Cardiovascular diseases remain as the most common cause of death worldwide. Remotely manipulated robotic systems are utilized to perform minimally invasive endovascular interventions. The main benefits of this methodology include reduced recovery time, improvement of clinical skills and procedural facilitation. Currently, robotic assistance, precision, and stability of instrument manipulation are compensated by the lack of haptic feedback and an excessive amount of radiation to the patient. This paper proposes a novel master-slave robotic platform that aims to bring the haptic feedback benefit on the master side, providing an intuitive user interface, and clinical familiar workflow. The slave robot is capable of manipulating conventional catheters and guidewires in multi-modal imaging environments. The system has been initially tested in a phantom cannulation study under fluoroscopic guidance, evaluating its reliability and procedural protocol. As the slave robot has been entirely produced by additive manufacturing and using pneumatic actuation, MR compatibility is enabled and was evaluated in a preliminary study. Results of both studies strongly support the applicability of the robot in different imaging environments and prospective clinical translation.

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Robotic and computer assistance can bring significant benefits to endovascular procedures in terms of precision and stability, reduced radiation doses, improved comfort and access to difficult and tortuous anatomy. However, the design of current commercially available platforms tends to alter the natural bedside manipulation skills of the operator, so that the manually acquired experience and dexterity are not well utilized. Furthermore, most of these systems lack of haptic feedback, preventing their acceptance and limiting the clinical usability. In this paper a new robotic platform for endovascular catheterization, the CathBot, is presented. It is an ergonomic master-slave system with navigation system and integrated vision-based haptic feedback, designed to maintain the natural bedside skills of the vascular surgeon. Unlike previous work reported in literature, dynamic motion tracking of both the vessel walls the catheter tip is incorporated to create dynamic active constraints. The system was evaluated through a combined quantitative and qualitative user study simulating catheterization tasks on a phantom. Forces exerted on the phantom were measured. The results showed a 70% decrease in mean force and 61% decrease in maximum force when force feedback is provided. This research provides the first integration of vision-based dynamic active constraints within an ergonomic robotic catheter manipulator. The technological advances presented here, demonstrates that vision-based haptic feedback can improve the effectiveness, precision, and safety of robot-assisted endovascular procedures.

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Cardiovascular diseases are the most common cause of global death. Endovascular interventions, in combination with advanced imaging technologies, are promising approaches for minimally invasive diagnosis and therapy. More recently, teleoperated robotic platforms target improved manipulation accuracy, stabilisation of instruments in the vasculature, and reduction of patient recovery times. However, benefits of recent platforms are undermined by a lack of haptics and residual patient exposure to ionising radiation. The purpose of this research was to design, implement, and evaluate a novel endovascular robotic platform, which accommodates emerging non-ionising magnetic resonance imaging (MRI). Methods: We proposed a pneumatically actuated MR-safe teleoperation platform to manipulate endovascular instrumentation remotely and to provide operators with haptic feedback for endovascular tasks. The platform task performance was evaluated in an ex vivo cannulation study with clinical experts (N = 7) under fluoroscopic guidance and haptic assistance on abdominal and thoracic phantoms. Results: The study demonstrated that the robotic dexterity involving pneumatic actuation concepts enabled successful remote cannulation of different vascular anatomies with success rates of 90% -100%. Compared to manual cannulation, slightly lower interaction forces between instrumentation and phantoms were measured for specific tasks. The maximum robotic interaction forces did not exceed 3 N. Conclusion: This research demonstrates a promising versatile robotic technology for remote manipulation of endovascular instrumentation in MR environments. Significance: The results pave the way for clinical translation with device deployment to endovascular interventions using non-ionising real-time 3D MR guidance.

Soft robots are envisioned as the next generation of safe biomedical devices in minimally invasive procedures. Yet, the difficulty of processing soft materials currently limits the size, aspect‐ratio, manufacturing throughput, as well as, the design complexity and hence capabilities of soft robots. Multi‐material thermal drawing is introduced as a material and processing platform to create soft robotic fibers imparted with multiple actuations and sensing modalities. Several thermoplastic and elastomeric material options for the fibers are presented, which all exhibit the rheological processing attributes for thermal drawing but varying mechanical properties, resulting in adaptable actuation performance. Moreover, numerous different fiber designs with intricate internal architectures, outer diameters of 700 µm, aspect ratios of 103, and a fabrication at a scale of 10s of meters of length are demonstrated. A modular tendon‐driven mechanism enables 3‐dimensional (3D) motion, and embedded optical guides, electrical wires, and microfluidic channels give rise to multifunctionality. The fibers can perceive and autonomously adapt to their environments, as well as, probe electrical properties, and deliver fluids and mechanical tools to spatially distributed targets.

To achieve regeneration of long sections of damaged nerves, restoration methods such as direct suturing or autologous grafting can be inefficient. Solutions involving biohybrid implants, where neural stem cells are grown in vitro on an active support before implantation, have attracted attention. Using such an approach, combined with recent advancements in microfabrication technology, the chemical and physical environment of cells can be tailored in order to control their behaviors. Herein, a neural stem cell polycarbonate fiber scaffold, fabricated by 3D printing and thermal drawing, is presented. The combined effect of surface microstructure and chemical functionalization using poly-L-ornithine (PLO) and double-walled carbon nanotubes (DWCNTs) on the biocompatibility of the scaffold, induced differentiation of the neural stem cells (NSCs) and channeling of the neural cells was investigated. Upon treatment of the fiber scaffold with a suspension of DWCNTs in PLO (0.039 g l−1) and without recombinants a high degree of differentiation of NSCs into neuronal cells was confirmed by using nestin, galactocerebroside and doublecortin immunoassays. These findings illuminate the potential use of this biohybrid approach for the realization of future nerve regenerative implants.

The development of miniaturised continuum robots has a wide range of applications in minimally invasive endoluminal interventions. In order to navigate inside tortuous lumens without impinging on the vessel wall and causing tissue damage or the risk of perforation, it is necessary to have simultaneous shape sensing of the continuum robot and its tip contact force sensing with the surrounding environment. Miniaturisation and size constraint of the device have precluded the use of conventional sensing hardware and embodiment schemes. In this paper, we propose the use of optical fibres for both actuation and tension/shape/force-sensing. It uses a model-based method with structural compensation, allowing direct measurement of the cable tension near the base of the manipulator without increasing the dimensions. It further structurally filters out disturbances from the flexible shaft. In addition, a model is built by considering segment differences, cable interactions/cross talks and external forces. The proposed model-based method can simultaneously estimate the shape of the manipulator and external force applied onto the robot tip. Detailed modelling and validation results demonstrate the accuracy and reliability of the proposed method for the miniaturised continuum robot for endoluminal intervention.