A few decades ago, robotics started to be implemented in the medical field, especially in the rehabilitation of patients with different neurological diseases that have led to neuromuscular disorders. The main concern regarding medical robots is their safety assurance in the medical environment. The goal of this paper is to assess the risk of a medical robotic system for elbow and wrist rehabilitation in terms of robot and patient safety. The approached risk assessment follows the ISO12100:2010 risk management chart in order to determine, identify, estimate, and evaluate the possible risk that can occur during the use of the robotic system. The result of the risk assessment process is further analyzed using a fuzzy logic system in order to determine the safety degree conferred during the use of the robotic system. The innovative process concerning the risk assessment allows the achievement of a reliable medical robotic system both for the patient and the clinicians as well. The clinical trials performed on a group of 18 patients validated the functionality and the safe behavior of the robotic system.

This paper is focused on the development of a control system, implemented on a parallel robot designed for the lower limb rehabilitation of bedridden stroke survivors. The paper presents the RECOVER robotic system kinematics, further implemented into the control system, which is described in terms of architecture and functionality. Through a battery of experimental tests, achieved in laboratory conditions using eight healthy subjects, the feasibility and functionality of the proposed robotic system have been validated, and the overall performance of the control system has been studied. The range of motion of each targeted joint has been recorded using a commercially available external sensor system. The kinematic parameters, namely the patient’s joints velocities and accelerations have been recorded and compared to the ones obtained using the virtual model, yielding a very small difference between them, which provides a validation of the RECOVER initial design, both in terms of mechanical construction and control system.

The problem: Single-incision surgery is a complex procedure in which any additional information automatically collected from the operating field can be of significance. While the use of robotic devices has greatly improved surgical outcomes, there are still many unresolved issues. One of the major surgical complications, with higher occurrence in cancer patients, is intraoperative hemorrhages, which if detected early, can be more efficiently controlled. Aim: This paper proposes a hazard detection system which incorporates the advantages of both Artificial Intelligence (AI) and Augmented Reality (AR) agents, capable of identifying, in real-time, intraoperative bleedings, which are subsequently displayed on a Hololens 2 device. Methods: The authors explored the different techniques for real-time processing and determined, based on a critical analysis, that YOLOv5 is one of the most promising solutions. An innovative, real-time, bleeding detection system, developed using the YOLOv5 algorithm and the Hololens 2 device, was evaluated on different surgical procedures and tested in multiple configurations to obtain the optimal prediction time and accuracy. Results: The detection system was able to identify the bleeding occurrence in multiple surgical procedures with a high rate of accuracy. Once detected, the area of interest was marked with a bounding box and displayed on the Hololens 2 device. During the tests, the system was able to differentiate between bleeding occurrence and intraoperative irrigation; thus, reducing the risk of false-negative and false-positive results. Conclusion: The current level of AI and AR technologies enables the development of real-time hazard detection systems as efficient assistance tools for surgeons, especially in high-risk interventions.

This paper presents a study regarding the design and the experimental setup of a medical robotic system for brachytherapy using tribology analysis. The robotic system is composed of a collaborative robotic arm and a multi-needle brachytherapy instrument controlled using a unified control system embedding a haptic device and force-feedback. This work is oriented towards identifying the technical characteristics of the system components to determine the accuracy of the procedure, as well as using different scenarios for needle insertion in ex vivo porcine liver tissue in order to determine the forces required for insertion and extraction of the needle and the friction coefficient that accompanies the previously mentioned forces. Subsequent to the computation of the friction forces, the normal forces and the wear during the needle insertion are determined with the scope of predicting the lifecycle of some components of the medical device.

Motor disability is a key feature of many neurological diseases, influencing the social roles of affected patients and their ability to perform daily life activities. Current rehabilitation capacities are overwhelmed by the age-related increase of motor dysfunctions seen, for example, in stroke, extrapyramidal or neuromuscular diseases. As the patient to rehabilitation personnel ration increases, robotic solutions might establish the possibility to rapidly satisfy the increasing demand for rehabilitation. This paper presents an inaugural exploratory study which investigates the interchangeability of a novel experimental robotic rehabilitation device system with classical physical therapy, using a multimodal neurophysiological assessment of the motor system—quantitative electroencephalogram (EEG), motor conduction times and turn/amplitude analysis. Preliminary results show no significant difference between the two methods; however, a significant effect of the therapy was found on different pathologies (beneficial for vascular and extrapyramidal, or limited, and only on preventing reduction of joint movements in neuromuscular).

Hepatic cancers represent an important worldwide health issue where surgery alone in most cases is not a feasible therapeutic solution since most tumors are non-resectable. Despite targeted therapies showing positive results in other areas of cancer treatment, in the case of liver tumors, no low-risk delivery methods have been identified. Based on a risk assessment approach, this paper proposes a technical solution in the form of a robotic system capable of achieving a reliable delivery method for targeted treatment, focusing on the patient safety and therapeutic efficiency. The design of the robotic system starts from the definition of the design constraints with respect to the medical protocol. An analytical hierarchy process is used to prioritize the data correlated with the technical characteristics of a new robotic system, aiming to minimize risks associated with the medical procedure. In a four-phase quality function deployment, the technical solution is evaluated with respect to the quality characteristics, functions, subsystems, and components aiming to achieve a safe and reliable system with high therapeutic efficiency. The results lead to the concept of HeRo, a parallel robotic system for the reliable targeted treatment of non-resectable liver tumors.