Minimally invasive endovascular procedures use catheters that are guided through blood vessels to perform interventions, resulting in an inevitable frictional interaction between the catheter and the vessel walls. While this friction enhances stability during the intervention, it poses a risk of damaging the inner layer of the blood vessel wall during navigation, leading to post-operative complications including infectious diseases and thrombus formation. To mitigate the risk of adverse complications, we propose a new concept of a variable-friction catheter capable of transitioning from low friction during navigation to high friction for increased stability while performing the intervention. This variable-friction catheter leverages ultrasonic lubrication to actively control the frictional forces experienced by the catheter during the procedure. In this paper, we demonstrate a proof-of-concept for a friction control module, a pivotal component of the proposed catheter design. Our experiments demonstrate that the prototype effectively reduce friction by up to 11% and 60%, on average, on soft and rigid surfaces, representing its potential performance on healthy and calcified tissue, respectively. This result underscores the feasibility of the design and its potential to improve the safety and efficacy of minimally invasive endovascular procedures.

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The success rate of spinal fusion surgery is mainly determined by the fixation strength of the spinal bone anchors. This study explores the use of an L-shaped spinal bone anchor that is intended to establish a macro-shape lock with the posterior cortical layer of the vertebral body, thereby increasing the pull-out resistance of the anchor. The performance of this L-shaped anchor was evaluated in lumbar vertebra phantoms (L1-L5) across four distinct perpendicular orientations (lateral, medial, superior, and inferior). During the pull-out experiments, the pull-out force, and the displacement of the anchor with respect to the vertebra was measured which allowed the determination of the maximal pull-out force (mean: 123 N ± 25 N) and the initial pull-out force, the initial force required to start motion of the anchor (mean: 23 N ± 16 N). Notably, the maximum pull-out force was observed when the anchor engaged the cortical bone layer. The results demonstrate the potential benefits of utilising a spinal bone anchor featuring a macro-shape lock with the cortical bone layer to increase the pull-out force. Combining the macro shape-lock fixation method with the conventional pedicle screw shows the potential to significantly enhance the fixation strength of spinal bone anchors.@en

Soft robots are intrinsically capable of adapting to different environments by changing their shape in response to interaction forces. However, sensory feedback is still required for higher level decisions. Most sensing technologies integrate separate sensing elements in soft actuators, which presents a considerable challenge for both the fabrication and robustness of soft robots. Here we present a versatile sensing strategy that can be retrofitted to existing soft fluidic devices without the need for design changes. We achieve this by measuring the fluidic input that is required to activate a soft actuator during interaction with the environment, and relating this input to its deformed state. We demonstrate the versatility of our strategy by tactile sensing of the size, shape, surface roughness and stiffness of objects. We furthermore retrofit sensing to a range of existing pneumatic soft actuators and grippers. Finally, we show the robustness of our fluidic sensing strategy in closed-loop control of a soft gripper for sorting, fruit picking and ripeness detection. We conclude that as long as the interaction of the actuator with the environment results in a shape change of the interval volume, soft fluidic actuators require no embedded sensors and design modifications to implement useful sensing.

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Engineers frequently aim to streamline environmental factors to facilitate the effective operation of robots. However, in nature, environmental considerations play a crucial role in shaping the embodiment of organisms. To comply robots with the complexity of real-world environments, embedding similar intelligence is key. In the field of soft robotics, various approaches offer insight into how intelligence can be integrated into artificial agents. A discussed topic is the intricate relationship between the brain and the body at the core of intelligence in robots. The goal of this article is, therefore, to unravel the strategies to implement different types of intelligence currently adopted in soft robots. A classification is made by making a distinction between agents that adapt to their environment by 1) their adaptive shape, 2) their adaptive functionality, and 3) their adaptive mechanics. Additionally, the perspectives on intelligence based on their computational approach are distinguished: centralized computation, decentralized computation, or embedded computation. It is concluded that a tailored robotic design approach attuned to specific environmental demands is needed. To unlock the full potential of soft robots, a fresh perspective on embodied intelligence is described, so-called mechanical intelligence, emphasizing the robot's responsiveness to changing external conditions of a real-world environment.@en

Robotics is entering our daily lives. The discipline is increasingly crucial in fields such as agriculture, medicine, and rescue operations, impacting our food, health, and planet. At the same time, it is becoming evident that robotic research must embrace and reflect the diversity of human society to address these broad challenges effectively. In recent years, gender inclusivity has received increasing attention, but it still remains a distant goal. In addition, awareness is rising around other dimensions of diversity, including nationality, religion, and politics. Unfortunately, despite the efforts, empirical evidence shows that the field has still a long way to go before achieving a sufficient level of equality, diversity, and inclusion across these spectra. This study focuses on the soft robotics community?a growing and relatively recent subfield?and it outlines the present state of equality and diversity panorama in this discipline. The article argues that its high interdisciplinary and accessibility make it a particularly welcoming branch of robotics. We discuss the elements that make this subdiscipline an example for the broader robotic field. At the same time, we recognize that the field should still improve in several ways and become more inclusive and diverse. We propose concrete actions that we believe will contribute to achieving this goal, and provide metrics to monitor its evolution.@en

Introduction: This study focuses on the quantification of and current guidelines on the hazards related to needle positioning in prostate cancer treatment: (1) access restrictions to the prostate gland by the pubic arch, so-called Pubic Arch Interference (PAI) and (2) needle positioning errors. Next, we propose solution strategies to mitigate these hazards. Methods: The literature search was executed in the Embase, Medline ALL, Web of Science Core Collection*, and Cochrane Central Register of Controlled Trials databases. Results: The literature search resulted in 50 included articles. PAI was reported in patients with various prostate volumes. The level of reported PAI varied between 0 and 22.3 mm, depending on the patient’s position and the measuring method. Low-Dose-Rate Brachytherapy induced the largest reported misplacement errors, especially in the cranio-caudal direction (up to 10 mm) and the largest displacement errors were reported for High-Dose-Rate Brachytherapy in the cranio-caudal direction (up to 47 mm), generally increasing over time. Conclusions: Current clinical guidelines related to prostate volume, needle positioning accuracy, and maximum allowable PAI are ambiguous, and compliance in the clinical setting differs between institutions. Solutions, such as steerable needles, assist in mitigating the hazards and potentially allow the physician to proceed with the procedure. This systematic review was performed in accordance with the PRISMA guidelines. The review was registered at Protocols.io (DOI: dx.doi.org/10.17504/protocols.io.6qpvr89eplmk/v1).

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This review explores the present knowledge of the unique properties of shark skin and possible applications of its functionalities, including drag reduction and swimming efficiency. Tooth-like denticles, with varied morphologies, sizes, and densities across the shark's body, significantly influence the flow and interaction of fluids. Examining dermal denticle morphology, this study unveils the functional properties of real shark skin, including mechanical properties such as stiffness, stress–strain characteristics, and denticle density's impact on tensile properties. The adaptive capabilities of the Mako shark scales, especially in high-speed swimming, are explored, emphasizing their passive flow-actuated dynamic micro-roughness. This research contains an overview of various studies on real shark skin, categorizing them into skin properties, morphology, and hydrodynamics. The paper extends exploration into industrial applications, detailing fabrication techniques and potential uses in vessels, aircraft, and water pipes for friction reduction. Three manufacturing approaches, bio-replicated forming, direct fabrication, and indirect manufacturing, are examined, with 3D printing and photoconfiguration technology emerging as promising alternatives. Investigations into the mechanical properties of shark skin fabrics reveal the impact of denticle size on tensile strength, stress, and strain. Beyond drag reduction, the study highlights the shark skin's role in enhancing thrust and lift during locomotion. The paper identifies future research directions, emphasizing live shark testing and developing synthetic skin with the help of 3D printing incorporating the bristling effect.@en

Suction grippers offer a distinct advantage in their ability to handle a wide range of items. However, attaching these grippers to irregular and rough surfaces presents an ongoing challenge. To address this obstacle, this study explores the integration of magnetic intelligence into a soft suction gripper design, enabling fast external magnetic actuation of the attachment process. Additionally, miniaturization options are enhanced by implementing a compliant deploying mechanism. The resulting design is the first-of-its-kind magnetically-actuated deployable suction gripper featuring a thin magnetic membrane (Ø 50 mm) composed of carbonyl iron particles embedded in a silicone matrix. This membrane is supported by a frame made of superelastic nitinol wires that facilitate deployment. During experiments, the proof-of-principle prototype demonstrates successful attachment on a diverse range of curved surfaces in both dry and wet environments. The gripper achieves attachment on curved surfaces with radii of 50-75 mm, exerting a maximum attachment force of 2.89 ± 0.54 N. The current gripper design achieves a folding percentage of 75%, enabling it to fit into a Ø 12.5 mm tube and access hard-to-reach areas while maintaining sufficient surface area for attachment forces. The proposed prototype serves as a foundational steppingstone for further research in the development of reliable and effective magnetically-actuated suction grippers across various configurations. By addressing the limitations of attachment to irregular surfaces and exploring possibilities for miniaturization and precise control, this study opens new avenues for the practical application of suction grippers in diverse industries and scenarios.

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Metal additive manufacturing is a promising technology for the production of functional medical products, due to its high shape complexity and resolution, and ability to withstand sterilization temperatures. This study explores the possibility of designing a completely non-assembly steerable surgical instrument using Selective Laser Melting. Despite its advantages for medical devices, the rough surface quality of unfinished parts can be problematic for non-assembly designs, leading to increased friction and wear in rigid body mechanisms and tendon-actuated mechanisms. We investigated printing of rolling contact joints with crossed flexures as low-friction joints, adjusted for printing in titanium for the design of the instrument. Grid-based lattice structures were incorporated as miniature flexures, and we explored the influence of various grid sizes on the flexibility and bending stiffness of the lattices. Based on this exploration, we altered the rolling joint configuration from two crossed flexures to a single straight flexure for our design. The resulting steerable surgical instrument design is completely non-assembly, including its actuation, facilitates easy removal of support structures, and requires no surface finishing steps. It has a diameter of less than 20 mm, facilitates opening and closing of a grasper, and steering of the grasper by 20 degrees.

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Transperineal laser ablation is a minimally invasive thermo-ablative treatment for prostate cancer that requires the insertion of a needle for accurate optical fiber positioning. Needle insertion in soft tissues may cause tissue motion and deformation, resulting in tissue damage and needle positioning errors. In this study, we present a wasp-inspired self-propelled needle that uses pneumatic actuation to move forward with zero external push force, thus avoiding large tissue motion and deformation. The needle consists of six parallel 0.25-mm diameter Nitinol rods driven by a pneumatic actuation system. The pneumatic actuation system consists of Magnetic Resonance (MR) safe 3D-printed parts and off-the-shelf plastic screws. A self-propelled motion is achieved by advancing the needle segments one by one, followed by retracting them simultaneously. The advancing needle segment has to overcome a cutting and friction force, while the stationary needle segments experience a friction force in the opposite direction. The needle self-propels through the tissue when the friction force of the five stationary needle segments overcomes the sum of the friction and cutting forces of the advancing needle segment. We evaluated the prototype’s performance in 10-wt% gelatin phantoms and ex vivo porcine liver tissue inside a preclinical Magnetic Resonance Imaging (MRI) scanner in terms of the slip ratio of the needle with respect to the phantom or liver tissue. Our results demonstrated that the needle was able to self-propel through the phantom and liver tissue with slip ratios of 0.912–0.955 and 0.88, respectively. The prototype is a promising step toward the development of self-propelled needles for MRI-guided transperineal laser ablation as a method to treat prostate cancer.@en

In the field of Additive Manufacturing, four-dimensional (4D) printing has emerged as a promising technique to fabricate smart structures capable of undergoing shape morphing in response to specific stimuli. Magnetic stimulation offers a safe, remote, and rapid actuation mechanism for magnetically responsive structures. This review provides a comprehensive overview of the various strategies and manufacturing approaches employed in the development of magnetically stimulated shape morphing 4D-printed structures, based on an extensive literature search. The review explores the use of magnetic stimulation either individually or in combination with other stimuli. While most of the literature focuses on single-stimulus responsive structures, a few examples of multistimuli responsive structures are also presented. We investigate the influence of the orientation of magnetic particles in smart material composites, which can be either random or programmed during or after printing. Finally, the similarities and differences among the different strategies and their impact on the resulting shapemorphing behavior are analyzed. This systematic overview functions as a guide for readers in selecting a manufacturing approach to achieve a specific magnetically actuated shape-morphing effect.

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Pipelines, vital for fluid transport, pose an important yet challenging inspection task, particularly in small, flexible biological systems, that robots have yet to master. In this study, we explored the development of an innovative robot inspired by the ovipositor of parasitic wasps to navigate and inspect pipelines. The robot features a flexible locomotion system that adapts to different tube sizes and shapes through a mechanical inflation technique. The flexible locomotion system employs a reciprocating motion, in which groups of three sliders extend and retract in a cyclic fashion. In a proof-of-principle experiment, the robot locomotion efficiency demonstrated positive linear correlation (r = 0.6434) with the diameter ratio (ratio of robot diameter to tube diameter). The robot showcased a remarkable ability to traverse tubes of different sizes, shapes and payloads with an average of (70%) locomotion efficiency across all testing conditions, at varying diameter ratios (0.7 1.5). Furthermore, the mechanical inflation mechanism displayed substantial load-carrying capacity, producing considerable holding force of (13 N), equivalent to carrying a payload of (≈5.8 Kg) inclusive the robot weight. This soft robotic system shows promise for inspection and navigation within tubular confined spaces, particularly in scenarios requiring adaptability to different tube shapes, sizes, and load-carrying capacities. The design of this system serves as a foundation for a new class of pipeline inspection robots that exhibit versatility across various pipeline environments, potentially including biological systems.

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Introduction: Bone biopsies have great value for the diagnosis of, amongst others, hematologic diseases. Although the bone biopsy procedure is mostly performed minimally invasive with the use of a slender cannula, the patient may still experience discomfort, especially when the procedure has to be repeated due to an unsuccessful biopsy. Areas covered: This review presents a comprehensive overview of bone biopsy devices presented in the patent literature. The patents were obtained using a classification search combined with keywords in the Espacenet patent database and were subsequently verified using pre-set eligibility criteria. This resulted in 62 unique patents included in this review. Expert opinion: The included patents were categorized based on the used strategies for the three steps that can be identified during a bone biopsy (1) biopsy sampling, (2) biopsy severing and (3) biopsy harvesting. Most patents described strategies for multiple steps. Insight into the used strategies and the comprehensive overview may serve as a source of inspiration for the design of novel bone biopsy devices.

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In the medical field, it is essential to remove delicate tissues from the body without damaging them or disturbing the surroundings. Current tissue transport mechanisms depend on the tissue composition and shape of the transported tissue, which results in problems such as clogging. This study presents a soft transportation mechanism for tissues inspired by the longitudinal muscles associated with the peristaltic movement of the gastrointestinal tract. The mechanism is designed as a conveying toroid that turns itself inside out in a continuous motion. A fabrication method was developed to manufacture a small-sized silicone toroid, filled with lubricating liquid. Comparable to the peristaltic movement, the silicone toroid adapts its shape to the transported tissue which results in a soft seal around the tissue. The toroid conveys the tissue while locking it at a stationary spot. A prototype was built to evaluate the transport efficiency of the conveying toroid in differently curved pathways. The preliminary experiments showed good transport efficiency, revealing the potential of the proposed soft transport mechanism for medical, and other transport applications.@en

Parts produced with metal additive manufacturing often suffer from a poor surface finish. Surface finishing techniques are effective to improve the quality of 3D printed surfaces, however they have as downsides that they also slightly change the geometry of the part, in an unpredictable way. This effect on the geometrical features of complex parts has received little attention. In this research, we illustrate a method to visualize the impact of surface finishing techniques on geometrical features, as well as their effectiveness on parts with high shape-complexity, by using centrifugal disk finishing as a case study. We designed and 3D printed test parts with different features using selective laser melting, which were coated with a blue metal lacquer prior to polishing. After polishing, the blue lacquer was eroded away from the spots that were easily reached by the polishing process, yet had remained on the surfaces that could not be reached by the process. We used measurements of material removal and image processing of the remaining blue lacquer on the surfaces to analyze these effects. Using this method, we were able to derive a number of specific design guidelines that can be incorporated while designing metal AM parts for centrifugal disk finishing. We suggest that this visualization method can be applied to different polishing methods to gain insight into their influence, as well as being used as an aid in the design process.

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Introduction Tissue extraction plays a crucial role in various medical disciplines, with aspiration catheters serving as the prevailing method. Unfortunately, these catheters face limitations such as clogging and dependence on tissue properties and device dimensions. Therefore, there is a pressing need for an improved tissue extraction device that enables efficient and reliable tissue removal during Minimally Invasive Surgery (MIS). Methods In this study, we present a novel tissue transport system that utilizes a cylindrical conveyor belt mechanism for reliable tissue transportation. We conducted experiments using a proof-of-principle prototype to explore the influence of tissue elasticity, rotational velocity, instrument orientation, and tissue shape on the transportation rate, efficiency, and reliability. Tissue phantoms with gelatine concentrations of 3, 9, and 12 wt% were employed to simulate a range of Young’s moduli from 1 to 110 kPa. Results The mean transportation rates for these phantoms were 7.75±0.48, 8.43±1.50, and 8.90±0.56 g/min, respectively. Notably, all phantoms were transported successfully. The perfect reliability exhibited underscores the potential of our instrument as an alternative to aspiration catheters. Conclusion This research presents a significant step forward in the field of tissue extraction, offering a promising approach for MIS with enhanced efficiency and reliability. @en

The fixation strength of pedicle screws could be increased by fixating along the much stronger cortical bone layer, which is not possible with the current rigid and straight bone drills. Inspired by the tsetse fly, a single-plane steerable bone drill was developed. The drill has a flexible transmission using two stacked leaf springs such that the drill is flexible in one plane and can drill along the cortical bone layer utilizing wall guidance. A proof-of-principle experiment was performed which showed that the Tsetse Drill was able to successfully drill through 5, 10 and 15 PCF cancellous bone phantom which has similar mechanical properties to severe osteoporotic, osteoporotic and healthy cancellous bone. Furthermore, the Tsetse Drill was able to successfully steer and drill along the cortical wall utilizing wall guidance for an insertion angle of 5°, 10° and 15°. The experiments conclude that the tsetse fly-inspired drilling method is successful and even allows the drilling along the cortical bone layer. The Tsetse Drill can create curved tunnels utilizing wall guidance which could increase the fixation strength of bone anchors and limit the risk of cortical breach and damage to surrounding anatomy.@en

Gripping slippery and flexible tissues during minimal invasive surgery (MIS) is often challenging using a conventional tissue gripper. A force grip has to compensate for the low friction coefficient between the gripper’s jaws and the tissue surface. This study focuses on the development of a suction gripper. This device applies a pressure difference to grip the target tissue without the need to enclose it. Inspiration is taken from biological suction discs, as these are able to attach to a wide variety of substrates, varying from soft and slimy surfaces to rigid and rough rocks. Our bio-inspired suction gripper is divided into two main parts: (1) the suction chamber inside the handle where vacuum pressure is generated, and (2) the suction tip that attaches to the target tissue. The suction gripper fits through a ∅ 10 mm trocar and unfolds in a larger suction surface when being extracted. The suction tip is structured in a layered manner. The tip integrates five functions in separate layers to allow for safe and effective tissue handling: (1) foldability, (2) air-tightness, (3) slideability, (4) friction magnification and (5) seal generation. The contact surface of the tip creates an air-tight seal with the tissue and enhances frictional support. The suction tip’s shape grip allows for the gripping of small tissue pieces and enhances its resistance against shear forces. The experiments illustrated that our suction gripper outperforms man-made suction discs, as well as currently described suction grippers in literature in terms of attachment force ( 5.95 ± 0.52 N on muscle tissue) and substrate versatility. Our bio-inspired suction gripper offers the opportunity for a safer alternative to the conventional tissue gripper in MIS.

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Transverse vibrations can induce the non-linear compression of a thin film of air to levitate objects, via the squeeze-film effect. This phenomenon is well captured by the Reynolds' lubrication theory; however, the same theory fails to describe this levitation when the fluid is incompressible. In this case, the computation predicts no steady-state levitation, contradicting the documented experimental evidence. In this Letter, we uncover the main source of the time-averaged pressure asymmetry in the incompressible fluid thin film, leading the levitation phenomenon to exist. Furthermore, we reveal the physical law governing the steady-state levitation height, which we confirm experimentally.

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A vitrectome is a commonly used instrument in eye surgery, which is used to cut and aspirate the vitreous body out of the eye. The mechanism of the vitrectome consists of miniature components that need to be assembled by hand due to their size. Non-assembly 3D printing, in which fully functional mechanisms can be produced in a single production step, can help create a more streamlined production process. We propose a vitrectome design based on a dual-diaphragm mechanism, which can be produced with minimal assembly steps using PolyJet printing. Two different diaphragm designs were tested to fulfill the requirements of the mechanism: a homogenous design based on ‘digital’ materials and a design using an ortho-planar spring. Both designs were able to fulfill the required displacement for the mechanism of 0.8 mm, as well as cutting forces of at least 8 N. The requirements for the cutting speed of the mechanism of 8000 RPM were not fulfilled by both designs, since the viscoelastic nature of the PolyJet materials resulted in a slow response time. The proposed mechanism does show promise to be used in vitrectomy; however, we suggest that more research into different design directions is required. @en