Medical Robotics

The first generation of surgical robots are already being installed in a number of operating rooms around the world. Robotics is being introduced to medicine because it allows for unprecedented control and precision of surgical instruments in minimally invasive procedures. So far, robots have been used to position an endoscope, perform gallbladder surgery and correct gastroesophogeal reflux and heartburn. The ultimate goal of the robotic surgery field is to design a robot that can be used to perform closed-chest, beating-heart surgery. The use of robotics in surgery will expand over the next decades without any doubt. Minimally Invasive Surgery (MIS) is a revolutionary approach in surgery. In MIS, the operation is performed with instruments and viewing equipment inserted into the body through small incisions created by the surgeon, in contrast to open surgery with large incisions. This minimizes surgical trauma and damage to healthy tissue, resulting in shorter patient recovery time. The aim of this book is to provide an overview of the state-of-art, to present new ideas, original results and practical experiences in this expanding area. Nevertheless, many chapters in the book concern advanced research on this growing area. The book provides critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies. This book is certainly a small sample of the research activity on Medical Robotics going on around the globe as you read it, but it surely covers a good deal of what has been done in the field recently, and as such it works as a valuable source for researchers interested in the involved subjects, whether they are currently “medical roboticists” or not

Micro-Scale Bio-Inspired Structured Polymer Surfaces for Tissue Adhesion

There are many cases when it would be beneficial to provide reliable, reversible adhesion at a tissue-device interface. There are currently many adhesion mechanisms used during surgical procedures such as graspers, vacuum cups and hooks. However, these are known to cause some scale of tissue trauma. This thesis investigates the viability of using a bio-inspired, structured polymer surfaces to provide wet adhesion forces through the formation of liquid bridges on the tip of discrete pillars. The mechanism described involves a contribution from both Stefan forces and capillary forces to provide the total adhesion force. A main factor to this work is the ability to successfully, repeatedly and reliably fabricate polymer surfaces at a micron scale with varying geometry, specifically in terms of pillar spacing. The substrate should be flexible and have the ability to tune the wettability. A number of lithography techniques have been explored for a range of polymers, finally settling on a nano-imprint lithography technique with Poly (dimethylsiloxane) (PDMS) as the polymer. Experimental adhesion tests have been performed and it has been found, that for such an adhesion mechanism to be successful, an optimal contact angle must be reached. If the contact angle is too high, repulsive forces in convex menisci will form and the adhesion will be low as a result. If the contact angle is too low, the capillary length : pillar height ratio results in the surface acting super-hydrophobic and completely wetting the pillars, preventing the formation of liquid bridges, and again resulting in low adhesion, it is proposed that such a mechanism would occur at contact angles lower than 50°. A mathematical model has been investigated, encompassing both the Stefan and adhesion forces and the limitations of this have been discussed in relation to the complexity of this system

Modular soft pneumatic actuator system design for compliance matching

The future of robotics is personal. Never before has technology been as pervasive as it is today, with advanced mobile electronics hardware and multi-level network connectivity pushing âsmartâ devices deeper into our daily lives through home automation systems, virtual assistants, and wearable activity monitoring. As the suite of personal technology around us continues to grow in this way, augmenting and offloading the burden of routine activities of daily living, the notion that this trend will extend to robotics seems inevitable. Transitioning robots from their current principal domain of industrial factory settings to domestic, workplace, or public environments is not simply a matter of relocation or reprogramming, however. The key differences between âtraditionalâ types of robots and those which would best serve personal, proximal, human interactive applications demand a new approach to their design. Chief among these are requirements for safety, adaptability, reliability, reconfigurability, and to a more practical extent, usability. These properties frame the context and objectives of my thesis work, which seeks to provide solutions and answers to not only how these features might be achieved in personal robotic systems, but as well what benefits they can afford. I approach the investigation of these questions from a perspective of compliance matching of hardware systems to their applications, by providing methods to achieve mechanical attributes complimentary to their environment and end-use. These features are fundamental to the burgeoning field of Soft Robotics, wherein flexible, compliant materials are used as the basis for the structure, actuation, sensing, and control of complete robotic systems. Combined with pressurized air as a power source, soft pneumatic actuator (SPA) based systems offers new and novel methods of exploiting the intrinsic compliance of soft material components in robotic systems. While this strategy seems to answer many of the needs for human-safe robotic applications, it also brings new questions and challenges: What are the needs and applications personal robots may best serve? Are soft pneumatic actuators capable of these tasks, or âusefulâ work output and performance? How can SPA based systems be applied to provide complex functionality needed for operation in diverse, real-world environments? What are the theoretical and practical challenges in implementing scalable, multiple degrees of freedom systems, and how can they be overcome? I present solutions to these problems in my thesis work, elucidated through scientific design, testing and evaluation of robotic prototypes which leverage and demonstrate three key features: 1) Intrinsic compliance: provided by passive elastic and flexible component material properties, 2) Extrinsic compliance: rendered through high number of independent, controllable degrees of freedom, and 3) Complementary design: exhibited by modular, plug and play architectures which combine both attributes to achieve compliant systems. Through these core projects and others listed below I have been engaged in soft robotic technology, its application, and solutions to the challenges which are critical to providing a path forward within the soft robotics field, as well as for the future of personal robotics as a whole toward creating a better society

Advanced Applications of Rapid Prototyping Technology in Modern Engineering

Rapid prototyping (RP) technology has been widely known and appreciated due to its flexible and customized manufacturing capabilities. The widely studied RP techniques include stereolithography apparatus (SLA), selective laser sintering (SLS), three-dimensional printing (3DP), fused deposition modeling (FDM), 3D plotting, solid ground curing (SGC), multiphase jet solidification (MJS), laminated object manufacturing (LOM). Different techniques are associated with different materials and/or processing principles and thus are devoted to specific applications. RP technology has no longer been only for prototype building rather has been extended for real industrial manufacturing solutions. Today, the RP technology has contributed to almost all engineering areas that include mechanical, materials, industrial, aerospace, electrical and most recently biomedical engineering. This book aims to present the advanced development of RP technologies in various engineering areas as the solutions to the real world engineering problems

Mechatronic Systems

Mechatronics, the synergistic blend of mechanics, electronics, and computer science, has evolved over the past twenty five years, leading to a novel stage of engineering design. By integrating the best design practices with the most advanced technologies, mechatronics aims at realizing high-quality products, guaranteeing at the same time a substantial reduction of time and costs of manufacturing. Mechatronic systems are manifold and range from machine components, motion generators, and power producing machines to more complex devices, such as robotic systems and transportation vehicles. With its twenty chapters, which collect contributions from many researchers worldwide, this book provides an excellent survey of recent work in the field of mechatronics with applications in various fields, like robotics, medical and assistive technology, human-machine interaction, unmanned vehicles, manufacturing, and education. We would like to thank all the authors who have invested a great deal of time to write such interesting chapters, which we are sure will be valuable to the readers. Chapters 1 to 6 deal with applications of mechatronics for the development of robotic systems. Medical and assistive technologies and human-machine interaction systems are the topic of chapters 7 to 13.Chapters 14 and 15 concern mechatronic systems for autonomous vehicles. Chapters 16-19 deal with mechatronics in manufacturing contexts. Chapter 20 concludes the book, describing a method for the installation of mechatronics education in schools

Development of a Novel Amphibious Locomotion System for use in Intra-Luminal Surgical Procedures

Colonoscopy is widely considered the gold standard for inspection of the colon. The procedure is however not without issue, current colonoscopes have seen little change or innovation throughout their 40 years of use with patient discomfort still limiting success. The aim of this PhD study was to develop a locomotion system for use on a robotic device that can traverse a liquid filled colon for atraumatic inspection and biopsy tasks. The PhD was undertaken as part of a larger two-centre EU project, which aimed to bring about a change in the way colonoscopy is done by moving to “robotic hydro-colonoscopy”. In this thesis the initial development and testing of an amphibious locomotion concept for use in a procedure known as hydro-colonoscopy is described. The locomotion system is comprised of four Archimedes’ screws arranged in two counter-rotating pairs. These aim to provide propulsion through a fluid-filled colon as well as provide locomotive traction against colonic tissue in partially fluid-filled or collapsed sections of the colon, such as the splenic flexure. Experimental studies were carried out on a single screw system in fluid and dual counter-rotating screws in contact conditions. These show the system’s ability to generate thrust in the two discrete modes of locomotion of the amphibious system. A 2:1 scale prototype of the proposed device was produced and features compliant screw threads to provide atraumatic locomotion. The scale prototype device was tested in ex-vivo porcine colon. The developed system was able to traverse through lumen to limited success, which demonstrated that this concept has the potential for use on an intra-luminal robotic device The key contributions of this research are: variable geometry locomotion system; amphibious locomotion using Archimedes’ screws; experimental assessment of the locomotion in fluid, contact and amphibious states; and analysis of the contact dynamics against tissue

METHODOLOGY FOR RESEARCH AND DEVELOPMENT OF NOVEL MEDICAL DEVICES FOR MINIMALLY INVASIVE INTERVENTIONS

The design of innovative medical device requires extensive and hard efforts to reach good results in terms of safety, efficacy and cost effectiveness. First of all the idea has to be set and a wide search of state of the art, both technological and academic, has to be developed. Then the materials, manufacturing processes and design constraints have to be understood. In this work three examples of innovative surgical devices for minimally invasive surgery and assistance have been presented. The Muneretto Beam catheter is a new device for atrial defibrillation. Starting from a catheter produced by Estech company for the treatment of atrial fibrillation by ablating cardiac tissue during surgery, a system for the magnetic guidance of the same has been implemented. Thanks to finite element analysis of various configurations of magnets and to several in vitro tests, a final configuration which allows a good balance between the sliding of the catheter on the tissues and the magnetic interaction and adhesion to tissues has been found. Further attention has been taken to the development of the cover and the right configuration and method of use of the device. The VideoDrain system is a new catheter for the monitoring of post-operative wound. After critical surgical procedures it is necessary to monitor the status of the surgical wound for avoiding second look surgical interventions. Therefore a new balloon catheter for allowing the vision of the abdominal cavity has been produced. Several in vitro and in vivo trials have been conducted and the device is at the pre-industrial stage. The FloSeal GI cath. is a new device for the gastrointestinal release of an haemostatic substance of the Baxter company: the Floseal thrombin matrix. It consists in a balloon catheter suited for the use in the lower and upper gastrointestinal tract in the occurrence of bleedings during endoscopic procedures. This device has been CE labelled and is now on the market. All the devices described in this work come from ideas of surgeons leader in innovation in the field of minimally invasive interventions. Their collaboration has been fundamental for the several phases of design and tests of the devices. This Ph.D. thesis is divided into five chapters. In the Introduction chapter the process of research and development of innovative MDs for minimally invasive surgery has been illustrated. The second chapter shows the efforts done to find a working configuration for the Muneretto Beam catheter and the subsequent first prototypes developed. The progress in the design of VideoDrain has been explained in the third chapter; the whole process goes from the idea to the animal test on prototypes and a preliminary risk analysis. The development of the Floseal GI Catheter is depicted in the fourth chapter; all the details of the materials used and tests done to ensure a CE mark have been reported. Finally, in the Conclusion chapter I have reported some lessons learned from the work in the field of MDs, as a student, researcher and engineer at close contact with the world of surgery and minimally invasive technologies. Some papers about a preliminary research activity in the field of minimally invasive surgery and robotic interventions have been also enclosed. These works have been very useful to start the understanding of the complex and amazing world of MIS

Bio-Inspired Soft Artificial Muscles for Robotic and Healthcare Applications

Soft robotics and soft artificial muscles have emerged as prolific research areas and have gained substantial traction over the last two decades. There is a large paradigm shift of research interests in soft artificial muscles for robotic and medical applications due to their soft, flexible and compliant characteristics compared to rigid actuators. Soft artificial muscles provide safe human-machine interaction, thus promoting their implementation in medical fields such as wearable assistive devices, haptic devices, soft surgical instruments and cardiac compression devices. Depending on the structure and material composition, soft artificial muscles can be controlled with various excitation sources, including electricity, magnetic fields, temperature and pressure. Pressure-driven artificial muscles are among the most popular soft actuators due to their fast response, high exertion force and energy efficiency. Although significant progress has been made, challenges remain for a new type of artificial muscle that is easy to manufacture, flexible, multifunctional and has a high length-to-diameter ratio. Inspired by human muscles, this thesis proposes a soft, scalable, flexible, multifunctional, responsive, and high aspect ratio hydraulic filament artificial muscle (HFAM) for robotic and medical applications. The HFAM consists of a silicone tube inserted inside a coil spring, which expands longitudinally when receiving positive hydraulic pressure. This simple fabrication method enables low-cost and mass production of a wide range of product sizes and materials. This thesis investigates the characteristics of the proposed HFAM and two implementations, as a wearable soft robotic glove to aid in grasping objects, and as a smart surgical suture for perforation closure. Multiple HFAMs are also combined by twisting and braiding techniques to enhance their performance. In addition, smart textiles are created from HFAMs using traditional knitting and weaving techniques for shape-programmable structures, shape-morphing soft robots and smart compression devices for massage therapy. Finally, a proof-of-concept robotic cardiac compression device is developed by arranging HFAMs in a special configuration to assist in heart failure treatment. Overall this fundamental work contributes to the development of soft artificial muscle technologies and paves the way for future comprehensive studies to develop HFAMs for specific medical and robotic requirements