Biocompatible Conductive Hydrogels: Applications in the Field of Biomedicine.

The impact of COVID-19 has rendered medical technology an important factor to maintain social stability and economic increase, where biomedicine has experienced rapid development and played a crucial part in fighting off the pandemic. Conductive hydrogels (CHs) are three-dimensional (3D) structured gels with excellent electrical conductivity and biocompatibility, which are very suitable for biomedical applications. CHs can mimic innate tissue's physical, chemical, and biological properties, which allows them to provide environmental conditions and structural stability for cell growth and serve as efficient delivery substrates for bioactive molecules. The customizability of CHs also allows additional functionality to be designed for different requirements in biomedical applications. This review introduces the basic functional characteristics and materials for preparing CHs and elaborates on their synthetic techniques. The development and applications of CHs in the field of biomedicine are highlighted, including regenerative medicine, artificial organs, biosensors, drug delivery systems, and some other application scenarios. Finally, this review discusses the future applications of CHs in the field of biomedicine. In summary, the current design and development of CHs extend their prospects for functioning as an intelligent and complex system in diverse biomedical applications.

Evaluation of a novel flexible snake robot for endoluminal surgery.

BACKGROUND: Endoluminal therapeutic procedures such as endoscopic submucosal dissection are increasingly attractive given the shift in surgical paradigm towards minimally invasive surgery. This novel three-channel articulated robot was developed to overcome the limitations of the flexible endoscope which poses a number of challenges to endoluminal surgery. The device enables enhanced movement in a restricted workspace, with improved range of motion and with the accuracy required for endoluminal surgery. OBJECTIVE: To evaluate a novel flexible robot for therapeutic endoluminal surgery. DESIGN: Bench-top studies. SETTING: Research laboratory. INTERVENTION: Targeting and navigation tasks of the robot were performed to explore the range of motion and retroflexion capabilities. Complex endoluminal tasks such as endoscopic mucosal resection were also simulated. MAIN OUTCOME MEASUREMENTS: Successful completion, accuracy and time to perform the bench-top tasks were the main outcome measures. RESULTS: The robot ranges of movement, retroflexion and navigation capabilities were demonstrated. The device showed significantly greater accuracy of targeting in a retroflexed position compared to a conventional endoscope. LIMITATIONS: Bench-top study and small study sample. CONCLUSIONS: We were able to demonstrate a number of simulated endoscopy tasks such as navigation, targeting, snaring and retroflexion. The improved accuracy of targeting whilst in a difficult configuration is extremely promising and may facilitate endoluminal surgery which has been notoriously challenging with a conventional endoscope.

A novel flexible hyper-redundant surgical robot: prototype evaluation using a single incision flexible access pelvic application as a clinical exemplar.

INTRODUCTION: The flexible endoscope is increasingly being considered as a surgical tool to enable innovative natural orifice or flexible access techniques. These experiences have exposed unique advantages but also significant challenges. Major current technical drawbacks in this setting relate to uncontrolled flexibility, inaccurate sustained target localization, unreliable navigation and overall platform instability. In striving to address existing technical limitations, this paper introduces a novel flexible hyper-redundant surgical robot and evaluates its clinical potential using a focused clinical application. METHOD: To assess utility of the device within tight confines of the human pelvis or peritoneal cavity, detailed laboratory workspace analysis experiments were undertaken using a computer-simulated model that incorporated anatomical data obtained via pelvic magnetic resonance images of eight women. Ten participants executed ninety usability and reliability trials on an ex vivo simulator, before the robot was repeatedly trialled in an in vivo porcine model. RESULTS: The robot demonstrated capability of targeting >90 % of the anatomic region of interest. All 90 user trials were successfully performed without interruption or malfunction. Significant improvements in performance, time and motion were observed between first and last sets of trials (p = 0.001). In vivo feasibility testing affirmed robustness of the device when deployed within the physiological demands of a live scale appropriate model. CONCLUSION: Technologically advanced flexible operative platforms are needed to fulfil aspirations for an introductory era of flexible access surgery. This prototype is proposed as a potential future platform for robot-assisted flexible endoscopic surgery. Encouraging pre-clinical feasibility results are demonstrated for diagnostic and therapeutic applications within the pelvis.

Robot-assisted transvaginal peritoneoscopy using confocal endomicroscopy: a feasibility study in a porcine model.

BACKGROUND: Optical biopsy methods such as probe-based confocal laser endomicroscopy (pCLE) provide useful intraoperative real-time information, especially during minimally invasive surgery with flexible endoscopic or robotic platforms. By translating the probe at constant pressure across the target tissue, undistorted "mosaics" can be produced. However, this poses ergonomic challenges with a conventional flexible endoscope. METHODS: A 100 µm confocal depth pCLE probe was integrated into a previously described seven degrees-of-freedom articulated endoscopic robot. After estimating the average workspace created by a female pneumoperitoneum, the accessibility of the peritoneal cavity by the device for robot-assisted pCLE peritoneoscopy was calculated. To demonstrate its in vivo feasibility, the robot was inserted transvaginally in a pig, under laparoscopic vision. Optical biopsy was performed of several targets within the peritoneal cavity. RESULTS: The workspace analysis calculated that 88 % of the surface of an estimated average female pneumoperitoneum could be contacted by the probe using the robot transvaginally. In vivo, the robot was manoeuvred to provide views of all abdominal and pelvic organs. At each target there was robotic acquisition of still pCLE images, and slowly translating images for the construction of increased field-of-view mosaics up to 2 mm in length. Optical biopsies took 1-2 min per target, and at 3.5 µm lateral resolution, the mosaic images showed characteristic features of anterior abdominal wall, liver, and spleen. CONCLUSION: In the porcine model, the robotically actuated method of performing peritoneoscopy and pCLE mosaicked optical biopsy is safe and provides a consistent means of acquiring near-histological grade images of submesothelial tissue. Clinical translation is likely to provide sufficient accessibility of the peritoneal cavity.

Vehicle unpaved road response spectrum acquisition based on accelerometer and GPS data.

This paper describes a response acquisition system composed of some spindle accelerometers and a time synchronized on-board GPS receiver developed in order to collect the dynamic response of vehicle riding on an unpaved road. A method of time-space conversion for calculating the response spectrum is proposed to eliminate the adverse effect of time-varying speed, based on the transform from the equitime sampled spindle acceleration responses to equidistance sampling. By using two groups of independent distance histories acquired from GPS, a method called long-range error correction is proposed to improve the accuracy of the vehicle's distance information, which is critical for the time-space conversion. The accuracy and limitations of the system have been analyzed, and its validity has been verified by implementing the system on a wheel loader for road response spectrum measuring. This paper offers a practical approach to obtaining unpaved road response spectra for durability road simulation.

Bio-Inspired New Hydraulic Actuator Imitating the Human Muscles for Mobile Robots.

Limited load capacity is the bottleneck for the practical application of mobile multi-joint legged robots. And improving the efficiency of the drive system is a key factor in improving the load capacity. To improve the efficiency of mobile robots, in this paper, a new kind of actuator that imitates the driving mechanism of human muscles is innovatively designed and validated through experiments. The proposed actuator consists of a single power source and multiple plunger pistons, and imitates the configuration of a human muscle, to improve the efficiency and load capacities. The design proposed here represents a new class of driving methods. The actuator selects the most appropriate combination of the effective areas of plunger pistons like the human muscles, to ensure that the maximal output force aligns with the load force. To validate that the new actuator can improve the efficiency of hydraulic systems of mobile robots, a robotic arm incorporating a prototype of the new actuator was designed. The proposed system was validated through a series of experiments. The experiments show that the bionic actuator can adjust the flow rate of the system input by adjusting the number and size of the motion units involved in the work, and with the change in load force, it changes the output force by recruiting different motion units, which indicates good controllability. The results reported herein reveal that the application of bionics to the design of robotic actuator can significantly improve the efficiency and overall performance of the robots, and this biomimetic approach can be applied to a variety of robots.

Flexible Actuator Based on Conductive PAM Hydrogel Electrodes with Enhanced Water Retention Capacity and Conductivity.

Conductive polyacrylamide (PAM) hydrogels with salts that act as electrolytes have been used as transparent electrodes with high elasticity in flexible electronic devices. Different types and contents of raw materials will affect their performance in all aspects. We tried to introduce highly hydratable salts into PAM hydrogels to improve their water retention capacity. Different salts can improve the water retention capacity of PAM hydrogels to a certain extent. In particular, PAM hydrogels containing higher concentrations of lithium chloride (LiCl) and calcium chloride (CaCl2) showed an extremely strong water retention capacity and could retain about 90% and more than 98% of the initial water in the experimental environment at a temperature of 25 °C and a relative humidity of 60% RH, respectively. In addition, we conducted electrical conductivity tests on these PAM hydrogels with different salts. The PAM hydrogels containing LiCl also show outstanding conductivity, and the highest conductivity value can reach up to about 8 S/m. However, the PAM hydrogels containing CaCl2, which also performed well in terms of their water retention capacity, were relatively common in terms of their electrical conductivity. On this basis, we attempted to introduce single-walled carbon nanotubes (SWCNTs), multi-walled carbon nanotubes (MWCNTs), and graphene (GO) electronic conductors to enhance the electrical conductivity of the PAM hydrogels containing LiCl. The conductivity of the PAM hydrogels containing LiCl was improved to a certain extent after the addition of these electronic conductors. The highest electrical conductivity was about 10 S/m after we added the SWCNTs. This experimental result indicates that these electronic conductors can indeed enhance the electrical conductivity of PAM hydrogels to a certain extent. After a maximum of 5000 repeated tensile tests, the conductive hydrogel samples could still maintain their original morphological characteristics and conductivity. This means that these conductive hydrogel samples have a certain degree of system reliability. We made the PAM conductive hydrogels with high water retention and good conductivity properties into thin electrodes and applied them to an electric response flexible actuator with dielectric elastomer as the functional material. This flexible actuator can achieve a maximum area strain of 18% under an external voltage of 10 kV. This new composite hydrogels with high water retention and excellent conductivity properties will enable more possibilities for the application of hydrogels.

Gyroscope Sensor Based In Vivo Finger Axes of Rotation Identification Using Screw Displacement.

This paper presents a low-cost, efficient, and portable in vivo method for identifying axes of rotation of the proximal interphalangeal and distal interphalangeal joints in an index finger. The approach is associated with the screw displacement representation of rigid body motion. Using the matrix exponential method, a detailed derivation of general spatial displacement of a rigid body in the form of screw displacement including the Rodrigues' formulae for rotation is presented. Then, based on a gyroscope sensor, a test framework for determining axes of rotation of finger joints is established, and experiments on finding the directions of joint axes of the PIP and DIP joints are conducted. The results obtained highly agree with those presented in literature through traditional but complex methods.

Vibration and damping characteristics of 3D printed Kagome lattice with viscoelastic material filling.

Constrained layer dampers (CLD) are in widespread use for passive vibration damping, in applications including aerospace structures. However, the introducing of the damping layer can reduce the stiffness of the sandwich structures. A viscoelastic material filling (VMF) is chosen to balance structural and vibrational performance of lattice truss in this work. The recently brought forward 3D Kagome truss with face sheet was manufactured by selective laser sintering technology and the thermosetting polyurethane was chosen as the viscoelastic filling material. A novel complex modal analysis finite element method for Hybrid composite lattice truss sandwich is introduced in this paper. Dynamic analysis experiment results show that the VMF method is found to be effective in reducing the vibration amplitude and it has the potential for band-gap design. The VMF method can provide high stiffness at low mass and considerable vibrational performance at low cost and it can be considered as a general vibration design method in lattice truss manufacture.

Thickness optimization of auricular silicone scaffold based on finite element analysis.

An optimized thickness of a transplantable auricular silicone scaffold was researched. The original image data were acquired from CT scans, and reverse modeling technology was used to build a digital 3D model of an auricle. The transplant process was simulated in ANSYS Workbench by finite element analysis (FEA), solid scaffolds were manufactured based on the FEA results, and the transplantable artificial auricle was finally obtained with an optimized thickness, as well as sufficient intensity and hardness. This paper provides a reference for clinical transplant surgery.

Design of a Multitasking Robotic Platform with Flexible Arms and Articulated Head for Minimally Invasive Surgery.

This paper describes a multitasking robotic platform for Minimally Invasive Surgery (MIS). The device is designed to be introduced through a standard trocar port. Once the device is inserted to the desired surgical site, it can be reconfigured by lifting an articulated section, and protruding two tendon driven flexible arms. Each of the arms holds an interchangeable surgical instrument. The articulated section features a 2 Degrees-of-Freedom (DoF) universal joint followed by a single DoF yaw joint. It incorporates an on-board camera and LED light source at the distal end, leaving a Ø3mm channel for an additional instrument. The main shaft of the robot is largely hollow, leaving ample space for the insertion of two tendon driven flexible arms integrated with surgical instruments. The ex-vivo and in-vivo experiments demonstrate the potential clinical value of the device for performing surgical tasks through single incision or natural orifice transluminal procedures.

A hand-held instrument to maintain steady tissue contact during probe-based confocal laser endomicroscopy.

Probe-based confocal laser endomicroscopy (pCLE) provides high-resolution in vivo imaging for intraoperative tissue characterization. Maintaining a desired contact force between target tissue and the pCLE probe is important for image consistency, allowing large area surveillance to be performed. A hand-held instrument that can provide a predetermined contact force to obtain consistent images has been developed. The main components of the instrument include a linear voice coil actuator, a donut load-cell, and a pCLE probe. In this paper, detailed mechanical design of the instrument is presented and system level modeling of closed-loop force control of the actuator is provided. The performance of the instrument has been evaluated in bench tests as well as in hand-held experiments. Results demonstrate that the instrument ensures a consistent predetermined contact force between pCLE probe tip and tissue. Furthermore, it compensates for both simulated physiological movement of the tissue and involuntary movements of the operator's hand. Using pCLE video feature tracking of large colonic crypts within the mucosal surface, the steadiness of the tissue images obtained using the instrument force control is demonstrated by confirming minimal crypt translation.

Force adaptive multi-spectral imaging with an articulated robotic endoscope.

Recent developments in optical spectroscopic techniques have permitted in vivo, in situ cellular and molecular sensing and imaging to allow for real-time tissue characterization, functional assessment, and intraoperative guidance. The small area sensed by these probes, however, presents unique challenges when attempting to obtain useful tissue information in-vivo due to the need to maintain constant distance or contact with the target, and tissue deformation. In practice, the effective area can be increased by translating the tip of the probe over the tissue surface and generating functional maps of the underlying tissue response. However, achieving such controlled motions under manual guidance is very difficult, particularly since the probe is typically passed down the instrument channel of a flexible endoscope. This paper describes a force adaptive multi-spectral imaging system integrated with an articulated robotic endoscope that allows a constant contact force to be maintained between the probe and the tissue as the robot tip is actuated across complex tissue profiles. Detailed phantom and ex-vivo tissue validation is provided.