Eighty percent of medical robotics papers have been published in the past decade—What has been accomplished?

In the prosthetics field, one of the most important bottlenecks is still the human-machine interface, namely the socket. Indeed, several amputees still reject their prostheses or report a low satisfaction level, due to factors dealing with the socket-tissues interaction. The aim of this paper is to describe the main parameters (displacements, stress, volume fluctuations and temperature) that affect the stump-socket interface and reduce the comfort of limb prostheses. In the review, a classification of the different socket types proposed in the literature is reported, together with an analysis of advantages and disadvantages of the different solutions, from multiple viewpoints. A specific focus concerns the technological solutions available commercially and in the state-of-the-art to face an altered distribution of stresses on the residual limb tissues, volume fluctuations affecting the stump overtime, and temperature variations affecting the residual tissues within the socket. The open challenges in this research field are highlighted and the possible future routes are discussed, towards the ambitious objective of achieving an advanced socket able to self-adapt in real-time to the complex interplay of factors affecting the stump, during both static and dynamic tasks.

Learning manipulation skills from open surgery provides more flexible access to the organ targets in the abdomen cavity and this could make the surgical robot working in a highly intelligent and friendly manner. Teaching by demonstration (TbD) is capable of transferring the manipulation skills from human to humanoid robots by employing active learning of multiple demonstrated tasks. This work aims to transfer motion skills from multiple human demonstrations in open surgery to robot manipulators in robot-assisted minimally invasive surgery (RA-MIS) by using TbD. However, the kinematic constraint should be respected during the performing of the learned skills by using a robot for minimally invasive surgery. In this article, we propose a novel methodology by integrating the cognitive learning techniques and the developed control techniques, allowing the robot to be highly intelligent to learn senior surgeons' skills and to perform the learned surgical operations in semiautonomous surgery in the future. Finally, experiments are performed to verify the efficiency of the proposed strategy, and the results demonstrate the ability of the system to transfer human manipulation skills to a robot in RA-MIS and also shows that the remote center of motion (RCM) constraint can be guaranteed simultaneously. Note to Practitioners-This article is inspired by limited access to the manipulation of laparoscopic surgery under a kinematic constraint at the point of incision. Current commercial surgical robots are mostly operated by teleoperation, which is representing less autonomy on surgery. Assisting and enhancing the surgeon's performance by increasing the autonomy of surgical robots has fundamental importance. The technique of teaching by demonstration (TbD) is capable of transferring the manipulation skills from human to humanoid robots by employing active learning of multiple demonstrated tasks. With the improved ability to interact with humans, such as flexibility and compliance, the new generation of serial robots becomes more and more popular in nonclinical research. Thus, advanced control strategies are required by integrating cognitive functions and learning techniques into the processes of surgical operation between robots, surgeon, and minimally invasive surgery (MIS). In this article, we propose a novel methodology to model the manipulation skill from multiple demonstrations and execute the learned operations in robot-assisted minimally invasive surgery (RA-MIS) by using a decoupled controller to respect the remote center of motion (RCM) constraint exploiting the redundancy of the robot. The developed control scheme has the following functionalities: 1) it enables the 3-D manipulation skill modeling after multiple demonstrations of the surgical tasks in open surgery by integrating dynamic time warping (DTW) and Gaussian mixture model (GMM)-based dynamic movement primitive (DMP) and 2) it maintains the RCM constraint in a smaller safe area while performing the learned operation in RA-MIS. The developed control strategy can also be potentially used in other industrial applications with a similar scenario.

Digestive diseases are a major burden for society and healthcare systems, and with an aging population, the importance of their effective management will become critical. Healthcare systems worldwide already struggle to insure quality and affordability of healthcare delivery and this will be a significant challenge in the midterm future. Wireless capsule endoscopy (WCE), introduced in 2000 by Given Imaging Ltd., is an example of disruptive technology and represents an attractive alternative to traditional diagnostic techniques. WCE overcomes conventional endoscopy enabling inspection of the digestive system without discomfort or the need for sedation. Thus, it has the advantage of encouraging patients to undergo gastrointestinal (GI) tract examinations and of facilitating mass screening programmes. With the integration of further capabilities based on microrobotics, e.g. active locomotion and embedded therapeutic modules, WCE could become the key-technology for GI diagnosis and treatment. This review presents a research update on WCE and describes the state-of-the-art of current endoscopic devices with a focus on research-oriented robotic capsule endoscopes enabled by microsystem technologies. The article also presents a visionary perspective on WCE potential for screening, diagnostic and therapeutic endoscopic procedures.

Over the past few decades the increased level of public awareness concerning healthcare, physical activities, safety and environmental sensing has created an emerging need for smart sensor technologies and monitoring devices able to sense, classify, and provide feedbacks to users’ health status and physical activities, as well as to evaluate environmental and safety conditions in a pervasive, accurate and reliable fashion. Monitoring and precisely quantifying users’ physical activity with inertial measurement unit-based devices, for instance, has also proven to be important in health management of patients affected by chronic diseases, e.g., Parkinson’s disease, many of which are becoming highly prevalent in Italy and in the Western world. This review paper will focus on MEMS sensor technologies developed in Italy in the last three years describing research achievements for healthcare and physical activity, safety and environmental sensing, in addition to smart systems integration. Innovative and smart integrated solutions for sensing devices, pursued and implemented in Italian research centres, will be highlighted, together with specific applications of such technologies. Finally, the paper will depict the future perspective of sensor technologies and corresponding exploitation opportunities, again with a specific focus on Italy.

The authors present a novel magnetomechanical elastic element that can be loaded remotely by varying the magnetic field surrounding it and that is able to store and release mechanical energy upon external triggering. The magnetic torsion spring (MTS) is used as the core component of a self-contained miniature biopsy capsule (9 mm in diameter and 24 mm long) for random tissue sampling in the small bowel. Thanks to the MTS concept, the biopsy mechanism can be loaded wirelessly by a magnetic field applied from outside the body of the patient. At the same time, magnetic coupling guarantees stabilization against the small bowel tissue during sampling. Extreme miniaturization is possible with the proposed approach since no electronics and no power supply are required onboard.