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.

Dental implant surgery is now a well versed approach for tooth replacement, addressing various limitations of fixed bridges and removable dentures, thereby reinstating both the form and function of missing teeth. However, it is technically sensitive and highly dependent on the clinical experience and the expertise of the dentist. With breakthrough progress in robot-assisted surgery for a variety of systemic diseases, robot-assisted dental implant surgery has emerged as a new way to potentially enhance the efficacy of dental implant procedures. Widely researched by dental researchers, it is progressively revealing advantages in the treatment of dentition defects or edentulism. This article summarizes the current research status of robot-assisted dental implant surgery and provides a perspective grounded in the ongoing research landscape.

The ergonomics of flexible endoscopes require improvement as the current design carries a high risk of musculoskeletal injury for endoscopists. Robotic systems offer a solution by separating the endoscope from the control handle, allowing a focus on ergonomics and usability. Despite the increasing interest in this field, little attention has been paid towards developing ergonomic human input devices. This study addresses two key questions: How can handheld control devices for flexible robotic endoscopy be designed to prioritize ergonomics and usability? And, how effective are these new devices in a simulated clinical environment?

Addressing this gap, the study proposes two handheld input device models for controlling a flexible endoscope in four degrees of freedom (DOFs) and an endoscopic instrument in three DOFs. A two-stage evaluation was conducted with six endoscopists evaluating the physical ergonomics and a final clinical user evaluation with seven endoscopists using a virtual colonoscopy simulator with proportional velocity and position mapping.

Both models demonstrated clinical suitability, with the first model scoring 4.8 and the second model scoring 5.2 out of 6 in the final evaluation. In sum, the study presents two designs of ergonomic control devices for robotic colonoscopy, which have the potential to reduce endoscopy-related injuries. Furthermore, the proposed colonoscopy simulator is useful to evaluate the benefits of different mapping modes. This could help to optimize the design and control mechanism of future control devices.

Traditional tendon-driven continuum robot (TDCR) models based on Cosserat rod theory often assume that tendon tension is a continuous wrench along the backbone. However, this assumption overlooks critical factors, including the discrete arrangement of disks, the segmented configuration of tensioned tendons, and the friction between tendons and guide holes. Additionally, tendon forces are not continuous but discrete, concentrated wrenches, with the frictional force magnitude and direction varying based on the TDCR's bending configuration. We propose a TDCR modeling method that integrates Cosserat rod theory with a finite element approach to address these limitations. We construct a Cosserat rod model for the robot's backbone, discretize the tendon geometry using the finite element method (FEM), and incorporate friction modeling between tendons and guide holes. Furthermore, we introduce an algorithm to determine the direction of friction forces, enhancing modeling accuracy. This approach results in a more realistic and comprehensive mathematical representation of TDCR behavior. Numerical simulations under various tendon-routing scenarios are conducted and compared with classical TDCR models. The results indicate that our friction-inclusive model improves accuracy, yielding an average configuration deviation of only 0.3% across different tendon routings. Experimental validation further confirms the model's accuracy and robustness.

Stimuli-responsive shape-morphing hydrogels with self-healing and tunable physiochemical properties are excellent candidates for functional building blocks of untethered small-scale soft robots. With mechanical properties similar to soft organs and tissues, such robots enable minimally invasive medical procedures, such as cargo/cell transportation. In this work, responsive hydrogels based on zwitterionic/acrylate chemistry with self-healing and stimuli-responsiveness are synthesized. Such hydrogels are then judiciously cut and pasted to form hybrid constructs with predetermined swelling and elastic anisotropy. This method is used to program hydrogel constructs with predetermined 2D-to-3D deformation upon exposure to different environmental ionic strengths. Untethered soft robotic functionalities are demonstrated, such as actuation, magnetic locomotion, and targeted transport of soft and light cargo in flooded media. The proposed hydrogel expands the repertoire of functional materials for fabricating small-scale soft robots.

Telesurgery has the potential to overcome geographical barriers in surgical care, encouraging its deployment in areas with sparse surgical expertise. Despite successful in-human experiments and substantial technological progress, the adoption of telesurgery remains slow. In this Review, we analyze the reasons for this slow adoption. First, we identify various contexts for telesurgery and highlight the vastly different requirements for their realization. We then discuss why procedures with high urgency and skill sparsity are particularly suitable for telesurgery. Last, we summarize key research areas essential for further progress. The goal of this Review is to provide the reader with a comprehensive analysis of the current state of telesurgery research and to provide guidance for faster adoption of this exciting technology.

Delicate manual microsurgeries rely on sufficient hands-on experience for safe manipulations. Automated surgical devices can enhance the effectiveness, but developing high-resolution, multi-axis force-sensing devices for micro operations remains challenging. In this study, a 6-axis force-sensing pneumatic forceps with a serial-parallel robotic platform for cochlear implantation is developed. The forceps features a curved body shape embedded with parallel and inclined fiber Bragg grating sensors for 6-axis force sensing, and a pneumatic gripper with decoupled actuation is located at its end for actively grasping and releasing the electrode array. The robotic platform comprises a customized spherical parallel mechanism and a robotic arm, which can provide independent 3-DOF rotations and 3-DOF translations. The feasibility of the developed robotic forceps is validated through cadaveric studies on a temporal bone and a human cadaveric head. In summary, the robotic forceps provides a decoupled mechanism for pneumatic actuation and force sensing, further demonstrating its potential for force interaction and stable operation during robotic microsurgery.

Terahertz (THz) light has the unique properties of being very sensitive to water, non-ionizing, and having sub-millimeter depth resolution, making it suitable for medical imaging. Skin conditions including eczema, psoriasis and skin cancer affect a high percentage of the population and we have been developing a THz probe to help with their diagnosis, treatment and management. Our in vivo studies have been using a handheld THz probe, but this has been prone to positional errors through sensorimotor perturbations and tremors, giving spatially imprecise measurements and significant variations in contact pressure. As the operator tires through extended device use, these errors are further exacerbated. A robotic system is therefore needed to tune the critical parameters and achieve accurate and repeatable measurements of skin. This paper proposes an autonomous robotic THz acquisition system, the PicoBot, designed for non-invasive diagnosis of healthy and diseased skin conditions, based on hydration levels in the skin. The PicoBot can 3D scan and segment out the region of interest on the skin's surface, precisely position (± 0.5/1 mm/degrees) the probe normal to the surface, and apply a desired amount of force (± 0.1N) to maintain firm contact for the required 60 s during THz data acquisition. The robotic automation improves the stability of the acquired THz signals, reducing the standard deviation of amplitude fluctuations by over a factor of four at 1 THz compared to hand-held mode. We show THz results for skin measurements of volunteers with healthy and dry skin conditions on various parts of the body such as the volar forearm, forehead, cheeks, and hands. The tests conducted validate the preclinical feasibility of the concept along with the robustness and advantages of using the PicoBot, compared to a manual measurement setup.

Minimally invasive surgical techniques, including endoscopic and robotic procedures, continue to revolutionize patient care, for their ability to minimize surgical trauma, thus promoting faster recovery and reduced hospital stays. Yet, the suturing of soft tissues ensuring damage-free tissue bonding during these procedures remains challenging due to missing haptics and the fulcrum effect. Laser tissue soldering has potential in overcoming these issues, offering atraumatic seamless tissue fusion. To ensure the precision and safety of laser tissue soldering, the study introduces feedback-controlled fluorescent nanothermometry-guided laser tissue soldering using nanoparticle-protein solders within endoscopic and robotic contexts. Temperature-sensitive fluorescent nanoparticles embedded in the solder provide surgeons with immediate feedback on tissue temperatures during laser application, all while within the confines of minimally invasive (robotic) surgical setups. By integrating fluorescent nanothermometry-guided laser tissue surgery into endoscopic and robotic surgery, the study paves the way for a new approach for safe and atraumatic soft tissue joining, especially in regions where traditional suturing is unfeasible.

Optical coherence tomography (OCT) is an interferometric technique for micron-level imaging in biological and non-biological contexts. As a non-invasive, non-ionizing, and video-rate imaging modality, OCT is widely used in biomedical and clinical applications, especially ophthalmology, where it functions in many roles, including tissue mapping, disease diagnosis, and intrasurgical visualization. In recent years, the rapid growth of medical robotics has led to new applications for OCT, primarily for 3D free-space scanning, volumetric perception, and novel optical designs for specialized medical applications. This review paper surveys these recent developments at the intersection of OCT and robotics and organizes them by degree of integration and application, with a focus on biomedical and clinical topics. We conclude with perspectives on how these recent innovations may lead to further advances in imaging and medical technology.

Rapid thrombolysis is very important to reduce complications caused by vascular blockage. A promising approach for improving thrombolysis efficiency is utilizing the permanent magnetically actuated locomotion of nanorobots. However, the thrombolytic drug transportation efficiency is challenged by in-plane rotating locomotion and the insufficient drug penetration limits further improvement of thrombolysis. Inspired by ciliary movement for cargo transportation in human body, in this study, cilia-mimic locomotion of magnetic colloidal collectives is realized under torque-force vortex magnetic field (TFV-MF) by a designed rotating permanent magnet assembly. This cilia-mimic locomotion mode can generate more disturbances to the fluids to improve thrombolytic drug transportation and the increased height and area of colloidal collectives boosted the imaging capability. In addition, low-intensity ultrasound is applied to enhance colloids infiltration by producing the fiber breakage and inducing erythrocyte deformation. In vitro thrombolytic experiments demonstrate that the thrombolysis efficiency increased by 16.2 times compared with that of pure tissue plasminogen activator (tPA) treatments. Furthermore, in vivo rat models of femoral vein thrombosis confirmed that this approach can achieve blood flow recanalization more quickly. The proposed cilia-mimic locomotion of magnetic colloidal collectives combined with low-intensity ultrasound irradiation mode provides a new insight of therapeutic interventions for vascular thrombus by enhancing drug penetration.

This article focuses on the integration of the Internet of Things (IoT) and the Internet of Robotic Things, representing a dynamic research area with significant potential for industrial applications. The Internet of Robotic Things (IoRT) integrates IoT technologies into robotic systems, enhancing their efficiency and autonomy. The article provides an overview of the technologies used in IoRT, including hardware components, communication technologies, and cloud services. It also explores IoRT applications in industries such as healthcare, agriculture, and more. The article discusses challenges and future research directions, including data security, energy efficiency, and ethical issues. The goal is to raise awareness of the importance of IoRT and demonstrate how this technology can bring significant benefits across various sectors.

Computer-assisted surgery is becoming essential in modern medicine to accurately plan, guide, and perform surgeries. Similarly, Digital Twin technology is expected to be instrumental in the future of surgery, owing to its capacity to virtually replicate patient-specific interventions whilst providing real-time updates to clinicians. This perspective introduces the term Digital Twin-Assisted Surgery and discusses its potential to improve surgical precision and outcome, along with key challenges for successful clinical translation.

There has been a delayed, yet steady uptake of robotic-assisted surgery over the past decade within the field of plastic surgery. In an era of rapidly evolving scientific and technological development, there is a need for an update on the current literature for robotic-assisted plastic surgery procedures.

Searches were conducted across major databases, including MEDLINE, Embase, and Central for published literature from March 2023 to December 2024. Only published articles written in English with full texts were considered for the final narrative synthesis.

Initially, we identified 1200 articles in the database search. Subsequently, 46 articles were included in our final narrative synthesis. Among the selected studies, 4 focused on reconstruction in transoral robotic surgery, 14 on breast surgery, 10 on robotic microsurgery, 5 on abdominal wall reconstruction, 6 on vaginoplasty, and 5 on flap harvest.

The evidence to support the advantage of robotic plastic surgery procedures over traditional methods is relatively weak. However, there have been some advancements, specifically in transoral robotic surgery, robotic mastectomy, and breast reconstruction. Nevertheless, comprehensive exploration and prospective randomized trials are essential across all procedures to define the role of surgical robots in plastic surgery. The impediments to wider adoption include high costs, disruption to operative flow, and the absence of haptic feedback in robotic-assisted procedures within the specialty.

Precise trajectory control is imperative to ensure the safety and efficacy of in vivo therapy employing the magnetic helical millirobots. However, achieving accurate 3-D path following of helical millirobots under fluid flow conditions remains challenging due to the presence of the lumped disturbances, encompassing complex fluid dynamics and input frequency saturation. This study proposes a robust 3-D path following control framework that combines a disturbance observer for perturbation estimation with an adaptive finite-time sliding mode controller for autonomous navigation along the reference trajectories. First, a magnetic helical millirobot's kinematic model based on the 3-D hand position approach is established. Subsequently, a robust smooth differentiator is implemented as an observer to estimate disturbances within a finite time. We then investigate an adaptive finite-time sliding mode controller incorporating an auxiliary system to mitigate the estimated disturbance and achieve precise 3-D path tracking while respecting the input constraints. The adaptive mechanism of this controller ensures fast convergence of the system while alleviating the chattering effects. Finally, we provide a rigorous theoretical analysis of the finite-time stability of the closed-loop system based on the Lyapunov functions. Utilizing a robotically-actuated magnetic manipulation system, experimental results demonstrate the efficacy of the proposed approach in terms of the control accuracy and convergence time.

To describe the use, activities, and human interactions of cobots as a delivery system for medications, supplies, and equipment within a complex and multi-level 900-bed hospital setting. Integrating collaborative robots (cobots) into existing hospital workflows as a secure delivery transportation system is an early innovation and emerging area to explore.

Guided by the Diffusion of Innovations theory, a qualitative descriptive design was used to build the foundational knowledge required to better understand and describe cobot implementation in the acute care hospital setting. The cobots were observed on all shifts, on different days of the week as they interacted with staff members, clinicians, and visitors while they traveled throughout the hospital completing deliveries. Data were analyzed among the study team members using an inductive coding approach followed by a qualitative content analysis level of interpretation.

For seven weeks from November 2022 - December 2022, 33 hours were collected from 23 individual cobot observation sessions. These observations included 89 end-to-end cobot deliveries. After analysis, four major themes emerged: 1) humanization of robots, 2) usability of robots, 3) cobots' autonomy, and 4) cobots' functionality within a dynamic hospital environment.

Implementing cobots as a semi-autonomous delivery transporter is still in the early innovation phase. The cobots used in this study required human support to function adequately in a complicated and unpredictable environment. To sustainably augment current and future workflows exclusively performed by human, the cobots will need to transition toward greater model of autonomy and less human assistance.

Endoluminal and endocavitary intervention via natural orifices of the body is an emerging trend in medicine, further underpinning the future of early intervention and precision surgery. This motivates the development of small continuum robots to navigate freely in confined and tortuous environment. The trade-off between a large range of motion and high precision with concomitant actuation cross-talk poses a major challenge. Here, we present a submillimeter-scale fiber robot (~1 mm) capable of decoupled macro and micro manipulations for intervention and operation. The thin optical fibers, working both as mechanical tendons and light waveguides, can be pulled/pushed to actuate the macro tendon-driven continuum robot and transmit light to actuate the liquid crystal elastomer-based micro built-in light-driven parallel robot. The combination of the decoupled macro and micro motions can accomplish accurate cross-scale motion from several millimeters down to tens of micrometers. In vivo animal studies are performed to demonstrate its positioning accuracy of precise micro operations in endoluminal or endocavitary intervention.

In developing medical interventions using untethered milli- and microrobots, ensuring safety and effectiveness relies on robust methods for real-time robot detection, tracking, and precise localization within the body. The inherent non-transparency of human tissues significantly challenges these efforts, as traditional imaging systems like fluoroscopy often lack crucial anatomical details, potentially compromising intervention safety and efficacy. To address this technological gap, in this study, we build a virtual reality environment housing an exact digital replica (digital twin) of the operational workspace and a robot avatar. We synchronize the virtual and real workspaces and continuously send the robot position data derived from the image stream into the digital twin with short average delay time around 20-25 ms. This allows the operator to steer the robot by tracking its avatar within the digital twin with near real-time temporal resolution. We demonstrate the feasibility of this approach with millirobots steered in confined phantoms. Our concept demonstration herein can pave the way for not only improved procedural safety by complementing fluoroscopic guidance with virtual reality enhancement, but also provides a platform for incorporating various additional real-time derivative data, e.g., instantaneous robot velocity, intraoperative physiological data obtained from the patient, e.g., blood flow rate, and pre-operative physical simulation models, e.g., periodic body motions, to further refine robot control capacity.

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.

Soft robotics presents innovative solutions across different scales. The flexibility and mechanical characteristics of soft robots make them particularly appealing for wearable and implantable applications. The scale and level of invasiveness required for soft robots depend on the extent of human interaction. This review provides a comprehensive overview of wearable and implantable soft robots, including applications in rehabilitation, assistance, organ simulation, surgical tools, and therapy. We discuss challenges such as the complexity of fabrication processes, the integration of responsive materials, and the need for robust control strategies, while focusing on advances in materials, actuation and sensing mechanisms, and fabrication techniques. Finally, we discuss the future outlook, highlighting key challenges and proposing potential solutions.

In robotic-assisted surgery (RAS), traditional surgical instruments without sensing capability cannot perceive accurate operational forces during the task, and such drawbacks can be largely intensified when sophisticated tasks involving flexible and slender arms with small end-effectors, such as in gastrointestinal endoscopic surgery (GES). In this study, we propose a microelectromechanical system (MEMS) piezoresistive 3-axial tactile sensor for GES forceps, which can intuitively provide surgeons with online force feedback during robotic surgery. The MEMS fabrication process facilitates sensor chips with miniaturized dimensions. The fully encapsulated tactile sensors can be effortlessly integrated into miniature GES forceps, which feature a slender diameter of just 3.5 mm and undergo meticulous calibration procedures via the least squares method. Through experiments, the sensor's ability to accurately measure directional forces up to 1.2 N in the Z axis was validated, demonstrating an average relative error of only 1.18% compared with the full-scale output. The results indicate that this tactile sensor can provide effective 3-axial force sensing during surgical operations, such as grasping and pulling, and in ex vivo testing with a porcine stomach. The compact size, high precision, and integrability of the sensor establish solid foundations for clinical application in the operating theater.

For individuals with hand motor function losses, rehabilitation is necessary for regaining strength and range of motion to accomplish daily activities. Typically within a clinical setting, repetitive strength-based and task-specific exercises are prescribed. However, these therapies are generally costly and non-portable, limiting patient accessibility and rendering patient compliance impractical. There is thus a clinical need for a system that is low-cost, portable, and accessible to improve patient compliance and outcomes. This work presents a proof-of-concept magnetically-controlled glove to provide targeted resistance-based rehabilitation for patients with hand motor impairments. The glove is inexpensive, customizable, and portable, allowing for use within a clinic and at home. Customizable resistance is achieved by electropermanent magnets (EPMs), which locally control magnetic attraction of the digits and produce rapid stiffness changes from magnetically induced jamming. Various rehabilitative exercises using the glove are demonstrated and the magnetic fields can be customized to provide necessary resistance.

Robots are being introduced into increasingly social environments. As these robots become more ingrained in social spaces, they will have to abide by the social norms that guide human interactions. At times, however, robots will violate norms and perhaps even deceive their human interaction partners. This study provides some of the first evidence for how people perceive and evaluate robot deception, especially three types of deception behaviors theorized in the technology ethics literature: External state deception (cues that intentionally misrepresent or omit details from the external world: e.g., lying), Hidden state deception (cues designed to conceal or obscure the presence of a capacity or internal state the robot possesses), and Superficial state deception (cues that suggest a robot has some capacity or internal state that it lacks).

Participants (N = 498) were assigned to read one of three vignettes, each corresponding to one of the deceptive behavior types. Participants provided responses to qualitative and quantitative measures, which examined to what degree people approved of the behaviors, perceived them to be deceptive, found them to be justified, and believed that other agents were involved in the robots' deceptive behavior.

Participants rated hidden state deception as the most deceptive and approved of it the least among the three deception types. They considered external state and superficial state deception behaviors to be comparably deceptive; but while external state deception was generally approved, superficial state deception was not. Participants in the hidden state condition often implicated agents other than the robot in the deception.

This study provides some of the first evidence for how people perceive and evaluate the deceptiveness of robot deception behavior types. This study found that people people distinguish among the three types of deception behaviors and see them as differently deceptive and approve of them differently. They also see at least the hidden state deception as stemming more from the designers than the robot itself.

Human-robot physical interaction contains crucial information for optimizing user experience, enhancing robot performance, and objectively assessing user adaptation. This study introduces a new method to evaluate human-robot interaction and co-adaptation in lower limb exoskeletons by analyzing muscle activity and interaction torque as a two-dimensional random variable. We introduce the interaction portrait (IP), which visualizes this variable's distribution in polar coordinates. We applied IP to compare a recently developed hybrid torque controller (HTC) based on kinematic state feedback and a novel adaptive model-based torque controller (AMTC) with online learning, proposed herein, against a time-based controller (TBC) during treadmill walking at varying speeds. Compared to TBC, both HTC and AMTC significantly lower users' normalized oxygen uptake, suggesting enhanced user-exoskeleton coordination. IP analysis reveals that this improvement stems from two distinct co-adaptation strategies, unidentifiable by traditional muscle activity or interaction torque analyses alone. HTC encourages users to yield control to the exoskeleton, decreasing overall muscular effort but increasing interaction torque, as the exoskeleton compensates for user dynamics. Conversely, AMTC promotes user engagement through increased muscular effort and reduces interaction torques, aligning it more closely with rehabilitation and gait training applications. IP phase evolution provides insight into each user's interaction strategy formation, showcasing IP analysis's potential in comparing and designing novel controllers to optimize human-robot interaction in wearable robots.

Surgical robotics application in the field of minimally invasive surgery has developed rapidly and has been attracting increasingly more research attention in recent years. A common consensus has been reached that surgical procedures are to become less traumatic and with the implementation of more intelligence and higher autonomy, which is a serious challenge faced by the environmental sensing capabilities of robotic systems. One of the main sources of environmental information for robots are images, which are the basis of robot vision. In this review article, we divide clinical image into direct and indirect based on the object of information acquisition, and into continuous, intermittent continuous, and discontinuous according to the target-tracking frequency. The characteristics and applications of the existing surgical robots in each category are introduced based on these two dimensions. Our purpose in conducting this review was to analyze, summarize, and discuss the current evidence on the general rules on the application of image technologies for medical purposes. Our analysis gives insight and provides guidance conducive to the development of more advanced surgical robotics systems in the future.

The complex anatomy of internal luminal organs, like bronchioles, poses challenges for endoscopic optical coherence tomography (OCT). These challenges include limited steerability for targeted imaging and nonuniform rotation distortion (NURD) with proximal scanning. Using rotary micromotors for distal scanning could address NURD but raises concerns about electrical safety and costs. We present pneumaOCT, the first pneumatic OCT endoscope, comprising a steerable catheter with a soft pneumatic actuator and an imaging probe with a miniature pneumatic turbine. With a diameter of 2.8 mm, pneumaOCT allows for a bending angle of up to 237°, facilitating navigation through narrow turns. The pneumatic turbine enables adjustable imaging speeds from 51 to 446 revolutions per second. We demonstrate the pneumaOCT in vivo imaging of mouse esophagus and colon, as well as targeted and distortion-free imaging of peripheral bronchioles in a bronchial phantom and a porcine lung. This advancement substantially improves endoscopic OCT for navigational imaging in curved and narrow lumens.

The sense of touch is a property that allows humans to interact delicately with their physical environment. This article reports on a technological advancement in intuitive human-robot interaction that enables an intrinsic robotic sense of touch without the use of artificial skin or tactile instrumentation. On the basis of high-resolution joint-force-torque sensing in a redundant arrangement, we were able to let the robot sensitively feel the surrounding environment and accurately localize touch trajectories in space and time that were applied on its surface by a human. Through an intertwined combination of manifold learning techniques and artificial neural networks, the robot identified and interpreted those touch trajectories as machine-readable letters, symbols, or numbers. This opens up unexplored opportunities in terms of intuitive and flexible interaction between human and robot. Furthermore, we showed that our concept of so-called virtual buttons can be used to straightforwardly implement a tactile communication link, including switches and slider bars, which are complementary to speech, hardware buttons, and control panels. These interaction elements could be freely placed, moved, and configured in arbitrary locations on the robot structure. The intrinsic sense of touch we proposed in this work can serve as the basis for an advanced category of physical human-robot interaction that has not been possible yet, enabling a shift from conventional modalities toward adaptability, flexibility, and intuitive handling.

Robotics for scientific research are evolving from grasping macro-scale solid materials to directly actuating micro-scale liquid samples. However, current liquid actuation mechanisms often restrict operable liquid types or compromise the activity of biochemical samples by introducing interfering mediums. Here, we propose a robotic liquid handling system enabled by a novel droplet actuation mechanism, termed electret-induced polarization on droplet (EPD). EPD enables all-liquid actuation in principle and experimentally exhibits generality for actuating various inorganic/organic liquids with relative permittivity ranging from 2.25 to 84.2 and volume from 500 nL to 1 mL. Moreover, EPD is capable of actuating various biochemical samples without compromising their activities, including various body fluids, living cells, and proteins. A robotic system is also coupled with the EPD mechanism to enable full automation. EPD's high adaptability with liquid types and biochemical samples thus promotes the automation of liquid-based scientific experiments across multiple disciplines.

Drawing inspiration from cohesive integration of skeletal muscles and sensory skins in vertebrate animals, we present a design strategy of soft robots, primarily consisting of an electronic skin (e-skin) and an artificial muscle. These robots integrate multifunctional sensing and on-demand actuation into a biocompatible platform using an in-situ solution-based method. They feature biomimetic designs that enable adaptive motions and stress-free contact with tissues, supported by a battery-free wireless module for untethered operation. Demonstrations range from a robotic cuff for detecting blood pressure, to a robotic gripper for tracking bladder volume, an ingestible robot for pH sensing and on-site drug delivery, and a robotic patch for quantifying cardiac function and delivering electrotherapy, highlighting the application versatilities and potentials of the bio-inspired soft robots. Our designs establish a universal strategy with a broad range of sensing and responsive materials, to form integrated soft robots for medical technology and beyond.

Dental implantation has emerged as an efficient substitute for missing teeth, which is essential for restoring oral function and aesthetics. Compared to traditional denture repair approaches, dental implants offer better stability and sustainability. The position, angle, and depth of dental implants are crucial factors for their long-term success and necessitate high-precision operation and technical support.

We propose an integrated dual-arm high-precision oral implant surgery navigation positioning system and a corresponding control strategy. Compared with traditional implant robots, the integrated dual-arm design greatly shortens the preparation time before surgery and simplifies the operation process. We propose a novel control flow and module for the proposed structure, including an Occluded Target Tracking Module (OTTM) for occlusion tracking, a Planting Plan Development Module (PPDM) for generating implant plans, and a Path Formulation Module (PFM) for controlling the movement path of the two robot arms.

Under the coordinated control of the aforementioned modules, the robot achieved excellent accuracy in clinical trials. The average angular error and entry point error for five patients who underwent implant surgery using the proposed robot were 2.1° and 0.39 mm, respectively.

In essence, our study introduces an integrated dual-arm high-precision navigation system for oral implant surgery, resolving issues like lengthy preoperative preparation and static surgical planning. Clinical results confirm its efficacy, emphasizing its accuracy and precision in guiding oral implant procedures.

Medical microrobotics is an emerging field to revolutionize clinical applications in diagnostics and therapeutics of various diseases. On the other hand, the mobile microrobotics field has important obstacles to pass before clinical translation. This article focuses on these challenges and provides a roadmap of medical microrobots to enable their clinical use. From the concept of a "magic bullet" to the physicochemical interactions of microrobots in complex biological environments in medical applications, there are several translational steps to consider. Clinical translation of mobile microrobots is only possible with a close collaboration between clinical experts and microrobotics researchers to address the technical challenges in microfabrication, safety, and imaging. The clinical application potential can be materialized by designing microrobots that can solve the current main challenges, such as actuation limitations, material stability, and imaging constraints. The strengths and weaknesses of the current progress in the microrobotics field are discussed and a roadmap for their clinical applications in the near future is outlined.

Wireless capsule endoscopy (WCE) offers a non-invasive evaluation of the digestive system, eliminating the need for sedation and the risks associated with conventional endoscopic procedures. Its significance lies in diagnosing gastrointestinal tissue irregularities, especially in the small intestine. However, existing commercial WCE devices face limitations, such as the absence of autonomous lesion detection and treatment capabilities. Recent advancements in micro-electromechanical fabrication and computational methods have led to extensive research in sophisticated technology integration into commercial capsule endoscopes, intending to supersede wired endoscopes. This Review discusses the future requirements for intelligent capsule robots, providing a comparative evaluation of various methods' merits and disadvantages, and highlighting recent developments in six technologies relevant to WCE. These include near-field wireless power transmission, magnetic field active drive, ultra-wideband/intrabody communication, hybrid localization, AI-based autonomous lesion detection, and magnetic-controlled diagnosis and treatment. Moreover, we explore the feasibility for future "capsule surgeons".

Millimeter-scale soft continuum robots offer safety and adaptability in transluminal procedures due to their passive compliance, but this feature necessitates interactions with surrounding lumina, leading to potential medical risks and restricted mobility. Here, we introduce a millimeter-scale continuum robot, enabling apical extension while maintaining structural stability. Utilizing phase transition components, the robot executes cycles of tip-based elongation, steered accurately through programmable magnetic fields. Each motion cycle features a solid-like backbone for stability, and a liquid-like component for advancement, thereby enabling autonomous shaping without reliance on environmental interactions. Together with clinical imaging technologies, we demonstrate the capability of navigating through tortuous and fragile lumina to transport microsurgical tools. Once it reaches larger anatomical spaces such as stomach, it can morph into functional 3D structures that serve as surgical tools or sensing units, overcoming the constraints of initially narrow pathways. By leveraging this design paradigm, we anticipate enhanced safety, multi-functionality, and cooperative capabilities among millimeter-scale continuum robots, opening new avenues for transluminal robotic surgery.

Robot-assisted surgery platforms are utilized globally thanks to their stereoscopic vision systems and enhanced functional assistance. However, the necessity of ergonomic improvement for their use by surgeons has been increased. In surgical robots, issues with chronic fatigue exist owing to the fixed posture of the conventional stereo viewer (SV) vision system. A head-mounted display was adopted to alleviate the inconvenience, and a virtual vision platform (VVP) is proposed in this study. The VVP can provide various critical data, including medical images, vital signs, and patient records, in three-dimensional virtual reality space so that users can access medical information simultaneously. An availability of the VVP was investigated based on various user evaluations by surgeons and novices, who executed the given tasks and answered questionnaires. The performances of the SV and VVP were not significantly different; however, the craniovertebral angle of the VVP was 16.35° higher on average than that of the SV. Survey results regarding the VVP were positive; participants indicated that the optimal number of displays was six, preferring the 2 × 3 array. Reflecting the tendencies, the VVP can be a neoconceptual candidate to be customized for medical use, which opens a new prospect in a next-generation surgical robot.

Microcatheters capable of active guidance have been proven to be effective and efficient solutions to interventional surgeries for cardiovascular and cerebrovascular diseases. Herein, a novel microcatheter made of two biocompatible materials, shape memory alloy (SMA) and polyethylene (PE), is proposed. It consists of a reconfigurable distal actuator and a separate polyethylene catheter. The distal actuator is created via embedding U-shape SMA wires into the PE base, and its reconfigurability is mainly dominated by the shape memory effect (SME) of SMA wires, as well as the effect of thermal mismatch between the SMA and PE base. A mathematical model was established to predict the distal actuator's deformation, and the analytical solutions show great agreement with the finite element results. Structural optimization of such microcatheters was carried out using the verified analytical model, followed by fabrication of some typical prototypes. Experimental testing of their mechanical behaviors demonstrates the feasibility of the structural designs, and the reliability and accuracy of the mathematical model. The active microcatheter, together with the prediction model, will lay a solid foundation for rapid development and optimization of active navigation strategies for vascular interventions.

Emerging technologies are changing hand surgery by improving surgical precision, minimizing tissue disruption, and expediting patient recovery. These advancements have the potential to revolutionize surgical procedures, patient outcomes, and rehabilitation processes. However, there are still challenges that need to be addressed before these technologies can be widely adopted. These challenges include the learning curve for surgeons, high costs, and ethical considerations. Future research should focus on addressing the limitations of these technologies, exploring their long-term effects, and evaluating their cost-effectiveness. To successfully implement them, a collaborative approach involving clinicians, researchers, engineers, and policymakers is necessary. This review provides an overview of current and future trends in emerging technologies for hand orthopedic surgery.

The use of robots to augment human capabilities and assist in work has long been an aspiration. Robotics has been developing since the 1960s when the first industrial robot was introduced. As technology has advanced, robotic-assisted surgery has shown numerous advantages, including more precision, efficiency, minimal invasiveness, and safety than is possible with conventional techniques, which are research hotspots and cutting-edge trends. This article reviewed the history of medical robot development and seminal research papers about current research progress. Taking the autonomous dental implant robotic system as an example, the advantages and prospects of medical robotic systems would be discussed which would provide a reference for future research.

Combining hyperthermic intraperitoneal chemotherapy with cytoreductive surgery is the main treatment modality for peritoneal metastatic (PM) carcinoma despite the off-target effects of chemotherapy drugs and the ineluctable side effects of total abdominal heating. Herein, a laser-integrated magnetic actuation system that actively delivers doxorubicin (DOX)-grafted magnetic nanorobot collectives to the tumor site in model mice for local hyperthermia and chemotherapy is reported. With intraluminal movements controlled by a torque-force hybrid magnetic field, these magnetic nanorobots gather at a fixed point coinciding with the position of the localization laser, moving upward against gravity over a long distance and targeting tumor sites under ultrasound imaging guidance. Because aggregation enhances the photothermal effect, controlled local DOX release is achieved under near-infrared laser irradiation. The targeted on-demand photothermal therapy of multiple PM carcinomas while minimizing off-target tissue damage is demonstrated. Additionally, a localization/treatment dual-functional laser-integrated magnetic actuation system is developed and validated in vivo, offering a potentially clinically feasible drug delivery strategy for targeting PM and other intraluminal tumors.

Patent Ductus Arteriosus (PDA) is a heart condition in which the ductus arteriosus-a blood vessel connecting the pulmonary artery to the aorta in a fetus-fails to undergo closure after birth. A PDA can be an important factor in neonates born with severe congenital heart disease (CHD) or born prematurely. With the advent of new intravascular stent technologies, treatments based on ductus arteriosus stenting can now be completed in many cases; however, difficulties remain in accessing the ductus arteriosus in small babies successfully using current guidewire-catheter systems. Recent developments for soft robotic endovascular instruments that leverage control schemes hold distinctive potential for addressing these access challenges, but such technologies are not yet at the sizes required for navigating neonatal vasculature safely and efficiently. In an effort to meet this clinical need, this work presents an approach for 3D printing 1.5 French (Fr) soft robotic guidewires that transition from straight to "S"-shaped configurations under the application of fluidic (e.g., pneumatic or hydraulic) loading. Two distinct dual-opposing segmented soft actuators, including a symmetric and asymmetric system design (both with heights of 2.5 mm), were 3D printed onto 1.1 Fr capillaries in 35-60 minutes via "Two-Photon Direct Laser Writing (DLW)". Experimental results revealed that both designs not only withstood pressures of up to 550 kPa, but also exhibited increased opposing bending deformations-corresponding to decreased radii of curvature-with increasing applied pressure. In combination, this study serves as a critical foundation for next-generation fluidically actuated soft robotic guidewire-catheter systems for PDA interventions.

Untethered capsules hold clinical potential for the diagnosis and treatment of gastrointestinal diseases. Although considerable progress has been achieved recently in this field, the constraints imposed by the narrow spatial structure of the capsule and complex gastrointestinal tract environment cause many open-ended problems, such as poor active motion and limited medical functions. In this work, we describe the development of small-scale magnetically driven capsules with a distinct magnetic soft valve made of dual-layer ferromagnetic soft composite films. A core technological advancement achieved is the flexible opening and closing of the magnetic soft valve by using the competitive interactions between magnetic gradient force and magnetic torque, laying the foundation for the functional integration of both drug release and sampling. Meanwhile, we propose a magnetic actuation strategy based on multi-frequency response control and demonstrate that it can achieve effective decoupled regulation of the capsule's global motion and local responses. Finally, through a comprehensive approach encompassing ideal models, animal ex vivo models, and in vivo assessment, we demonstrate the versatility of the developed magnetic capsules and their multiple potential applications in the biomedical field, such as targeted drug delivery and sampling, selective dual-drug release, and light/thermal-assisted therapy.