Most devices for single-site or natural orifice transluminal surgery are very application specific and, hence, capable of effectively carrying out specific surgical tasks only. However, most of these instruments are rigid, lack a sufficient number of degrees of freedom (DOFs), and/or are incapable of modifying their mechanical properties based on the tasks to be performed. The current philosophy in commercial instrument design is mainly focused on creating minimally invasive surgical systems using rigid tools equipped with dexterous tips. Only few research efforts are aimed at developing flexible surgical systems, with many DOFs or even continuum kinematics. The authors propose a radical change in surgical instrument design: away from rigid tools toward a new concept of soft and stiffness-controllable instruments. Inspired by biology, we envision creating such soft and stiffness-controllable medical devices using the octopus as a model. The octopus presents all the capabilities requested and can be viewed as a precious source of inspiration. Several soft technologies are suitable for meeting the aforementioned capabilities, and in this article a brief review of the most promising ones is presented. Then we illustrate how specific technologies can be applied in the design of a novel manipulator for flexible surgery by discussing its potential and by presenting feasibility tests of a prototype responding to this new design philosophy. Our aim is to investigate the feasibility of applying these technologies in the field of minimally invasive surgery and at the same time to stimulate the creativeness of others who could take the proposed concepts further to achieve novel solutions and generate specific application scenarios for the devised technologies.

Robot-assisted minimally invasive surgery (RMIS) made it possible to perform a number of medical manipulations with reduced patient trauma and better accuracy. Various devices, including tactile sensors, have been developed in recent years to enhance the quality of this procedure. The objective of this paper is to review the latest advancements and challenges in the development of tactile sensing devices designed for surgical applications. In particular, the focus is on palpation and probing devices that can be potentially used in RMIS. In addition, we explore the aspects that should be taken into account when designing tactile sensors for RMIS, incorporating biological inspiration of tactile sensing, features of manual palpation, requirements of RMIS. We provide an overview of recommendations for the development of tactile sensing devices, especially in the context of RMIS.

Robotic manipulators for minimally invasive surgeries have traditionally been rigid, with a steerable end effector. While the rigidity of manipulators improve precision and controllability, it limits reachability and dexterity in constrained environments. Soft manipulators with controllable stiffness on the other hand, can be deployed in single port or natural orifice surgical applications to reach a wide range of areas inside the body, while being able to passively adapt to uncertain external forces, adapt the stiffness distribution to suit the kinematic and dynamic requirements of the task, and provide flexibility for configuration control. Here, we present the design of a snake-like laboratory made soft robot manipulator of 20 mm in average diameter, which can actuate, soften, or stiffen joints independently along the length of the manipulator by combining granular jamming with McKibben actuators. It presents a comprehensive study on the relative contributions of the granule size, material type, and membrane coupling on the range, profile, and variability of stiffness.

To address the challenges with real-time accurate modeling of multisegment continuum manipulators in the presence of significant external and body loads, we introduce a novel series solution for variable-curvature Cosserat rod static and Lagrangian dynamic methods. By combining a modified Lagrange polynomial series solution, based on experimental observations, with Ritz and Ritz-Galerkin methods, the infinite modeling state space of a continuum manipulator is minimized to geometrical position of a handful of physical points (in our case two). As a result, a unified easy to implement vector formalism is proposed for the nonlinear impedance and configuration control. We showed that by considering the mechanical effects of highly elastic axial deformation, the model accuracy is increased up to 6%. The proposed model predicts experimental results with 6%-8% (4-6 mm) mean error for the Ritz-Galerkin method in static cases and 16%-20% (12-14 mm) mean error for the Ritz method in dynamic cases, in planar and general three-dimensional motions. Comparing to five different models in the literature, our approximate solution is shown to be more accurate with the smallest possible number of modeling states and suitable for real-time modeling, observation, and control applications.

Soft robotics for medical, endoscopic applications requires a dexterous and compliant mechanism to increase accessibility and decrease patient injury. However, soft structures do not offer the level of image and platform stability provided by rigid structures. Thus, a variable stiffness mechanism is an ideal solution to reconcile the two requirements of compliance and stability; the mechanism explored here is granular jamming. Granular jamming is a phenomenon in which particulate matter within a membrane can transition from a fluidlike to a solidlike state, based on the level of applied vacuum pressure. In the solidlike jammed state, the conventional assumption is made that granule–granule contacts dominantly contribute to the system's stiffness. Thus, many works have evaluated the effects of different granule types by experimentally varying the sizes, shapes, and material properties of the particles. However, the role of the membrane in determining the possible range of stiffness or the variability of granular jamming has not been well studied. This article investigates the effects and significance of membranes for a granular jamming system. Several membranes were experimentally tested and analyzed in order to find the amount of flexibility and stiffness they provide when the system is in an unjammed and jammed state, respectively. This article presents for the first time that the membrane plays a significant contributing factor in granular jamming stiffness.