Endowed with the expected visions for future surgery, minimally invasive surgery (MIS) has become one of the most rapid developing areas in modern surgery. Soft robotics, which originates from interdisciplinary advances in materials, fabrication, and electronics, featuring better adaptability and safer interaction, holds great promises in addressing current technical challenges in MIS, which are difficult to be solved with current rigid robotic technologies. For the first time, herein, the expected characteristics of next-generation MIS from the surgeons' perspectives are analyzed and the recent progress of soft surgical instruments from three different aspects is comprehensively summarized: engineering design, fabrication techniques, and human-robot interaction. Perspectives of nextgeneration soft surgical robots are then discussed, where some exciting possibilities are emphasized. It is believed that further developments of intelligent soft robotics enable the next-generation MIS to agilely navigate to the target and conduct dexterous diagnostic or therapeutic procedures without any trade-offs in invasiveness and ultimately be a propitious solution for future surgery.
Being minimally invasive and highly effective, radiofrequency ablation (RFA) is widely used for small‐sized malignant tumor treatment. However, in clinical practice, a large number of tumors are found in irregular shape, while the current RFA devices are hard to control the morphologic appearance of RFA lesions on demand, which usually ends up with unnecessarily excessive tissue ablation and subsequently often brings irreversible damage to the organs’ functions. Herein, active cannulas for each of the individually controlled subelectrodes to achieve an on‐demand shape morphing and thus conformal RFA lesion are introduced. The target shape as well as the length of inserted subelectrodes can be precisely controlled by tuning the active stylets and cannulas. What's more, owing to independent movement and energy control of each subelectrodes, the electrode is shown to be not only efficient enough to accomplish accurate trajectory control to target tissue in a single insertion, but also adaptive enough to ablate target tissues with diverse morphologic appearances and locations. On‐demand conformal ablation of target tissue is demonstrated as well under the guidance of ultrasound imaging with the device. Potentially, the RFA electrode is a promising minimally invasive treatment of malignant tumors in future clinical practice. An interactive preprint version of the article can be found at: https://www.authorea.com/doi/full/10.22541/au.164019293.38729522.
Soft Surgical Robots
In article number http://doi.wiley.com/10.1002/aisy.202100011, Zhigang Wu and co‐workers provide a comprehensive overview on the emerging soft robotic technologies for minimally invasive surgery which are expected to redefine/expand current surgical robots and bring some exciting possibilities. The cover image demonstrates a high‐demanding scene of kidney stone lithotripsy, in which the soft surgical robot can be as gentle, biocompatible, powerful, and all‐pervasive as a plant.
Being minimally invasive and highly effective, radiofrequency ablation
(RFA) is widely used for small size malignant tumors treatment. However,
in clinical practice, a large number of tumors are found in irregular
shape, while the current RFA devices are hard to control their
morphologic appearance of RFA lesions on demand, which usually ends up
excessively ablating the tissues and often brings excessively
irreversible damage to the organs’ functions. Here, we introduce active
cannulas for each of individually-controlled sub-electrodes to achieve
an on-demand shape morphing and thus conformal RFA lesion. The shape as
well as the length of inserted sub-electrode can be precisely controlled
by tuning the expanded length of the active stylet and relative position
of the active cannula. Furthermore, owing to independent movement and
energy control of each sub-electrodes, our electrode is shown to be not
only efficient enough to accomplish accurate trajectory to target tissue
in a single insertion, but also adaptive enough to ablate target tissues
with diverse morphologic appearances and locations. Potentially, our RFA
electrode is a better choice in the future clinical practice for
minimally invasive treatments of malignant tumors of which preferred
treatment is conformal ablation.
Corresponding author(s) Email: zgwu@hust.edu.cn
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