Fiberbots: Robotic fibers for high-precision minimally invasive surgery.

Precise manipulation of flexible surgical tools is crucial in minimally invasive surgical procedures, necessitating a miniature and flexible robotic probe that can precisely direct the surgical instruments. In this work, we developed a polymer-based robotic fiber with a thermal actuation mechanism by local heating along the sides of a single fiber. The fiber robot was fabricated by highly scalable fiber drawing technology using common low-cost materials. This low-profile (below 2 millimeters in diameter) robotic fiber exhibits remarkable motion precision (below 50 micrometers) and repeatability. We developed control algorithms coupling the robot with endoscopic instruments, demonstrating high-resolution in situ molecular and morphological tissue mapping. We assess its practicality and safety during in vivo laparoscopic surgery on a porcine model. High-precision motion of the fiber robot delivered endoscopically facilitates the effective use of cellular-level intraoperative tissue identification and ablation technologies, potentially enabling precise removal of cancer in challenging surgical sites.

In-Vivo Validation of a Novel Robotic Platform for Endovascular Intervention.

OBJECTIVE: In-vivo validation on animal setting of a pneumatically propelled robot for endovascular intervention, to determine safety and clinical advantage of robotic cannulations compared to manual operation. METHODS: Robotic assistance and image-guided intervention are increasingly used for improving endovascular procedures with enhanced navigation dexterity and accuracy. However, most platforms developed in the past decade still present inherent limitations in terms of altered clinical workflow, counterintuitive human-robot interaction, and a lack of versatility. We have created a versatile, highly integrated platform for robot-assisted endovascular intervention aimed at addressing such limitations, and here we demonstrate its clinical usability through in-vivo animal trials. A detailed in-vivo study on four porcine models conducted with our robotic platform is reported, involving cannulation and balloon angioplasty of five target arteries. RESULTS: The trials showed a 100% success rate, and post-mortem histopathological assessment demonstrated a reduction in the incidence and severity of vessel trauma with robotic navigation versus manual manipulation. CONCLUSION: In-vivo experiments demonstrated that the applicability of our robotic system within the context of this study was well tolerated, with good feasibility, and low risk profile. Comparable results were observed with robotics and manual cannulation, with clinical outcome potentially in favor of robotics. SIGNIFICANCE: This study showed that the proposed robotic platform can potentially improve the execution of endovascular procedures, paving the way for clinical translation.

Current State of Robotics in Interventional Radiology.

As a relatively new specialty with a minimally invasive nature, the field of interventional radiology is rapidly growing. Although the application of robotic systems in this field shows great promise, such as with increased precision, accuracy, and safety, as well as reduced radiation dose and potential for teleoperated procedures, the progression of these technologies has been slow. This is partly due to the complex equipment with complicated setup procedures, the disruption to theatre flow, the high costs, as well as some device limitations, such as lack of haptic feedback. To further assess these robotic technologies, more evidence of their performance and cost-effectiveness is needed before their widespread adoption within the field. In this review, we summarise the current progress of robotic systems that have been investigated for use in vascular and non-vascular interventions.

Highly Integrated Multi-Material Fibers for Soft Robotics.

Soft robots are envisioned as the next generation of safe biomedical devices in minimally invasive procedures. Yet, the difficulty of processing soft materials currently limits the size, aspect-ratio, manufacturing throughput, as well as, the design complexity and hence capabilities of soft robots. Multi-material thermal drawing is introduced as a material and processing platform to create soft robotic fibers imparted with multiple actuations and sensing modalities. Several thermoplastic and elastomeric material options for the fibers are presented, which all exhibit the rheological processing attributes for thermal drawing but varying mechanical properties, resulting in adaptable actuation performance. Moreover, numerous different fiber designs with intricate internal architectures, outer diameters of 700 µm, aspect ratios of 103 , and a fabrication at a scale of 10s of meters of length are demonstrated. A modular tendon-driven mechanism enables 3-dimensional (3D) motion, and embedded optical guides, electrical wires, and microfluidic channels give rise to multifunctionality. The fibers can perceive and autonomously adapt to their environments, as well as, probe electrical properties, and deliver fluids and mechanical tools to spatially distributed targets.

An MR-Safe Endovascular Robotic Platform: Design, Control, and Ex-Vivo Evaluation.

OBJECTIVE: Cardiovascular diseases are the most common cause of global death. Endovascular interventions, in combination with advanced imaging technologies, are promising approaches for minimally invasive diagnosis and therapy. More recently, teleoperated robotic platforms target improved manipulation accuracy, stabilisation of instruments in the vasculature, and reduction of patient recovery times. However, benefits of recent platforms are undermined by a lack of haptics and residual patient exposure to ionising radiation. The purpose of this research was to design, implement, and evaluate a novel endovascular robotic platform, which accommodates emerging non-ionising magnetic resonance imaging (MRI). METHODS: We proposed a pneumatically actuated MR-safe teleoperation platform to manipulate endovascular instrumentation remotely and to provide operators with haptic feedback for endovascular tasks. The platform task performance was evaluated in an ex vivo cannulation study with clinical experts ( N = 7) under fluoroscopic guidance and haptic assistance on abdominal and thoracic phantoms. RESULTS: The study demonstrated that the robotic dexterity involving pneumatic actuation concepts enabled successful remote cannulation of different vascular anatomies with success rates of 90%-100%. Compared to manual cannulation, slightly lower interaction forces between instrumentation and phantoms were measured for specific tasks. The maximum robotic interaction forces did not exceed 3N. CONCLUSION: This research demonstrates a promising versatile robotic technology for remote manipulation of endovascular instrumentation in MR environments. SIGNIFICANCE: The results pave the way for clinical translation with device deployment to endovascular interventions using non-ionising real-time 3D MR guidance.

Induced neural stem cell differentiation on a drawn fiber scaffold-toward peripheral nerve regeneration.

To achieve regeneration of long sections of damaged nerves, restoration methods such as direct suturing or autologous grafting can be inefficient. Solutions involving biohybrid implants, where neural stem cells are grown in vitro on an active support before implantation, have attracted attention. Using such an approach, combined with recent advancements in microfabrication technology, the chemical and physical environment of cells can be tailored in order to control their behaviors. Herein, a neural stem cell polycarbonate fiber scaffold, fabricated by 3D printing and thermal drawing, is presented. The combined effect of surface microstructure and chemical functionalization using poly-L-ornithine (PLO) and double-walled carbon nanotubes (DWCNTs) on the biocompatibility of the scaffold, induced differentiation of the neural stem cells (NSCs) and channeling of the neural cells was investigated. Upon treatment of the fiber scaffold with a suspension of DWCNTs in PLO (0.039 g l-1) and without recombinants a high degree of differentiation of NSCs into neuronal cells was confirmed by using nestin, galactocerebroside and doublecortin immunoassays. These findings illuminate the potential use of this biohybrid approach for the realization of future nerve regenerative implants.