Mechatronics in Medicine

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• Conference paper
  Runciman M, Franco E, Avery J, Rodriguez y Baena F, Mylonas Get al., 2023,

  Model based position control of soft hydraulic actuators

  , IEEE International Conference on Robotics and Automation, Publisher: IEEE, Pages: 1-7

  In 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 paper
  Treratanakulchai S, Franco E, Rodriguez y Baena F, 2023,

  Model-free position control of a soft continuum manipulator in cartesian space

  , International Conference on Control, Automation and Diagnosis, Publisher: IEEE, Pages: 1-6

  This work investigates the position control in Cartesian space of a soft continuum manipulator with pneumatic actuation. To this end, we employ a feedback integral action initialized using an optimized mapping between pressure and tip position. This approach is detailed for a manipulator consisting of either a single actuated segment or of two actuated segments connected in series. Experiments are conducted on individual prototypes and with a teleoperation setup including a master unit from our track record.

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• Conference paper
  Bautista-Salinas D, Kirby C, Abdelaziz MEMK, Temelkuran B, Huins CT, Rodriguez y Baena Fet al., 2023,

  Semi-autonomous robotic control of a self-shaping cochlear implant

  , 2023 IEEE International Conference on Robotics and Automation (ICRA), Publisher: IEEE, Pages: 6823-6829

  Cochlear implants (CIs) can improve hearing in patients suffering from sensorineural hearing loss via an electrode array (EA) carefully inserted in the scala tympani. Current EAs can cause trauma during insertion, threatening hearing preservation; hence we proposed a pre-curved thermally drawn EA that curls into the cochlea under the influence of body temperature. However, the additional surgical skill required to insert pre-curved EAs usually produces worse surgical outcomes. Medical robots can offer an effective solution to assist surgeons in improving surgical outcomes and reducing outliers. This work proposes a collaborative approach to insert our EA where manageable tasks are automated using a vision-based system. The insertion strategy presented allowed us to insert our EA successfully. The feasibility study showed that we can insert EAs following the defined control strategy while keeping the exerted contact forces within safe levels. The teleoperated robotic system and robotic vision approach to control a self-shaping CI has thus shown potential to provide the tools for a more delicate and atraumatic approach.

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• Conference paper
  Virdyawan V, Ayatullah T, Sugiharto A, Franco E, Garriga Casanovas A, Mahyuddin AI, Rodriguez y Baena F, Indrawantoet al., 2023,

  Design and manufacturing of an affordable soft robotic manipulator for minimally invasive diagnosis

  , International Conference on Robotics and Automation Engineering (ICRAE), Publisher: IEEE

  Soft robotic manipulators are inherently compliant thus they are ideally suited for minimally invasive diagnosis and intervention. In addition, soft robotics allows for affordable manufacturing, thus it could be adopted in low and middle-income countries where conventional robotics is prohibitively expensive. In this work, the design, manufacturing, and actuation strategy of an affordable soft robotic manipulator is presented. The manufacturing process does not rely on sophisticated technologies, and the pneumatic actuation does not require digital pressure regulators. Instead, a low-cost solution consisting of a needle valve operated by a servo motor is employed. The prototype is assessed with experiments that demonstrate its functionality.

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• Journal article
  Donder A, Rodriguez y Baena F, 2023,

  3-D path-following control for steerable needles with fiber Bragg gratings in multi-core fibers

  , IEEE Transactions on Biomedical Engineering, Vol: 70, Pages: 1072-1085, ISSN: 0018-9294

  Steerable needles have the potential for accurateneedle tip placement even when the optimal path to a target tissueis curvilinear, thanks to their ability to steer, which is an essen-tial function to avoid piercing through vital anatomical features.Autonomous path-following controllers for steerable needles havealready been studied, however they remain challenging, especiallybecause of the complexities associated to needle localization. Inthis context, the advent of fiber Bragg Grating (FBG)-inscribedmulti-core fibers (MCFs) holds promise to overcome these diffi-culties. Objective: In this study, a closed-loop, 3-D path-followingcontroller for steerable needles is presented. Methods: The controlloop is closed via the feedback from FBG-inscribed MCFs embed-ded within the needle. The nonlinear guidance law, which is a well-known approach for path-following control of aerial vehicles, isused as the basis for the guidance method. To handle needle-tissueinteractions, we propose using Active Disturbance Rejection Con-trol (ADRC) because of its robustness within hard-to-model en-vironments. We investigate both linear and nonlinear ADRC, andvalidate the approach with a Programmable Bevel-tip SteerableNeedle (PBN) in both phantom tissue and ex vivo brain, with someof the experiments involving moving targets. Results: The mean,standard deviation, and maximum absolute position errors areobserved to be 1.79 mm, 1.04 mm, and 5.84 mm, respectively, for3-D, 120 mm deep, path-following experiments. Conclusion: MCFswith FBGs are a promising technology for autonomous steerableneedle navigation, as demonstrated here on PBNs. Significance:FBGs in MCFs can be used to provide effective feedback in path-following controllers for steerable needles

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• Journal article
  Alian A, Zari E, Wang Z, Franco E, Avery JP, Runciman M, Lo B, Rodriguez y Baena F, Mylonas Get al., 2023,

  Current engineering developments for robotic systems in flexible endoscopy

  , Techniques and Innovations in Gastrointestinal Endoscopy, Vol: 25, Pages: 67-81, ISSN: 2590-0307

  The 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 paper
  Treratanakulchai S, Franco E, Garriga Casanovas A, Hu M, Kassanos P, Rodriguez y Baena Fet al., 2022,

  Development of a 6 DOF soft robotic manipulator with integrated sensing Skin

  , International Conference on Intelligent Robots and Systems (IROS 2022), Publisher: IEEE, Pages: 6944-6951

  This paper presents a new 6 DOF soft roboticmanipulator intended for colorectal surgery. The manipulator,based on a novel design that employs an inextensible tube tolimit axial extension, is shown to maximize the force exertedat its tip and the bending angle, the latter being measuredwith a soft sensing skin. Manufacturing of the prototypeis achieved with a lost-wax silicone-casting technique. Thekinematic model of the manipulator, its workspace, and itsmanipulability are discussed. The prototype is evaluated withextensive experiments, including pressure-deflection measure-ment with and without tip load, and lateral force measurementswith and without the soft sensing skin to assess hysteresis. Theexperimental results indicate that the prototype fulfils the keydesign requirements for colorectal surgery: (i) it can generatesufficient force to perform a range of laparoscopic tasks; (ii) theworkspace is commensurate with the dimensions of the largeintestine; (iii) the soft sensing skin only results in a marginalreduction of the maximum tip rotation within the range ofpressures and external loads relevant for the chosen application.

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• Journal article
  Lima MR, Wairagkar M, Gupta M, Baena FRY, Barnaghi P, Sharp DJ, Vaidyanathan Ret al., 2022,

  Conversational affective social robots for ageing and dementia support

  , IEEE Transactions on Cognitive and Developmental Systems, Vol: 14, Pages: 1378-1397, ISSN: 2379-8920

  Socially assistive robots (SAR) hold significant potential to assist older adults and people with dementia in human engagement and clinical contexts by supporting mental health and independence at home. While SAR research has recently experienced prolific growth, long-term trust, clinical translation and patient benefit remain immature. Affective human-robot interactions are unresolved and the deployment of robots with conversational abilities is fundamental for robustness and humanrobot engagement. In this paper, we review the state of the art within the past two decades, design trends, and current applications of conversational affective SAR for ageing and dementia support. A horizon scanning of AI voice technology for healthcare, including ubiquitous smart speakers, is further introduced to address current gaps inhibiting home use. We discuss the role of user-centred approaches in the design of voice systems, including the capacity to handle communication breakdowns for effective use by target populations. We summarise the state of development in interactions using speech and natural language processing, which forms a baseline for longitudinal health monitoring and cognitive assessment. Drawing from this foundation, we identify open challenges and propose future directions to advance conversational affective social robots for: 1) user engagement, 2) deployment in real-world settings, and 3) clinical translation.

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• Journal article
  Hu X, Baena FRY, 2022,

  Automatic Bone Surface Restoration for Markerless Computer-Assisted Orthopaedic Surgery

  , CHINESE JOURNAL OF MECHANICAL ENGINEERING, Vol: 35, ISSN: 1000-9345
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• Journal article
  Secoli R, Matheson E, Pinzi M, Galvan S, Donder A, Watts T, Riva M, Zani DD, Bello L, Rodriguez y Baena Fet al., 2022,

  Modular robotic platform for precision neurosurgery with a bio-inspired needle: system overview and first in-vivo deployment

  , PLoS One, Vol: 17, ISSN: 1932-6203

  Over the past 10 years, minimally invasive surgery (MIS) has shown significant benefits compared to conventional surgical techniques, with reduced trauma, shorter hospital stays, and shorter patient recovery times. In neurosurgical MIS procedures, inserting a straight tool (e.g. catheter) is common practice in applications ranging from biopsy and laser ablation, to drug delivery and fluid evacuation. How to handle tissue deformation, target migration and access to deep-seated anatomical structures remain an open challenge, affecting both the preoperative planning phase and eventual surgical intervention. Here, we present the first neurosurgical platform in the literature, able to deliver an implantable steerable needle for a range of diagnostic and therapeutic applications, with a short-term focus on localised drug delivery. This work presents the system’s architecture and first in vivo deployment with an optimised surgical workflow designed for pre-clinical trials with the ovine model, which demonstrate appropriate function and safe implantation.

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