We use perceptual methods, AI, and frugal robotics innovation to deliver transformative diagnostic and treatment solutions.
Head of Group
B415B Bessemer Building
South Kensington Campus
+44 (0)20 3312 5145
What we do
The HARMS lab leverages perceptually enabled methodologies, artificial intelligence, and frugal innovation in robotics (such as soft surgical robots) to deliver transformative solutions for diagnosis and treatment. Our research is driven by both problem-solving and curiosity, aiming to build a comprehensive understanding of the actions, interactions, and reactions occurring in the operating room. We focus on using robotic technologies to facilitate procedures that are not yet widely adopted, particularly in endoluminal surgery, such as advanced treatments for gastrointestinal cancer.
Meet the team
Results
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Journal articleRobertson D, van Duijn M, Arezzo A, et al., 2023,
The influence of prolonged instrument manipulation on gas leakage through trocars.
, Surg Endosc, Vol: 37, Pages: 7325-7335BACKGROUND: During laparoscopic surgery, CO2 insufflation gas could leak from the intra-abdominal cavity into the operating theater. Medical staff could therefore be exposed to hazardous substances present in leaked gas. Although previous studies have shown that leakage through trocars is a contributing factor, trocar performance over longer periods remains unclear. This study investigates the influence of prolonged instrument manipulation on gas leakage through trocars. METHODS: Twenty-five trocars with diameters ranging from 10 to 15 mm were included in the study. An experimental model was developed to facilitate instrument manipulation in a trocar under loading. The trocar was mounted to a custom airtight container insufflated with CO2 to a pressure of 15 mmHg, similar to clinical practice. A linear stage was used for prolonged instrument manipulation. At the same time, a fixed load was applied radially to the trocar cannula to mimic the reaction force of the abdominal wall. Gas leakage was measured before, after, and during instrument manipulation. RESULTS: After instrument manipulation, leakage rates per trocar varied between 0.0 and 5.58 L/min. No large differences were found between leakage rates before and after prolonged manipulation in static and dynamic measurements. However, the prolonged instrument manipulation did cause visible damage to two trocars and revealed unintended leakage pathways in others that can be related to production flaws. CONCLUSION: Prolonged instrument manipulation did not increase gas leakage rates through trocars, despite damage to some individual trocars. Nevertheless, gas leakage through trocars occurs and is caused by different trocar-specific mechanisms and design issues.
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Conference paperRunciman M, Franco E, Avery J, et al., 2023,
Model based position control of soft hydraulic actuators
, IEEE International Conference on Robotics and Automation, Publisher: IEEE, Pages: 1-7In this article, we investigate the model based position control of soft hydraulic actuators arranged in an an-tagonistic pair. A dynamical model of the system is constructed by employing the port-Hamiltonian formulation. A control algorithm is designed with an energy shaping approach, which accounts for the pressure dynamics of the fluid. A nonlinear observer is included to compensate the effect of unknown external forces. Simulations demonstrate the effectiveness of the proposed approach, and experiments achieve positioning accuracy of 0.043 mm with a standard deviation of 0.033 mm in the presence of constant external forces up to 1 N.
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Conference paperSivananthan A, Kokgas A, Glover B, et al., 2023,
EYE CONTROLLED ENDOSCOPY - A BENCHTOP TRIAL OF A NOVEL ROBOTIC SYSTEM
, Digestive Disease Week (DDW), Publisher: MOSBY-ELSEVIER, Pages: AB770-AB771, ISSN: 0016-5107 -
Conference paperAlian A, Mylonas G, Avery J, 2023,
Soft continuum actuator tip position and contact force prediction, using electrical impedance tomography and recurrent neural networks
, IEEE International Conference on Soft Robotics (RoboSoft), Publisher: IEEE, Pages: 1-6, ISSN: 2769-4534Enabling dexterous manipulation and safe human-robot interaction, soft robotsare widely used in numerous surgical applications. One of the complicationsassociated with using soft robots in surgical applications is reconstructingtheir shape and the external force exerted on them. Several sensor-based andmodel-based approaches have been proposed to address the issue. In this paper,a shape sensing technique based on Electrical Impedance Tomography (EIT) isproposed. The performance of this sensing technique in predicting the tipposition and contact force of a soft bending actuator is highlighted byconducting a series of empirical tests. The predictions were performed based ona data-driven approach using a Long Short-Term Memory (LSTM) recurrent neuralnetwork. The tip position predictions indicate the importance of using EIT dataalong with pressure inputs. Changing the number of EIT channels, we evaluatedthe effect of the number of EIT inputs on the accuracy of the predictions. Theleast RMSE values for the tip position are 3.6 and 4.6 mm in Y and Zcoordinates, respectively, which are 7.36% and 6.07% of the actuator's totalrange of motion. Contact force predictions were conducted in three differentbending angles and by varying the number of EIT channels. The results of thepredictions illustrated that increasing the number of channels contributes tohigher accuracy of the force estimation. The mean errors of using 8 channelsare 7.69%, 2.13%, and 2.96% of the total force range in three different bendingangles.
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Journal articleAvila-Rencoret F, Mylonas G, Elson D, 2023,
Robotic large-area optical biopsy imaging for automated detection of gastrointestinal cancers tested in tissue phantoms and ex vivo porcine bowel
, Translational Biophotonics, Vol: 5, ISSN: 2627-1850Gastrointestinal endoscopy is a subjective procedure that frequently requires tissue samples for diagnosis. Contact optical biopsy (OB) techniques have the aim of providing direct diagnosis of endoscopic areas without excising tissue samples but lack the wide-area coverage required for locating and resecting lesions. This article presents a large-area robotically deployed OB imaging platform for endoscopic detection of colorectal cancer as an add-on for conventional endoscopes. In vitro, in silicon colon phantoms, the platform achieves an optical resolution of 0.5 line pairs per millimeter, while resolving simulated cancer lesions down to 0.75 mm diameter across large-area images (55-103 cm2). Large-area OB images were generated in an ex vivo porcine colon. The platform allows centimeter-sized large-area OB imaging in vitro and ex vivo with submillimeter resolution, including automatic data segmentation of simulated cancer areas. The ability for robotic actuation and spectrum collection is also shown for ex vivo animal colon. If successful, this technology could widen access to user-independent high-quality endoscopy and early detection of gastrointestinal cancers.
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Journal articleDeLorey C, Davids JD, Cartucho J, et al., 2023,
A cable‐driven soft robotic end‐effector actuator for probe‐based confocal laser endomicroscopy: Development and preclinical validation
, Translational Biophotonics, Vol: 5, ISSN: 2627-1850Soft robotics is becoming a popular choice for end-effectors. An end-effector was designed that has various advantages including ease of manufacturing, simplicity and control. This device may have the advantage of enabling probe-based devices to intraoperatively measure cancer histology, because it can flexibly and gently position a probe perpendicularly over an area of delicate tissue. This is demonstrated in a neurosurgical setting where accurate cancer resection has been limited by lack of accurate visualisation and impaired tumour margin delineation with the need for in-situ histology. Conventional surgical robotic end-effectors are unsuitable to accommodate a probe-based confocal laser endomicroscopy (p-CLE) probe because of their rigid and non-deformable properties, which can damage the thin probe. We have therefore designed a new soft robotic platform, which is advantageous by conforming to the probe's shape to avoid damage and to facilitate precision scanning.
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Journal articleFelinska EA, Fuchs TE, Kogkas A, et al., 2023,
Telestration with augmented reality improves surgical performance through gaze guidance
, SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol: 37, Pages: 3557-3566, ISSN: 0930-2794 -
Journal articleSivananthan A, Ahmed J, Kogkas A, et al., 2023,
Eye tracking technology in endoscopy: Looking to the future
, DIGESTIVE ENDOSCOPY, Vol: 35, Pages: 314-322, ISSN: 0915-5635 -
Journal articleAlian A, Zari E, Wang Z, et al., 2023,
Current engineering developments for robotic systems in flexible endoscopy
, Techniques and Innovations in Gastrointestinal Endoscopy, Vol: 25, Pages: 67-81, ISSN: 2590-0307The past four decades have seen an increase in the incidence of early-onset gastrointestinal cancer. Because early-stage cancer detection is vital to reduce mortality rate, mass screening colonoscopy provides the most effective prevention strategy. However, conventional endoscopy is a painful and technically challenging procedure that requires sedation and experienced endoscopists to be performed. To overcome the current limitations, technological innovation is needed in colonoscopy. In recent years, researchers worldwide have worked to enhance the diagnostic and therapeutic capabilities of endoscopes. The new frontier of endoscopic interventions is represented by robotic flexible endoscopy. Among all options, self-propelling soft endoscopes are particularly promising thanks to their dexterity and adaptability to the curvilinear gastrointestinal anatomy. For these devices to replace the standard endoscopes, integration with embedded sensors and advanced surgical navigation technologies must be investigated. In this review, the progress in robotic endoscopy was divided into the fundamental areas of design, sensing, and imaging. The article offers an overview of the most promising advancements on these three topics since 2018. Continuum endoscopes, capsule endoscopes, and add-on endoscopic devices were included, with a focus on fluid-driven, tendon-driven, and magnetic actuation. Sensing methods employed for the shape and force estimation of flexible endoscopes were classified into model- and sensor-based approaches. Finally, some key contributions in molecular imaging technologies, artificial neural networks, and software algorithms are described. Open challenges are discussed to outline a path toward clinical practice for the next generation of endoscopic devices.
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Conference paperMaleki AN, Thompson A, Runciman MS, et al., 2023,
A soft hydraulic endorectal actuator for prostate radiotherapy
Despite advances in radiotherapy, motion error remains a challenge in prostate radiotherapy. Rectal obturators and endorectal balloons may reduce motion error and improve outcomes but have limitations. We aimed to create a deployable rectal obturator with precise angle control to personalise to a patient's rectal anatomy, by using an antagonistic pair of "muscle"actuators to flex and extend the device. Results on deployability, angle control, and radial stiffness are presented here. The device can be compressed down to 16 x 3 x 91 mm, and be deployed to maximum dimensions of 24 x 25.5 x 77 mm. The device provides radial stiffness that may be sufficient to stabilise the rectum during radiotherapy. Angle control can be achieved with an average change of 7.5°/ml inflation in the extensor actuator.
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The Hamlyn Centre
Bessemer Building
South Kensington Campus
Imperial College
London, SW7 2AZ
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