing and shortening the sound propagation distance. Then, the amplitude spectrum of the heart sound was obtained over clothes of different thicknesses and materials in a phantom study and human trial at varying contact forces with a developed passive-actuated end-effector. Our results demonstrate the feasibility of the attenuation suppression method by applying an optimum contact force, which varied according to the clothing condition. In the phantom experiments, the attenuation rate was improved maximumly by 48% when applying the optimal contact force (1 N). In human trials, the attenuation rate was under the acceptable attenuation (40%) when applying the optimal contact force in all combinations in each subject. The proposed method promises the potential of robotic auscultation toward eliminating gender bias.

Towards fully automated robotic platform for remote auscultation.

BACKGROUND: Since most developed countries are facing an increase in the number of patients per healthcare worker due to a declining birth rate and an ageing population, relatively simple and safe diagnosis tasks may need to be performed using robotics and automation technologies, without specialists and hospitals. This study presents an automated robotic platform for remote auscultation, which is a highly cost-effective screening tool for detecting abnormal clinical signs. METHOD: The developed robotic platform is composed of a 6-degree-of-freedom cooperative robotic arm, LiDAR camera, and a spring-based mechanism holding an electric stethoscope. The platform enables autonomous stethoscope positioning based on external body information acquired using the LiDAR camera-based multi-way registration; the platform also ensures safe and flexible contact, maintaining the contact force within a certain range through the passive-actuated mechanism. RESULTS: Our preliminary results confirm that the robotic platform enables estimation of the landing positions required for cardiac examinations based on the depth and landmark information of the body surface. It also handles the stethoscope while maintaining the contact force without relying on the push-in displacement by the robotic arm. CONCLUSION: The developed robotic platform enables the estimation of the landing positions and handling the stethoscope while maintaining the contact force, which promises the potential of automatic remote auscultation.

Robot-assisted subretinal injection system: development and preliminary verification.

BACKGROUND: To design and develop a surgical robot capable of assisting subretinal injection. METHODS: A remote center of motion (RCM) mechanical design and a master-slave teleoperation were used to develop and manufacture the assisted subretinal surgery robot (RASR). Ten fresh isolated porcine eyes were divided into the Robot Manipulation (RM) group and Manual Manipulation (MM) group (5 eyes for each group), and subretinal injections were performed by the robot and manual manipulation methods, respectively. A preliminary verification of the robot was performed by comparing the advantages and disadvantages of the robot manipulation and manual manipulation by using optical coherent tomography (OCT), fundus photography, and video motion capture analysis after the surgery. RESULTS: Both the robot and the manual manipulation were able to perform subretinal injections with a 100% success rate. The OCT results showed that the average subretinal area was 1.548 mm2 and 1.461 mm2 in the RM and MM groups, respectively (P > 0.05). Meanwhile the volume of subretinal fluid obtained using the retinal map mode built in OCT was not statistically different between the RM and MM groups (P > 0.05). By analyzing the surgical video using Kinovea, a motion capture and analysis software, the results suggest that the mean tremor amplitude of the RM group was 0.3681 pixels (x direction), which was significantly reduced compared to 18.8779 pixels (x direction) in the MM group (P < 0.0001). CONCLUSION: Robot-assisted subretinal injection system (RASR) is able to finish subretinal injection surgery with better stability and less fatigue than manual manipulation.

"Design of a Suspension Lever Mechanism in Biomedical Robotic System".

The article discusses the design of a suspended lever mechanism with elastic elements, which is used as a safety device in a robotic system for the rehabilitation of the lower limbs. The article analyzes the existing mechanical structures of devices for rehabilitation, identifies the problems of operation, design, and safety systems and suggests a new design of the device. The process of reverse development of a lever mechanism scheme to ensure safety during rehabilitation of the lower limbs is presented. The design of the lever mechanism consists of movable levers connected by elastic elements. The device allows you to dampen the force during active rehabilitation. The power calculation of the lever mechanism in the rehabilitation system was carried out. The article addresses the issues present in the current mechanical designs with a brief discussion on the system architecture.

Intuitive endoscopic robot master device with image orientation correction.

BACKGROUND: The camera of an endoscope is fixed to the device, and the image rotates together with the endoscope. This can lead to visual confusion for the user and incorrect image reading. The problem also occurs with endoscopic robots. Using a master device with the same degrees of freedom as the endoscope to control an endoscopic robot causes visual-motor misorientation, making intuitive control difficult. METHODS: The roll misorientation between the image and master device handle was removed by measuring and correcting for the roll axis displacement of the master device. This enabled intuitive manipulation of the master device. The work speed and number of mistakes were experimentally measured with and without image correction. RESULTS: The tasks were completed significantly faster and more accurately with image orientation correction than without. CONCLUSIONS: The proposed method enables intuitive manipulation of the master device by correcting the image orientation in endoscopic robot control.

Contact Compliance Based Visual Feedback for Tool Alignment in Robot Assisted Bone Drilling.

In recent decades, robot-assisted surgery has been proven superior at providing more accurate outcomes than the conventional one, particularly in minimally invasive procedures. However, there are still limitations to these kinds of surgical robots. Accurate bone drilling on the steep and hard surface of cortical bone is still challenging. The issues of slipping away from the target entry point on the bone surface and subsequently deviating from the desired path are still not completely solved. Therefore, in this paper, a force control is proposed to accompany the resolved motion rate controller in a handheld orthopedic robot system. The force control makes it possible to adjust the contact compliance of the drill to the bone surface. With the proper contact compliance, the drill can be prevented from deflecting in contact with the bone surface, and will eventually be directed to the target entry point. The experiments on test jig and vertebra phantom also show that the robot under the proposed contact compliance visual feedback control structure could produce better usability positioning accuracy under various contact disturbances than its counterpart.