Advancement of Flexible Robot Technologies for Endoluminal Surgeries

Kim, Joonhwan; Mathelin, Michel de; Ikuta, Koji; Kwon, Dong‐Soo

doi:10.1109/jproc.2022.3170109

Cited by 44 publications

(22 citation statements)

References 233 publications

(228 reference statements)

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“…Although a tendon–sheath system has been used in many robotic applications, the non-linear characteristics of these systems attributed to the friction losses are not fully explored, leading to considerable difficulties in optimizing the system performance. They are very beneficial for the surgical system, which have to access the surgical site through narrow passages and have high dexterity to perform safe manipulation ( Kim et al., 2022 ).…”

Section: Discussionmentioning

confidence: 99%

Reproducibility challenges in robotic surgery

Faragasso

Bonsignorio²

2023

Front. Robot. AI

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Reproducibility of results is, in all research fields, the cornerstone of the scientific method and the minimum standard for assessing the value of scientific claims and conclusions drawn by other scientists. It requires a systematic approach and accurate description of the experimental procedure and data analysis, which allows other scientists to follow the steps described in the published work and obtain the “same results.” In general and in different research contexts with “same” results, we mean different things. It can be almost identical measures in a fully deterministic experiment or “validation of a hypothesis” or statistically similar results in a non-deterministic context. Unfortunately, it has been shown by systematic meta-analysis studies that many findings in fields like psychology, sociology, medicine, and economics do not hold up when other researchers try to replicate them. Many scientific fields are experiencing what is generally referred to as a “reproducibility crisis,” which undermines the trust in published results, imposes a thorough revision of the methodology in scientific research, and makes progress difficult. In general, the reproducibility of experiments is not a mainstream practice in artificial intelligence and robotics research. Surgical robotics is no exception. There is a need for developing new tools and putting in place a community effort to allow the transition to more reproducible research and hence faster progress in research. Reproducibility, replicability, and benchmarking (operational procedures for the assessment and comparison of research results) are made more complex for medical robotics and surgical systems, due to patenting, safety, and ethical issues. In this review paper, we selected 10 relevant published manuscripts on surgical robotics to analyze their clinical applicability and underline the problems related to reproducibility of the reported experiments, with the aim of finding possible solutions to the challenges that limit the translation of many scientific research studies into real-world applications and slow down research progress.

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Section: Discussionmentioning

confidence: 99%

Reproducibility challenges in robotic surgery

Faragasso

Bonsignorio²

2023

Front. Robot. AI

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“…For minimal invasive exible surgery 16 (MIFS) where the operational approaches are less constrained by anatomical structures, it necessitates the design of lightweight exible manipulators with minimum footprint. Continuum robots [17][18][19][20] equipped with multiple DOFs by compacting more actuated cables / tendons are proving to be an effective approach. These robots 21,22 are actuated by a large number of motors in the robot base, making the robot system especially huge and expensive, and shows a sharp learning curve to surgeons.…”

Section: Introductionmentioning

confidence: 99%

Bioinspired handheld time-share driven robot with expandable dexterity

Wang

Cui

et al. 2023

Preprint

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Handheld robots are welcome solutions with a short learning curve to extend operator capabilities. However, the controllable degree-of-freedoms are limited due to scarce space for actuators. Inspired by muscle movements stimulated by nerves, we report a handheld time-share driven robot composed of several motion modules powered by only one motor. The modules are connected to shape memory alloy wires as nerves for activation, to be actuated by the motor. The robot contains a 202-gram motor base and a 1.2 cm diameter manipulator consisting of serially socketed bending modules. The manipulator can be tailored in length and integrated with various instruments in situ, for non-invasive access and high-dexterous operation on remote surgical sites. The applicability was demonstrated in clinical scenarios, where a surgeon held the robot to perform transluminal experiments on a human stomach model and an ex vivo porcine stomach. The time-share driven mechanism provides a practical way to build a multi-degree-of-freedom robot for broader applications.

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“…Flexible manipulators have been increasingly developed and play an essential role in the MIFS [3]. Compared with traditional rigid instruments, flexible manipulators feature high dexterity and an extensive workspace to perform complex examinations and surgical operations through narrow cavities or paths and provide relatively safe physical interactions that significantly reduce tissue damage and accelerate the postoperative recovery of patients [4][5][6]. The distal end of flexible manipulators is typically required to integrate various surgical tools to approach the lesion for further examinations and treatments during surgical procedures.…”

Section: Introductionmentioning

confidence: 99%

“…However, the torsional stiffness of this design was insufficient, affecting the torque transfer efficiency and the accuracy of the in-situ torsional motion with a maximum average positioning error of 5.75%. Therefore, discrete manipulators usually demonstrate poor constant curvature performance due to high and uneven friction, resulting in failing to accurately fit curves with continuous tangential vectors [6,26], and tend to shrink into a zigzag shape for the initial stage due to static instability [27]. In addition, such manipulators typically suffer from poor torsional stiffness, leading to difficulties in anti-torsion and effective torque transmission, and thus fail to be applied in insitu torsional motion to address the typical issue of limited dexterity for torsional motion.…”

Section: Introductionmentioning

confidence: 99%

Development of a Novel Ball-and-Socket Flexible Manipulator for Minimally Invasive Flexible Surgery

Song

et al. 2023

IEEE Trans. Med. Robot. Bionics

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This work proposes a novel flexible manipulator consisting of a series of 2-DOF vertebrae based on a ball-andsocket joint that is connected by a ball-shaped surface and a cupshaped socket and constrained by pins for circumferential rotation. This manipulator can demonstrate outstanding torsional stiffness since the circumferential rotation between the vertebrae is constrained by four ball pins. The point contact between ball pins and guideways effectively reduces the friction between the vertebrae, thus allowing the designed manipulator to yield a smooth bending shape with constant curvature. This manipulator features high axial and torsional stiffness, excellent bending performance, sufficient loading capacity, and convenient integration with surgical instruments. Moreover, the excellent torsional stiffness enables this manipulator to efficiently transfer torque and be applied in in-situ torsional motion, effectively addressing the typical issue of limited dexterity for torsional motion. The kinematic modeling of the proposed manipulator under in-situ torsional motion has been derived, and its workspace has been analyzed. A robotic system has been assembled, and experiments have verified the proposed design and modeling validity. The results show that the maximum position errors in bending motion are 2.39% (horizontal direction) and 1.98% (vertical direction), and its torsional stiffness is 21.13N•mm/deg, which is 46 times higher than that of a typical spherical flexible manipulator (SFM). Such merits support this manipulator excellently performing the in-situ torsional motion with a maximum average position error of 3.58%. Furthermore, a phantom test of the larynx has been performed to verify the potential of clinical feasibility.

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Advancement of Flexible Robot Technologies for Endoluminal Surgeries

Abstract: This article covers the key technical issues in flexible surgical robotics, such as manipulator design, modeling, and control, and it introduces emerging flexible technologies organized according to their target application in the endoluminal surgical field.

Cited by 44 publications

References 233 publications

Reproducibility challenges in robotic surgery

Reproducibility challenges in robotic surgery

Bioinspired handheld time-share driven robot with expandable dexterity

Development of a Novel Ball-and-Socket Flexible Manipulator for Minimally Invasive Flexible Surgery

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