The evolution of robotics:research and application progress of dental implant robotic systems

The use of robots to augment human capabilities and assist in work has long been an aspiration.Robotics has been developing since the 1960s when the first industrial robot was introduced.As technology has advanced,robotic-assisted surgery has shown numerous advantages,including more precision,efficiency,minimal invasiveness,and safety than is possible with conventional techniques,which are research hotspots and cutting-edge trends.This article reviewed the history of medical robot development and seminal research papers about current research progress.Taking the autonomous dental implant robotic system as an example,the advantages and prospects of medical robotic systems would be discussed which would provide a reference for future research.

Treatment of hemolymphangioma by robotic surgery: A case report

BACKGROUND Hemolymphangioma of the jejunum is rare and lacks clinical specificity,and can manifest as gastrointestinal bleeding,abdominal pain,and intestinal obstruction.Computed tomography,magnetic resonance imaging,and other examinations show certain characteristics of the disease,but lack accuracy.Although capsule endoscopy and enteroscopy make up for this deficiency,the diagnosis also still re-quires pathology.CASE SUMMARY A male patient was admitted to the hospital due to abdominal distension and abdominal pain,but a specific diagnosis by computed tomography examination was not obtained.Partial resection of the small intestine was performed by robotic surgery,and postoperative pathological biopsy confirmed the diagnosis of hemo-lymphangioma.No recurrence in the follow-up examination was observed.CONCLUSION Robotic surgery is an effective way to treat hemolymphangioma through minima-lly invasive techniques under the concept of rapid rehabilitation.

Summarizing the evidence for robotic-assisted bladder neck reconstruction: Systematic review of patency and incontinence outcomes

Objective:Bladder neck contracture and vesicourethral anastomotic stenosis are difficult to manage endoscopically,and open repair is associated with high rates of incontinence.In recent years,there have been increasing reports of robotic-assisted bladder neck reconstruction in the literature.However,existing studies are small,heterogeneous case series.The objective of this study was to perform a systematic review of robotic-assisted bladder neck reconstruction to better evaluate patency and incontinence outcomes.Methods:We performed a systematic review of PubMed from first available date to May 2023 for all studies evaluating robotic-assisted reconstructive surgery of the bladder neck in adult men.Articles in non-English,author replies,editorials,pediatric-based studies,and reviews were excluded.Outcomes of interest were patency and incontinence rates,which were pooled when appropriate.Results:After identifying 158 articles on initial search,we included only ten studies that fit all aforementioned criteria for robotic-assisted bladder neck reconstruction.All were case series published from March 2018 to March 2022 ranging from six to 32 men,with the median follow-up of 5e23 months.A total of 119 patients were included in our analysis.A variety of etiologies and surgical techniques were described.Patency rates ranged from 50%to 100%,and pooled patency was 80%(95/119).De novo incontinence rates ranged from 0%to 33%,and pooled incontinence was 17%(8/47).Our findings were limited by small sample sizes,relatively short follow-ups,and heterogeneity between studies.

Robotic surgery in living liver donors and liver recipients

There have been nearly 60 years since Thomas Starzl’s first liver transplant.During this period,advancements in medical technology have progressively enabled the adoption of new methods for transplantation.Among these innovations,robotic surgery has emerged in recent decades and is gradually being integrated into transplant medicine.Robotic hepatectomy and liver implantation represent significant advancements in the field of transplant surgery.The precision and minimally invasive nature of robotic surgery offer substantial benefits for both living donors and recipients.In living donors,robotic hepatectomy reduces postoperative pain,minimizes scarring,and accelerates recovery.For liver recipients,robotic liver implantation enhances surgical accuracy,leading to better graft positioning and vascular anastomosis.Robotic systems provide more precise and maneuverable control of instruments,allowing surgeons to perform complex procedures with greater accuracy and reduced risk to patients.This review encompasses publications on minimally invasive donor liver surgery,with a specific focus on robotic liver resection in transplantation,and aims to summarize current knowledge and the development status of robotic surgery in liver transplantation,focusing on liver resection in donors and graft implantation in recipients.

Managerial perspectives of scaling up robotic-assisted surgery in healthcare systems:A systematic literature review

Objectives Robotic-assisted surgery(RAS)is a minimally invasive technique practiced in multiple specialties.Standard training is essential for the acquisition of RAS skills.The cost of RAS is considered to be high,which makes it a burden for institutes and unaffordable for patients.This systematic literature review(SLR)focused on the various RAS training methods applied in different surgical specialties,as well as the cost elements of RAS,and was to summarize the opportunities and challenges associated with scaling up RAS.Methods An SLR was carried out based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses reporting guidelines.The PubMed,EBSCO,and Scopus databases were searched for reports from January 2018 through January 2024.Full-text reviews and research articles in the English language from Asia-Pacific countries were included.Articles that outlined training and costs associated with RAS were chosen.Results The most common training system is the da Vinci system.The simulation technique,which includes dry-lab,wet-lab,and virtual reality training,was found to be a common and important practice.The cost of RAS encompasses the installation and maintenance costs of the robotic system,the operation theatre rent,personnel cost,surgical instrument and material cost,and other miscellaneous charges.The synthesis of SLR revealed the challenges and opportunities regarding RAS training and cost.Conclusions The results of this SLR will help stakeholders such as decision-makers,influencers,and end users of RAS to understand the significance of training and cost in scaling up RAS from a managerial perspective.For any healthcare innovation to reach a vast population,cost-effectiveness and standard training are crucial.

Assistive Robotics for Upper Limb Physical Rehabilitation:A Systematic Review and Future Prospects

Physical assistive robotics are oriented to support and improve functional capacities of people.In physical rehabilitation,robots are indeed useful for functional recovery of affected limb.However,there are still open questions related to technological aspects.This work presents a systematic review of upper limb rehabilitation robotics in order to analyze and establish technological challenges and future directions in this area.A bibliometric analysis was performed for the systematic literature review.Literature from the last six years,conducted between August 2020 and May 2021,was reviewed.The methodology for the literature search and a bibliometric analysis of the metadata are presented.After a preliminary search resulted in 820 articles,a total of 66 articles were included.A concurrency network and bibliographic analysis were provided.And an analysis of occurrences,taxonomy,and rehabilitation robotics reported in the literature is presented.This review aims to provide to the scientific community an overview of the state of the art in assistive robotics for upper limb physical rehabilitation.The literature analysis allows access to a gap of unexplored options to define the technological prospects applied to upper limb physical rehabilitation robotics.

Comment on“Robotic surgery and liver transplantation:A single-center experience of 501 robotic donor hepatectomies”

To the Editor:We read with great interest the article by Schulze et al.entitled“Robotic surgery and liver transplantation:A single-center experience of 501 robotic donor hepatectomies”[1].It is the first single-center report including over 500 fully robotic donor hepatectomies.For the donors,the overall complication rate was 6.4%(n=32).Postoperative self-limiting bleeding(0.4%)and bile leakage from the resection plane(1.8%)were rare.

Deterministic Learning-Based Neural PID Control for Nonlinear Robotic Systems

Traditional proportional-integral-derivative(PID)controllers have achieved widespread success in industrial applications.However,the nonlinearity and uncertainty of practical systems cannot be ignored,even though most of the existing research on PID controllers is focused on linear systems.Therefore,developing a PID controller with learning ability is of great significance for complex nonlinear systems.This article proposes a deterministic learning-based advanced PID controller for robot manipulator systems with uncertainties.The introduction of neural networks(NNs)overcomes the upper limit of the traditional PID feedback mechanism’s capability.The proposed control scheme not only guarantees system stability and tracking error convergence but also provides a simple way to choose the three parameters of PID by setting the proportional coefficients.Under the partial persistent excitation(PE)condition,the closed-loop system unknown dynamics of robot manipulator systems are accurately approximated by NNs.Based on the acquired knowledge from the stable control process,a learning PID controller is developed to further improve overall control performance,while overcoming the problem of repeated online weight updates.Simulation studies and physical experiments demonstrate the validity and practicality of the proposed strategy discussed in this article.

Robotic complete mesocolic excision for right colon cancer:Learning curve,training,techniques,approach,platforms,and future perspectives

Colon cancer has the fifth highest incidence worldwide and has the sixth highest mortality.Compared with rectal cancer,colon cancer currently has the worst 5-year overall survival for patients with stage Ⅱ and Ⅲ disease.Complete mesocolic excision has been developed as a standardized and optimized surgical technique for the excision of colon cancers.This technique has traditionally been performed through an open approach since laparoscopy is generally considered technically challenging.The robotic approach has been slowly implemented for colon cancer,but the newest robotic platforms allow for a safer and optimized approach for right colon cancer.Several robotic approaches have been developed and explored.The expansion of the current robotic platform ecosystem is gradually providing new outputs in the application of the robotic approach to complete mesocolic excision.This review gains an oversight of existing literature on robotic complete mesocolic excision for right colon cancer(learning curve,training,techniques,approach,platforms,and future perspectives).

Long Duration Coverage Control of Multiple Robotic Surface Vehicles Under Battery Energy Constraints

Dear Editor,This letter addresses long duration coverage problem of multiple robotic surface vehicles(RSVs) subject to battery energy constraints,in addition to uncertainties and disturbances. An anti-disturbance energy-aware control method is proposed for performing coverage task of RSVs. Firstly, a centroidal Voronoi tessellation(CVT) is used to optimize the partition of the given coverage area.

Robotic management of urinary fistula

Objectives:To highlight critical preoperative and intraoperative considerations in approaching fistula repair robotically.Methods:A search of the literature was conducted to identify relevant articles pertaining to robotic management of urinary fistulae.Results:Fistulae of the genitourinary tract can be a challenging dilemma for urologists,as definitive management may require surgical intervention.Pathogenesis of both enteric and non-enteric fistulae are multifactorial,and successful repair hinges on the meticulous perioperative evaluation,planning,and execution.Traditional open techniques can subject patients to increased morbidity and prolonged hospitalizations.Since its introduction,the robotic surgical platform has continued to expand its indications.Its three-dimensional visualization and tremor free wristed instrument movements have made the robotic platform an attractive option for genitourinary fistula reconstruction.Conclusion:Robotic management of complex urinary fistulae is feasible in expert hands;more studies are needed to define its role in the treatment algorithm of this devastating conditions.

Robotic versus laparoscopic surgery for sporadic benign insulinoma:Short-and long-term outcomes

Background:Minimally invasive surgery is the optimal treatment for insulinoma.The present study aimed to compare short-and long-term outcomes of laparoscopic and robotic surgery for sporadic benign insulinoma.Methods:A retrospective analysis of patients who underwent laparoscopic or robotic surgery for insulinoma at our center between September 2007 and December 2019 was conducted.The demographic,perioperative and postoperative follow-up results were compared between the laparoscopic and robotic groups.Results:A total of 85 patients were enrolled,including 36 with laparoscopic approach and 49 with robotic approach.Enucleation was the preferred surgical procedure.Fifty-nine patients(69.4%)underwent enucleation;among them,26 and 33 patients underwent laparoscopic and robotic surgery,respectively.Robotic enucleation had a lower conversion rate to laparotomy(0 vs.19.2%,P=0.013),shorter operative time(102.0 vs.145.5 min,P=0.008)and shorter postoperative hospital stay(6.0 vs.8.5 d,P=0.002)than laparoscopic enucleation.There were no differences between the groups in terms of intraoperative blood loss,the rates of postoperative pancreatic fistula and complications.After a median follow-up of 65 months,two patients in the laparoscopic group developed a functional recurrence and none of the patients in the robotic group had a recurrence.Conclusions:Robotic enucleation can reduce the conversion rate to laparotomy and shorten operative time,which might lead to a reduction in postoperative hospital stay.

An Automatic Implementation of Oropharyngeal Swab Sampling for Diagnosing Respiratory Infectious Diseases via Soft Robotic End-Effectors

The most widely adopted method for diagnosing respiratory infectious diseases is to conduct polymerase chain reaction(PCR)assays on patients’respiratory specimens,which are collected through either nasal or oropharyngeal swabs.The manual swab sampling process poses a high risk to the examiner and may cause false-negative results owing to improper sampling.In this paper,we propose a pneumatically actuated soft end-effector specifically designed to achieve all of the tasks involved in swab sampling.The soft end-effector utilizes circumferential instability to ensure grasping stability,and exhibits several key properties,including high load-to-weight ratio,error tolerance,and variable swab-tip stiffness,leading to successful automatic robotic oropharyngeal swab sampling,from loosening and tightening the transport medium tube cap,holding the swab,and conducting sampling,to snapping off the swab tail and sterilizing itself.Using an industrial collaborative robotic arm,we integrated the soft end-effector,force sensor,camera,lights,and remote-control stick,and developed a robotic oropharyngeal swab sampling system.Using this swab sampling system,we conducted oropharyngeal swab-sampling tests on 20 volunteers.Our Digital PCR assay results(RNase P RNA gene absolute copy numbers for the samples)revealed that our system successfully collected sufficient numbers of cells from the pharyngeal wall for respiratory disease diagnosis.In summary,we have developed a pharyngeal swab-sampling system based on an“enveloping”soft actuator,studied the sampling process,and imple-mented whole-process robotic oropharyngeal swab-sampling.

Disorder-to-order transition induced by spontaneous cooling regulation in robotic active matter

In classical matter systems, typical phase-transition phenomena usually stem from changes in state variables, such as temperature and pressure, induced by external regulations such as heat transfer and volume adjustment. However, in active matter systems, the self-propulsion nature of active particles endows the systems with the ability to induce unique collectivestate transitions by spontaneously regulating individual properties to alter the overall states. Based on an innovative robot-swarm experimental system, we demonstrate a field-driven active matter model capable of modulating individual motion behaviors through interaction with a recoverable environmental resource field by the resource perception and consumption.In the simulated model, by gradually reducing the individual resource-conversion coefficient over time, this robotic active matter can spontaneously decrease the overall level of motion, thereby actively achieving a regulation behavior like the cooling-down control. Through simulation calculations, we discover that the spatial structures of this robotic active matter convert from disorder to order during this process, with the resulting ordered structures exhibiting a high self-adaptability on the geometry of the environmental boundaries.

Enabling Technologies for Autonomous Robotic Systems in Manufacturing

Research of autonomous manufacturing systems is motivated both by the new technical possibilities of cyber-physical systems and by the practical needs of the industry.Autonomous operation in semi-structured industrial environments can now be supported by advanced sensor technologies,digital twins,artificial intelligence and novel communication techniques.These enable real-time monitoring of production processes,situation recognition and prediction,automated and adaptive(re)planning,teamwork and performance improvement by learning.This paper summarizes the main requirements towards autonomous industrial robotics and suggests a generic workflow for realizing such systems.Application case studies will be presented from recent practice at HUN-REN SZTAKI in a broad range of domains such as assembly,welding,grinding,picking and placing,and machining.The various solutions have in common that they use a generic digital twin concept as their core.After making general recommendations for realizing autonomous robotic solutions in the industry,open issues for future research will be discussed.

Robotic Surgery: An Effective Treatment Option for Epiphrenic Diverticulum Associated with Nutcracker Esophagus

Background: Epiphrenic Diverticulum is frequently associated with esophageal motility disorders, such as nutcrackers esophagus. The diagnosis is usually made using imaging studies such as a Barium esophagogram, and esophageal manometry. Surgical treatment options for epiphrenic diverticulum and EN include diverticulectomy and wide myotomy. Aim: The resection of three epiphrenic diverticula and extensive myotomy were performed by robotic thoracoscopy uneventfully. Case presentation: A 65-year-old female complaining of dysphagia for solid foods, Chest pain and regurgitation. Esophagogastroduodenoscopy (EDG) with difficulty in advancing the endoscope at 25 cm and demonstrating an ED, no hiatal hernia and normal stomach and duodenum. Barium Esophagogram showed multiple diverticula and tortuosity throughout the esophagus. Conclusion: With robotic surgery, surgeons can perform highly precise operations with enhanced 3D vision and control. Through this cutting-edge approach, the treatment of ED associated with EN can be drastically changed, promising better outcomes for patients.

Generative adversarial networks based motion learning towards robotic calligraphy synthesis

Robot calligraphy visually reflects the motion capability of robotic manipulators.While traditional researches mainly focus on image generation and the writing of simple calligraphic strokes or characters,this article presents a generative adversarial network(GAN)-based motion learning method for robotic calligraphy synthesis(Gan2CS)that can enhance the efficiency in writing complex calligraphy words and reproducing classic calligraphy works.The key technologies in the proposed approach include:(1)adopting the GAN to learn the motion parameters from the robot writing operation;(2)converting the learnt motion data into the style font and realising the transition from static calligraphy images to dynamic writing demonstration;(3)reproducing high-precision calligraphy works by synthesising the writing motion data hierarchically.In this study,the motion trajectories of sample calligraphy images are firstly extracted and converted into the robot module.The robot performs the writing with motion planning,and the writing motion parameters of calligraphy strokes are learnt with GANs.Then the motion data of basic strokes is synthesised based on the hierarchical process of‘stroke-radicalpart-character’.And the robot re-writes the synthesised characters whose similarity with the original calligraphy characters is evaluated.Regular calligraphy characters have been tested in the experiments for method validation and the results validated that the robot can actualise the robotic calligraphy synthesis of writing motion data with GAN.

Oncologic outcomes with and without amniotic membranes in robotic-assisted radical prostatectomy:A propensity score matched analysis

Objective:Placement of human placenta derived grafts during robotic-assisted radical prostatectomy(RARP)hastens the return of continence and potency.The long-term impact on the oncologic outcomes remains to be investigated.Our objective was to determine the oncologic outcomes of patients with dehydrated human amnion chorion membrane(dHACM)at RARP compared to a matched cohort.Methods:In a referral centre,from August 2013 to October 2019,599 patients used dHACM in bilateral nerve-sparing RARP.We excluded patients with less than 12 months follow-up,simple prostatectomy,and unilateral nerve-sparing.Patients with dHACM(amnio group)were 529,and were propensity score matched 1:1 to 2465 patients without dHACM(non-amnio group)and a minimum follow-up of 36 months.At the time of RARP,dHACM was placed around the neurovascular bundle in the amnio group.Continuous and categorical variables in matched groups was tested by two-sample Kolmogorov-Smirnov test and Fisher's exact test respectively.Outcomes measured were biochemical recurrence(BCR),adjuvant and salvage therapy rates.Results:Propensity score matching resulted in two groups of 444 patients.Cumulative incidence functions for BCR did not show a difference between the groups(p=0.3).Patients in the non-amnio group required salvage therapy more frequently than the amnio group,particularly after partial nerve-sparing RARP(6.3%vs.2.3%,p=0.001).Limitations are the absence of prospective randomization.Conclusion:The data suggest that using dHACM does not have a negative impact on BCR in patients.Outcomes of cancer specific and overall survival will require follow-up study to increase our understanding of these grafts’impact on prostate cancer biology.

A Novel Disturbance Observer Based Fixed-Time Sliding Mode Control for Robotic Manipulators With Global Fast Convergence

This paper proposes a new global fixed-time sliding mode control strategy for the trajectory tracking control of uncertain robotic manipulators.First,a fixed-time disturbance observer(FTDO) is designed to deal with the adverse effects of model uncertainties and external disturbances in the manipulator systems.Then an adaptive scheme is used and the adaptive FTDO(AFTDO) is developed,so that the priori knowledge of the lumped disturbance is not required.Further,a new non-singular fast terminal sliding mode(NFTSM) surface is designed by using an arctan function,which helps to overcome the singularity problem and enhance the robustness of the system.Based on the estimation of the lumped disturbance by the AFTDO,a fixed-time non-singular fast terminal sliding mode controller(FTNFTSMC)is developed to guarantee the trajectory tracking errors converge to zero within a fixed time.The settling time is independent of the initial state of the system.In addition,the stability of the AFTDO and FTNFTSMC is strictly proved by using Lyapunov method.Finally,the fixed-time NFESM(FTNFTSM) algorithm is validated on a 2-link manipulator and comparisons with other existing sliding mode controllers(SMCs) are performed.The comparative results confirm that the FTNFTSMC has superior control performance.

Kinematic analysis of flexible bipedal robotic systems

In spite of its intrinsic complexities,the passive gait of bipedal robots on a sloping ramp is a subject of interest for numerous researchers.What distinguishes the present research from similar works is the consideration of flexibility in the constituent links of this type of robotic systems.This is not a far-fetched assumption because in the transient(impact)phase,due to the impulsive forces which are applied to the system,the likelihood of exciting the vibration modes increases considerably.Moreover,the human leg bones that are involved in walking are supported by viscoelastic muscles and ligaments.Therefore,for achieving more exact results,it is essential to model the robot links with viscoelastic properties.To this end,the Gibbs-Appell formulation and Newton's kinematic impact law are used to derive the most general form of the system's dynamic equations in the swing and transient phases of motion.The most important issue in the passive walking motion of bipedal robots is the determination of the initial robot configuration with which the system could accomplish a periodic and stable gait solely under the effect of gravitational force.The extremely unstable nature of the system studied in this paper and the vibrations caused by the impulsive forces induced by the impact of robot feet with the inclined surface are some of the very serious challenges encountered for achieving the above-mentioned goal.To overcome such challenges,an innovative method that uses a combination of the linearized equations of motion in the swing phase and the algebraic motion equations in the transition phase is presented in this paper to obtain an eigenvalue problem.By solving this problem,the suitable initial conditions that are necessary for the passive gait of this bipedal robot on a sloping surface are determined.The effects of the characteristic parameters of elastic links including the modulus of elasticity and the Kelvin-Voigt coefficient on the walking stability of this type of robotic systems are also studied.The findings of this parametric study reveal that the increase in the Kelvin-Voigt coefficient enhances the stability of the robotic system,while the increase in the modulus of elasticity has an opposite effect.