Editorial on the Research Topic.
Novel Actuators, Sensors and Control Systems for Endoscopic Robots

Manfredi, Luigi

Mattos, Leonardo S.

Melzer, Andreas

English

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Editorial: Novel Actuators, Sensorsand Control Systems for EndoscopicRobotsLuigi Manfredi1*, Leonardo S. Mattos2 and Andreas Melzer1,31Institute for Medical Science and Technology, IMSaT, University Dundee, Dundee, United Kingdom, 2Advanced RoboticsDepartment, Istituto Italiano di Tecnologia, Genova, Italy, 3Institute and Innovation Center for Computer Assisted Surgery,University Leipzig, Leipzig, GermanyKeywords: endoscopic robots, endorobots, laser microsurgery, image robotics, soft roboticsEditorial on the Research TopicNovel Actuators, Sensors and Control Systems for Endoscopic RobotsINTRODUCTIONDesign of medical robots should arise from a close collaboration between clinicians and scientists andas a result of the identification of unmet clinical needs. Starting from this early stage, where an idea isjust conceived, concept designs and proof of concepts are the following steps. This is a long journeythat eventually may terminate with a product that is available at clinical stage to improve the healthcare quality for patients. Through this journey, an important role is played by the selection of theappropriate components to be used for the development of the device. Actuators, sensors, and theway to control these components can decide the success or unsuccess of an idea. Precision, safety,reliability, and dexterity in narrow areas are some of the aspects that have spread the use of medicalrobots in current medical practice. To gain access to difficult-to-reach organs, endoscopic robots orendorobots, need to be small, flexible, smart, and versatile. The main challenge in designing anendorobot stands in the limited space that surrounds the device, which restricts the use of standardand off-the shelf components (Manfredi et al., 2017) (Manfredi and Cuschieri 2018). To gain accessthrough small apertures or natural orifices, scientists need to provide innovative solutions as well asproduce and assemble these prototypes “in-house”. Soft materials are nowadays used as analternative paradigm to design miniaturised actuators (Manfredi et al., 2018a) (Manfredi et al.,2018b) (Manfredi et al., 2019a) (Manfredi and Cuschieri, 2019) (Manfredi et al., 2019b) and sensors.These materials are soft with variable geometries. Compliance remains the main advantage,presenting mechanical properties similar to humans’ organs. However, precision, and low outputforce or torque at small scale are still limitations to be taken into account.CONTENTS OF THE RESEARCH TOPICThis research topic includes a collection of articles and reviews that can be summarised in three mainthemes: 1) GI (gastrointestinal) endoscopy, 2) laser microsurgery, and 3) imaging robotics.GI EndoscopyEndorobots can have various medical applications. For example, inspection of the GI tract isperformed by using an endoscope, which consists of a long tube, most of which has a passiveEdited and reviewed by:Sanja Dogramadzi,The University of Sheffield,United Kingdom*Correspondence:Luigi Manfredimail@luigimanfredi.comSpecialty section:This article was submitted toBiomedical Robotics,a section of the journalFrontiers in Robotics and AIReceived: 18 October 2021Accepted: 26 October 2021Published: 22 November 2021Citation:Manfredi L, Mattos LS and Melzer A(2021) Editorial: Novel Actuators,Sensors and Control Systems forEndoscopic Robots.Front. Robot. AI 8:797467.doi: 10.3389/frobt.2021.797467Frontiers in Robotics and AI | www.frontiersin.org November 2021 | Volume 8 | Article 7974671EDITORIALpublished: 22 November 2021doi: 10.3389/frobt.2021.797467mechanical system that relies on forces exchanged with the GIwall to bend and follow the GI shape. These forces cause pain,discomfort and can damage the mucosa or even causeperforation. Several companies have tried to produce, certify,and commercialise medical devices for colonoscopy. Researchinstitutes are working on novel concepts that reduce pain anddiscomfort, facilitate the procedure, are cost-effective, and singleuse to avoid disease cross-contamination (Manfredi). Softactuators are an alternative solution to the rigid counterparts,because they can reduce forces applied to the GI wall andpotentially improve the acceptability of the procedure. Anorigami-based soft robotic actuator for upper GI endoscopicapplication was presented in (Chauhan et al.). The proposedorigami design was constructed and tested. Experiments showedflexibility in bending and permitted continuous change in thebending plane, three actuations and one channel for cabling acamera, compact fabrication, and production of an actuatorwithout damage in an elastomeric material. Manoeuvrability ofsoft and continuous devices still face many open challenges inmodelling and control, especially when a task requires a closed-loop controller (Isbister et al.). developed an analytical model andthen validated it through experiments by using an endoscopiccontinuum robot. The experimental setup consisted of a systemactuated by four tendons via a motorised lead screw mechanismwith load cells. The deformation of the backbone was measuredusing a contactless optical tracking system. When the model wasunloaded, the prediction was very similar to the deformations ofthe backbone.Laser MicrosurgeryWhen the requirements in precision become high in delicateorgans, such as larynx, laser microsurgery is one of the currentlywell accepted techniques. The European project μRALP haspioneered research to redesign the current laser microsurgeryapproach, transforming it into an endoscopic surgery procedure(Mattos et al.). They have developed robotic micro-technologiesto enable the miniaturization of the surgical system and producean advance device that includes hardware and softwareinfrastructure for remote operation, accurate and robust laservisual servoing for 3D control of the laser spot in unknownenvironments, and augmented reality to plan and control laserincisions in 3D.Imaging RoboticsImaging robotics to develop novel assistance systems has beendeveloped since 2000 (Unger et al.). reports a review on the latestadvances in academia and applied research on commercialdevices. The high precision and reproducibility of robot-assistance enable a wide range of applications. This reviewcovers a comprehensive description on computer tomography(CT) guided interventions, magnet resonance imaging (MRI),robotic systems for MR-guided interventions and robotic assistedUS-guidance (Patel et al.). presents a body mounted robot forMRI-guided surgery, designed to be compact and lightweight,constructed with nonmagnetic material for MRI safety. Theauthors aim to move away from the current two-steparthrography procedure, which consists of a CT/x-ray guidedneedle insertion followed by diagnostic MRI, into a single-stepionising radiation-free procedure underMRI guidance. The robotwas evaluated on a Thiel soft embalmed cadaver, attached to theshoulder using straps. The experiments showed that the needlewas successfully placed in the shoulder joint space in all thetargeting attempts with high accuracy, and no image qualitydegradation was detected due to the robot.CONCLUSIONThe manuscripts published in this research topic show recentadvancements in medical robotics with particular attention toendoscopy (actuators and control strategies of continuumrobots), laser microsurgery, and image guidance. The wideradoption of medical robots in health centres, and the recentcommercialisation of new robotics devices, have increased theiracceptability in health care centres and patients. More effort isstill required to widen the clinical application areas and to reducethe impact of cost for health care centres in adopting newtechnologies.AUTHOR CONTRIBUTIONSLM conceived the idea for the Research Topic and recruited LSMand AM to form a team of guest editors for this Research Topic.Together, this team of guest editors have crafted the ResearchTopic abstract and the international call for papers. The editorshave reviewed submitted papers within their expertise andaccepted six papers for this Research Topic. This editorial hasbeen written by LM based on joint efforts of all three guest editors.All authors contributed to the article and approved the submittedversion.ACKNOWLEDGMENTSThe guest associate editors of this Research Topic wish to expresstheir gratitude to Kaspar Althoefer, Special Chief Editor ofFrontiers in Robotics and AI, for the opportunity to publishthis Research Topic. We greatly appreciate the responsiveness ofthe Specialty Chief Editor, associate editors, and staff members onthe timely support throughout the review and publicationprocesses. We also express our sincere gratitude to the manyreviewers who contributed to this Research Topic with their timeand expertise.Frontiers in Robotics and AI | www.frontiersin.org November 2021 | Volume 8 | Article 7974672Manfredi et al. Editorial: Endoscopic RobotsREFERENCESManfredi, L., Yue, L., and Cuschieri, A. (2018a). “A 3 DOFs Mini Variable StiffnessSoft Pneumatic Actuator,” in ACTUATOR 2018 - 16th InternationalConference and Exhibition on New Actuators and Drive Systems,Conference Proceedings (IEEE), 169–172.Manfredi, L., Capoccia, E., Ciuti, G., and Cuschieri, A. (2019a). A Soft PneumaticInchworm Double Balloon (SPID) for Colonoscopy. Sci. Rep. 9 (1), 1–10.doi:10.1038/s41598-019-47320-3Manfredi, L., and Cuschieri, A. (2019). “A Wireless Compact Control Unit(WiCCU) for Untethered Pneumatic Soft Robots,” in RoboSoft 2019 - 2019IEEE International Conference on Soft Robotics (IEEE), 31–36. doi:10.1109/ROBOSOFT.2019.8722788Manfredi, L., and Cuschieri, A. (2018). Design of a 2 DOFsMini Hollow Joint Actuatedwith SMA Wires. Materials 11 (10), 1–13. doi:10.3390/ma11102014Manfredi, L., Huan, Y., and Cuschieri, A. (2017). Low Power Consumption MiniRotary Actuator with SMA Wires. Smart Mater. Struct. 26 (11), 115003.doi:10.1088/1361-665X/aa8aa4Manfredi, L., Putzu, F., Guler, S., Huan, Y., and Cuschieri, A. (2019b). 4 DOFsHollow Soft Pneumatic Actuator-HOSE. Mater. Res. Express 6 (4),045703–045709. doi:10.1088/2053-1591/aaebeaManfredi, L., Yue, L., Zhang, J., and Cuschieri, A. (2018b). A 4DOFs Variable Stiffness Soft Module. 2018 IEEE Int. Conf.Soft Robotics, RoboSoft 1 (2), 94–99. doi:10.1109/ROBOSOFT.2018.8404903Conflict of Interest: The authors declare that the research was conducted in theabsence of any commercial or financial relationships that could be construed as apotential conflict of interest.Publisher’s Note: All claims expressed in this article are solely those of the authorsand do not necessarily represent those of their affiliated organizations, or those ofthe publisher, the editors and the reviewers. Any product that may be evaluated inthis article, or claim that may be made by its manufacturer, is not guaranteed orendorsed by the publisher.Copyright © 2021 Manfredi, Mattos and Melzer. This is an open-access articledistributed under the terms of the Creative Commons Attribution License (CC BY).The use, distribution or reproduction in other forums is permitted, provided theoriginal author(s) and the copyright owner(s) are credited and that the originalpublication in this journal is cited, in accordance with accepted academic practice.No use, distribution or reproduction is permitted which does not comply withthese terms.Frontiers in Robotics and AI | www.frontiersin.org November 2021 | Volume 8 | Article 7974673Manfredi et al. Editorial: Endoscopic Robots

Editorial: Novel Actuators, Sensors and Control Systems for Endoscopic Robots

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