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1

O'Donnell, B. D., O. O'Sullivan, A. G. Gallagher, and G. D. Shorten. "Robotic assistance with needle guidance." British Journal of Anaesthesia 114, no. 4 (April 2015): 708–9. http://dx.doi.org/10.1093/bja/aev045.

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2

Kronreif, Gernot, Martin Fürst, Joachim Kettenbach, Michael Figl, and Rudolf Hanel. "Robotic guidance for percutaneous interventions." Advanced Robotics 17, no. 6 (January 2003): 541–60. http://dx.doi.org/10.1163/15685530360675532.

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3

Agyei, Justice O., Asham Khan, Patrick K. Jowdy, Timothy E. O’Connor, Joshua E. Meyers, Jeffrey P. Mullin, and John Pollina. "Robot-Assisted Cortical Bone Trajectory Insertion of Pedicle Screws: 2-Dimensional Operative Video." Operative Neurosurgery 18, no. 5 (July 25, 2019): E171. http://dx.doi.org/10.1093/ons/opz216.

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Abstract Robot-assisted pedicle screw insertion has been slowly gaining popularity in the spine surgery community. In previous studies, robotics has been shown to increase accuracy and reduce complication rates compared to other navigation technologies, although those studies have been conducted using traditional trajectories for pedicle screw insertion. We present a surgical video in which a robotics system (Mazor X; Mazor Robotics Ltd, Caesarea, Israel) was used to create cortical bone trajectories for the insertion of the screws. The patient in this case is a 52-yr-old woman with severe L4-5 disc herniation requiring a transforaminal interbody fusion with the insertion of pedicle screws. The robotic system's scan-and-plan technique was utilized, in which an intraoperative computed tomography (CT) scan generates a real-time operative plan. Other techniques for inserting pedicle screws using cortical bone trajectories include CT navigation and fluoroscopic guidance. These techniques allow the surgeon to manually direct the screw under precise guidance in multiple planes, although the surgeon is still using all 6 degrees of freedom the human hand provides. With robotic guidance, a pilot hole is drilled, which eliminates 4 of 6 degrees of freedom, which can potentially reduce the risk of misplaced screws. To our knowledge, this is the first video demonstrating pedicle screw insertion through cortical bone trajectories using robotic guidance. Future studies are warranted to compare cortical bone trajectory insertion using different navigation techniques to determine the long-term efficacy of each technique. The patient gave informed consent for surgery and video recording. Institutional review board approval was deemed unnecessary.
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Nouaille, L., MA Laribi, CA Nelson, T. Essomba, G. Poisson, and S. Zeghloul. "Design process for robotic medical tool guidance manipulators." Proceedings of the Institution of Mechanical Engineers, Part C: Journal of Mechanical Engineering Science 230, no. 2 (June 10, 2015): 259–75. http://dx.doi.org/10.1177/0954406215590639.

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This paper deals with the design process adapted to medical robots. The large diversity of kinematic architectures that can be encountered in medical robotics leads us to seek a robust method dedicated to tool-guidance medical robot design. First, we detail a proposed design process adapted especially for handling the inherent needs in tool-guidance in medical robotics. This proposed method ties together the phases of the design process with their respective tools. We describe the spectrum of medical robots and particularly the variety of kinematic architectures used. Each phase of the design process is detailed through application examples in the domains of tele-echography and minimally invasive surgery, which exhibit a number of commonalities. The use of tools for accomplishing the various steps of the design process is detailed, with emphasis on medical gesture analysis. This is followed by topological and dimensional synthesis. This study illustrates how the type of medical robot can impose specific requirements and a particular approach in the design process. We expect through this paper to bring a significant contribution to the design of medical tool-guidance robots and to facilitate their integration in the clinical environment. The main contribution of this work is to propose a design process method for robotic medical tool-guidance manipulators.
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Meyers, Joshua E., Asham Khan, and John Pollina. "Robotic Guidance for the Insertion of Posterior Pedicle Screws: 2-Dimensional Operative Video." Operative Neurosurgery 16, no. 6 (August 30, 2018): 766–67. http://dx.doi.org/10.1093/ons/opy246.

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Abstract Recent years have shown an increase in implementing robotics in surgical procedures. Utilizing robotic technology in spine surgery remains limited in comparison to other surgical fields. We present a surgical video of minimally invasive robotic-assisted insertion of posterior pedicle screws using the newest generation robotic technology (Mazor X, Mazor Robotics Ltd, Caesarea, Israel), in a 29-yr-old man who suffers from Grade I degenerative spondylolisthesis at L5-S1 levels and severe, right-sided foraminal stenosis. The plan was to perform anterior fusion at L5-S1 using robotic guidance with posterior pedicle screw supplementation due to his extensive smoking history. This technology has two distinct registration methods: (1) using a preoperative thin-cut computed tomography (CT) scan to create a surgical plan for screw placement; and (2) scan-and-plan using intraoperative 3-dimensional (3D) imaging to create a plan in real-time intraoperatively. We present the scan-and-plan technique. The widely used freehand technique allows the surgeon to manually direct tools and implants relying on the 6-degrees-of-freedom of the human arm. When Mazor X robotic technology is utilized, a pilot hole is drilled through a cannula docked to the bone above the entry point, which provides the surgeon with a planned trajectory and eliminates 4 of 6-degrees-of-freedom (up/down and yaw remain). This provides increased multidimensional control and reduces reliance on hand-eye coordination with simultaneous concentration on the imaging, potentially leading to increased rates of accuracy and reduction in severe complications of misplaced screws. Further prospective clinical studies are needed to determine the long-term effectiveness of this technology. Patient consent was obtained prior to performing the procedure. Institutional board review approval is not required for the report of a single case at the University at Buffalo.
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Snyder, Laura A. "Integrating robotics into a minimally invasive transforaminal interbody fusion workflow." Neurosurgical Focus 45, videosuppl1 (July 2018): V4. http://dx.doi.org/10.3171/2018.7.focusvid.18111.

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Minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) is a well-accepted procedure with good outcomes. Robotics has the potential to augment these outcomes. This video demonstrates and discusses how surgeons can implement the use of a robotic device in an MIS TLIF workflow. The planning software and robotic arm guidance allow the surgeon to use intraoperative CT to guide the placement of pedicle screws in an MIS TLIF with optimal trajectory and decreased radiation. As robotic technology continues to improve, developing safe workflows that integrate robotics with currently well-established techniques should improve patient outcomes.The video can be found here: https://youtu.be/rJWOa6XVLW0.
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Khanna, Omaditya, Ryan Beasley, Daniel Franco, and Simon DiMaio. "The Path to Surgical Robotics in Neurosurgery." Operative Neurosurgery 20, no. 6 (May 13, 2021): 514–20. http://dx.doi.org/10.1093/ons/opab065.

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Abstract Robotic systems may help efficiently execute complicated tasks that require a high degree of accuracy, and this, in large part, explains why robotics have garnered widespread use in a variety of neurosurgical applications, including intracranial biopsies, spinal instrumentation, and placement of intracranial leads. The use of robotics in neurosurgery confers many benefits, and inherent limitations, to both surgeons and their patients. In this narrative review, we provide a historical overview of robotics and its implementation across various surgical specialties, and discuss the various robotic systems that have been developed specifically for neurosurgical applications. We also discuss the relative advantages of robotic systems compared to traditional surgical techniques, particularly as it pertains to integration of image guidance with the ability of the robotic arm to reliably execute pre-planned tasks. As more neurosurgeons adopt the use of robotics in their practice, we postulate that further technological advancements will become available that will help achieve improved technical capabilities, user experience, and overall patient clinical outcomes.
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Faissal, Zahrawi, Manzi Brian, and Sager Jill. "Comparative Retrospective Analysis of Accuracy of Robotic-Guided versus Fluoroscopy-Guided Percutaneous Pedicle Screw Placement in Adults with Degenerative Spine Disease." Open Orthopaedics Journal 12, no. 1 (December 31, 2018): 576–82. http://dx.doi.org/10.2174/1874325001812010576.

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Background:Robotic-guidance for pedicle screws can reportedly increase placement accuracies and surgical efficiencies especially in percutaneous approaches.Objective:The study aimed to compare the accuracy of percutaneous pedicle screw placement and post-operative course of robotic-guidance versus fluoroscopy-guidance performed by a surgeon experienced in performing fluoroscopy-guided MIS spinal fusions.Study Design:This is a retrospective medical chart review of 2 cohorts of consecutive patients operated by the same surgeon.Methods:Medical records of adults suffering from degenerative spine disease treated by percutaneous spinal fusion surgeries with robotic-guidancevs. fluoroscopy-guidance were reviewed. Endpoints included pedicle screw placement accuracy (on post-operative CTs) and surgical complications and revisions.Results:Ninety-nine patients were reviewed in each arm which were similar in demographics and surgical indications. The robotic arm had 5.8 screws per case on average and 6.0 in the control arm (p=0.65). No significant differences were found in postoperative complication rates revision surgeries length of stay duration of surgery screw implantation times blood loss or results of Oswestry Disability Index questionnaires.Post-operative CTs were available for 52 patients (293 screws) in the robotic arm and 70 (421 screws) in the freehand controls. In the robotic arm 100% of screws were found accurately placed within the “safe zone”vs. 410 screws (97.4%) in the control arm (p=0.005). Of 11 breaching screws in the control arm one breached by 6mm but the patient did not suffer from any sequelae (12-month follow-up). The average follow up period was 9.2±4 months in the robotic-guided arm and 10.5±3 in the control arm. There were no significant differences in complications or revisions.Conclusion:A modest yet statistically significant increase in pedicle screw placement accuracy was observed with robotic-guidance compared to freehand. Larger prospective studies are needed to demonstrate differences in clinical outcomes.
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9

Bested, Stephen R., Gerome A. Manson, and Luc Tremblay. "Combining Unassisted and Robot-Guided Practice Benefits Motor Learning for a Golf Putting Task." Journal of Motor Learning and Development 7, no. 3 (December 1, 2019): 408–25. http://dx.doi.org/10.1123/jmld.2018-0040.

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Robotic guidance has been employed with limited effectiveness in neurologically intact and patient populations. For example, our lab has effectively used robotic guidance to acutely improve movement smoothness of a discrete trajectory without influencing movement endpoint distributions. The purpose of the current study was to investigate the efficacy of combining robotic guidance and unassisted trials in the learning of a golf putting task. Participants completed a pre-test, an acquisition phase, and an immediate and delayed (24-hour) post-test. During the pre-test, kinematic data from the putter was converted into highly accurate, consistent, and smooth trajectories delivered by a robot arm. During acquisition, three groups performed putts towards three different targets with robotic guidance on either 0%, 50%, or 100% of acquisition trials. Only the 50% guidance group statistically reduced both the ball endpoint distance and variability between the pre-test and the immediate or 24-hr post-test. The results of the 50% guidance group yielded seminal evidence that combining both unassisted and robotic guidance trials (i.e., mixed practice) could facilitate at least short-term motor learning for a golf putting task. Such work is relevant to incorporating robotic guidance in sport skills and other practical areas (e.g., rehabilitation).
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10

Bederman, S. Samuel, Gregory Lopez, Tao Ji, and Bang H. Hoang. "Robotic Guidance for En Bloc Sacrectomy." Spine 39, no. 23 (November 2014): E1398—E1401. http://dx.doi.org/10.1097/brs.0000000000000575.

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11

Bárdosi, Zoltán, Christian Plattner, Yusuf Özbek, Thomas Hofmann, Srdjan Milosavljevic, Volker Schartinger, and Wolfgang Freysinger. "CIGuide: in situ augmented reality laser guidance." International Journal of Computer Assisted Radiology and Surgery 15, no. 1 (September 11, 2019): 49–57. http://dx.doi.org/10.1007/s11548-019-02066-1.

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Abstract Purpose A robotic intraoperative laser guidance system with hybrid optic-magnetic tracking for skull base surgery is presented. It provides in situ augmented reality guidance for microscopic interventions at the lateral skull base with minimal mental and workload overhead on surgeons working without a monitor and dedicated pointing tools. Methods Three components were developed: a registration tool (Rhinospider), a hybrid magneto-optic-tracked robotic feedback control scheme and a modified robotic end-effector. Rhinospider optimizes registration of patient and preoperative CT data by excluding user errors in fiducial localization with magnetic tracking. The hybrid controller uses an integrated microscope HD camera for robotic control with a guidance beam shining on a dual plate setup avoiding magnetic field distortions. A robotic needle insertion platform (iSYS Medizintechnik GmbH, Austria) was modified to position a laser beam with high precision in a surgical scene compatible to microscopic surgery. Results System accuracy was evaluated quantitatively at various target positions on a phantom. The accuracy found is 1.2 mm ± 0.5 mm. Errors are primarily due to magnetic tracking. This application accuracy seems suitable for most surgical procedures in the lateral skull base. The system was evaluated quantitatively during a mastoidectomy of an anatomic head specimen and was judged useful by the surgeon. Conclusion A hybrid robotic laser guidance system with direct visual feedback is proposed for navigated drilling and intraoperative structure localization. The system provides visual cues directly on/in the patient anatomy, reducing the standard limitations of AR visualizations like depth perception. The custom- built end-effector for the iSYS robot is transparent to using surgical microscopes and compatible with magnetic tracking. The cadaver experiment showed that guidance was accurate and that the end-effector is unobtrusive. This laser guidance has potential to aid the surgeon in finding the optimal mastoidectomy trajectory in more difficult interventions.
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12

Liounakos, Jason I., Louis Chenin, Nicholas Theodore, and Michael Y. Wang. "Robotics in Spine Surgery and Spine Surgery Training." Operative Neurosurgery 21, no. 2 (May 20, 2021): 35–40. http://dx.doi.org/10.1093/ons/opaa449.

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Abstract The increasing interest and advancements in robotic spine surgery parallels a growing emphasis on maximizing patient safety and outcomes. In addition, an increasing interest in minimally invasive spine surgery has further fueled robotic development, as robotic guidance systems are aptly suited for these procedures. This review aims to address 3 of the most critical aspects of robotics in spine surgery today: salient details regarding the current and future development of robotic systems and functionalities, the reported accuracy of implant placement over the years, and how the implementation of robotic systems will impact the training of future generations of spine surgeons. As current systems establish themselves as highly accurate tools for implant placement, the development of novel features, including even robotic-assisted decompression, will likely occur. As spine surgery robots evolve and become increasingly adopted, it is likely that resident and fellow education will follow suit, leading to unique opportunities for both established surgeons and trainees.
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13

Antico, Maria, Fumio Sasazawa, Liao Wu, Anjali Jaiprakash, Jonathan Roberts, Ross Crawford, Ajay K. Pandey, and Davide Fontanarosa. "Ultrasound guidance in minimally invasive robotic procedures." Medical Image Analysis 54 (May 2019): 149–67. http://dx.doi.org/10.1016/j.media.2019.01.002.

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14

Li, Y. F., and M. H. Lee. "Applying vision guidance in robotic food handling." IEEE Robotics & Automation Magazine 3, no. 1 (March 1996): 4–12. http://dx.doi.org/10.1109/100.486656.

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15

Ikoma, Naruhiko, Brian D. Badgwell, and Paul Mansfield. "Fluorescent-Image Guidance in Robotic Subtotal Gastrectomy." Annals of Surgical Oncology 27, no. 13 (May 7, 2020): 5322. http://dx.doi.org/10.1245/s10434-020-08523-5.

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16

Guirguis, M., J. Alshiek, and A. S. Shobeiri. "76: Robotic myomectomy with intraoperative ultrasound guidance." American Journal of Obstetrics and Gynecology 222, no. 3 (March 2020): S858. http://dx.doi.org/10.1016/j.ajog.2019.12.225.

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17

Nelson, Carl A., Xiaoli Zhang, Shelby Buettner, and Dmitry Oleynikov. "Tool guidance using a compact robotic assistant." Journal of Robotic Surgery 3, no. 3 (September 23, 2009): 171–73. http://dx.doi.org/10.1007/s11701-009-0156-4.

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18

Khoramshahi, Mahdi, and Aude Billard. "A dynamical system approach for detection and reaction to human guidance in physical human–robot interaction." Autonomous Robots 44, no. 8 (July 26, 2020): 1411–29. http://dx.doi.org/10.1007/s10514-020-09934-9.

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Abstract A seamless interaction requires two robotic behaviors: the leader role where the robot rejects the external perturbations and focuses on the autonomous execution of the task, and the follower role where the robot ignores the task and complies with human intentional forces. The goal of this work is to provide (1) a unified robotic architecture to produce these two roles, and (2) a human-guidance detection algorithm to switch across the two roles. In the absence of human-guidance, the robot performs its task autonomously and upon detection of such guidances the robot passively follows the human motions. We employ dynamical systems to generate task-specific motion and admittance control to generate reactive motions toward the human-guidance. This structure enables the robot to reject undesirable perturbations, track the motions precisely, react to human-guidance by providing proper compliant behavior, and re-plan the motion reactively. We provide analytical investigation of our method in terms of tracking and compliant behavior. Finally, we evaluate our method experimentally using a 6-DoF manipulator.
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19

Pham, Martin H., Joseph A. Osorio, and Ronald A. Lehman. "Navigated Spinal Robotics in Minimally Invasive Spine Surgery, With Preoperative and Intraoperative Workflows: 2-Dimensional Operative Video." Operative Neurosurgery 19, no. 4 (April 15, 2020): E422. http://dx.doi.org/10.1093/ons/opaa095.

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Abstract The use of robotic guidance for spinal instrumentation has become promising for its ability to offer the advantages of precision, accuracy, and reproducibility. However, the utilization and adoption of robotic platforms for spine surgery remain limited, especially in comparison to other surgical fields. We present here a case of a 52-yr-old man with a grade 1 L4-5 degenerative spondylolisthesis causing severe claudication and radiculopathy who subsequently underwent a minimally invasive L4-5 transforaminal lumbar interbody fusion with navigated spinal robotic assistance (Mazor X Stealth Edition, Mazor Robotics Ltd, Caesarea, Israel). This platform allows for planning and registration via (1) a preoperative thin-cut computed tomography (CT) scan, or (2) an intraoperative CT “scan-and-plan” method. We show here the preoperative CT method that we use in the majority of our patients. To our knowledge, this is the first video demonstrating the preoperative software and intraoperative surgical registration and instrument workflow of navigated spinal robotic guidance using the Mazor X Stealth Edition for the insertion of pedicle screws in a minimally invasive spine surgery procedure. There is no identifying information in this video. Patient consent was obtained for the surgical procedure and for publishing of the material included in the video.
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Minchev, Georgi, Gernot Kronreif, Mauricio Martínez-Moreno, Christian Dorfer, Alexander Micko, Aygül Mert, Barbara Kiesel, Georg Widhalm, Engelbert Knosp, and Stefan Wolfsberger. "A novel miniature robotic guidance device for stereotactic neurosurgical interventions: preliminary experience with the iSYS1 robot." Journal of Neurosurgery 126, no. 3 (March 2017): 985–96. http://dx.doi.org/10.3171/2016.1.jns152005.

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OBJECTIVE Robotic devices have recently been introduced in stereotactic neurosurgery in order to overcome the limitations of frame-based and frameless techniques in terms of accuracy and safety. The aim of this study is to evaluate the feasibility and accuracy of the novel, miniature, iSYS1 robotic guidance device in stereotactic neurosurgery. METHODS A preclinical phantom trial was conducted to compare the accuracy and duration of needle positioning between the robotic and manual technique in 162 cadaver biopsies. Second, 25 consecutive cases of tumor biopsies and intracranial catheter placements were performed with robotic guidance to evaluate the feasibility, accuracy, and duration of system setup and application in a clinical setting. RESULTS The preclinical phantom trial revealed a mean target error of 0.6 mm (range 0.1–0.9 mm) for robotic guidance versus 1.2 mm (range 0.1–2.6 mm) for manual positioning of the biopsy needle (p < 0.001). The mean duration was 2.6 minutes (range 1.3–5.5 minutes) with robotic guidance versus 3.7 minutes (range 2.0–10.5 minutes) with manual positioning (p < 0.001). Clinical application of the iSYS1 robotic guidance device was feasible in all but 1 case. The median real target error was 1.3 mm (range 0.2–2.6 mm) at entry and 0.9 mm (range 0.0–3.1 mm) at the target point. The median setup and instrument positioning times were 11.8 minutes (range 4.2–26.7 minutes) and 4.9 minutes (range 3.1–14.0 minutes), respectively. CONCLUSIONS According to the preclinical data, application of the iSYS1 robot can significantly improve accuracy and reduce instrument positioning time. During clinical application, the robot proved its high accuracy, short setup time, and short instrument positioning time, as well as demonstrating a short learning curve.
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Xu, Zhenyu, Yongsen Zhou, Baoping Zhang, Chao Zhang, Jianfeng Wang, and Zuankai Wang. "Recent Progress on Plant-Inspired Soft Robotics with Hydrogel Building Blocks: Fabrication, Actuation and Application." Micromachines 12, no. 6 (May 24, 2021): 608. http://dx.doi.org/10.3390/mi12060608.

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Millions of years’ evolution has imparted life on earth with excellent environment adaptability. Of particular interest to scientists are some plants capable of macroscopically and reversibly altering their morphological and mechanical properties in response to external stimuli from the surrounding environment. These intriguing natural phenomena and underlying actuation mechanisms have provided important design guidance and principles for man-made soft robotic systems. Constructing bio-inspired soft robotic systems with effective actuation requires the efficient supply of mechanical energy generated from external inputs, such as temperature, light, and electricity. By combining bio-inspired designs with stimuli-responsive materials, various intelligent soft robotic systems that demonstrate promising and exciting results have been developed. As one of the building materials for soft robotics, hydrogels are gaining increasing attention owing to their advantageous properties, such as ultra-tunable modulus, high compliance, varying stimuli-responsiveness, good biocompatibility, and high transparency. In this review article, we summarize the recent progress on plant-inspired soft robotics assembled by stimuli-responsive hydrogels with a particular focus on their actuation mechanisms, fabrication, and application. Meanwhile, some critical challenges and problems associated with current hydrogel-based soft robotics are briefly introduced, and possible solutions are proposed. We expect that this review would provide elementary tutorial guidelines to audiences who are interested in the study on nature-inspired soft robotics, especially hydrogel-based intelligent soft robotic systems.
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Schaible, Jan, Benedikt Pregler, Niklas Verloh, Ingo Einspieler, Wolf Bäumler, Florian Zeman, Andreas Schreyer, Christian Stroszczynski, and Lukas Beyer. "Improvement of the primary efficacy of microwave ablation of malignant liver tumors by using a robotic navigation system." Radiology and Oncology 54, no. 3 (May 28, 2020): 295–300. http://dx.doi.org/10.2478/raon-2020-0033.

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AbstractBackgroundThe aim of the study was to assess the primary efficacy of robot-assisted microwave ablation and compare it to manually guided microwave ablation for percutaneous ablation of liver malignancies.Patients and methodsWe performed a retrospective single center evaluation of microwave ablations of 368 liver tumors in 192 patients (36 female, 156 male, mean age 63 years). One hundred and nineteen ablations were performed between 08/2011 and 03/2014 with manual guidance, whereas 249 ablations were performed between 04/2014 and 11/2018 using robotic guidance. A 6-week follow-up (ultrasound, computed tomography and magnetic resonance imaging) was performed on all patients.ResultsThe primary technique efficacy outcome of the group treated by robotic guidance was significantly higher than that of the manually guided group (88% vs. 76%; p = 0.013). Multiple logistic regression analysis indicated that a small tumor size (≤ 3 cm) and robotic guidance were significant favorable prognostic factors for complete ablation.ConclusionsIn addition to a small tumor size, robotic navigation was a major positive prognostic factor for primary technique efficacy.
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Erchao, Li, Li Zhanming, and He Junxue. "ROBOTIC ADAPTIVE IMPEDANCE CONTROL BASED ON VISUAL GUIDANCE." International Journal on Smart Sensing and Intelligent Systems 8, no. 4 (2015): 2159–74. http://dx.doi.org/10.21307/ijssis-2017-847.

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Graf, Birgit. "An Adaptive Guidance System for Robotic Walking Aids." Journal of Computing and Information Technology 17, no. 1 (2009): 109. http://dx.doi.org/10.2498/cit.1001159.

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Hou, Chao-zhen. "Three-Dimension Automatic Tracing System for Robotic Guidance." IFAC Proceedings Volumes 18, no. 9 (August 1985): 269–74. http://dx.doi.org/10.1016/s1474-6670(17)60298-2.

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Pratt, Philip, and Asit Arora. "Transoral Robotic Surgery: Image Guidance and Augmented Reality." ORL 80, no. 3-4 (2018): 204–12. http://dx.doi.org/10.1159/000489467.

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de la Fuente, Eusebio, F. M. Trespaderne, and J. R. Perán. "Applying vision guidance in robotic fresh meat handling." IFAC Proceedings Volumes 32, no. 2 (July 1999): 790–95. http://dx.doi.org/10.1016/s1474-6670(17)56134-0.

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Desai, Shaun C., Chih-Kwang Sung, and Eric M. Genden. "Transoral Robotic Surgery Using an Image Guidance System." Laryngoscope 118, no. 11 (November 2008): 2003–5. http://dx.doi.org/10.1097/mlg.0b013e3181818784.

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Chen, Alvin I., Max L. Balter, Timothy J. Maguire, and Martin L. Yarmush. "Deep learning robotic guidance for autonomous vascular access." Nature Machine Intelligence 2, no. 2 (February 2020): 104–15. http://dx.doi.org/10.1038/s42256-020-0148-7.

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McFarlane, Nigel J. B. "Image-guidance for robotic harvesting of micropropagated plants." Computers and Electronics in Agriculture 8, no. 1 (February 1993): 43–56. http://dx.doi.org/10.1016/0168-1699(93)90057-8.

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31

Liounakos, Jason I., and Michael Y. Wang. "Lumbar 3–Lumbar 5 Robotic-Assisted Endoscopic Transforaminal Lumbar Interbody Fusion: 2-Dimensional Operative Video." Operative Neurosurgery 19, no. 1 (December 7, 2019): E73—E74. http://dx.doi.org/10.1093/ons/opz385.

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Abstract Minimally invasive spine surgery has the potential to reduce soft tissue destruction, blood loss, postoperative pain, and overall perioperative morbidity while accelerating recovery. Robotic guidance systems are relatively new tools in the minimally invasive surgeon's armamentarium, striving to increase accuracy of instrumentation placement, decrease complications, reduce radiation burden, and enhance surgical ergonomics in order to improve efficiency and maximize patient outcomes. We present the case of a 78-yr-old male with intractable lower back and bilateral lower extremity pain with multilevel degenerative spondylosis. The procedure performed was a L3-5 robotic-assisted endoscopic transforaminal lumbar interbody fusion (TLIF) utilizing the Mazor X robotic guidance system (Medtronic) for both percutaneous pedicle screw placement, as well as trajectory localization for endoscopic discectomy and percutaneous interbody delivery. Previously, clinical and radiographic success has been published regarding the awake, endoscopic TLIF.1 We document the first use of robotic guidance for disc space localization and its combination with endoscopy to achieve interbody fusion, utilizing an expandable, allograft-filled mesh interbody device.2 This video demonstrates appropriate patient positioning, work flow for this unique technique, and the benefits of using robotic guidance to plan and execute percutaneous trajectories through Kambin's triangle. This procedure involves the off-label use of recombinant human bone morphogenetic protein-2 (Infuse™, Medtronic), OptiMesh® graft containment device (Spineology), and liposomal bupivacaine (Exparel®, Pacira).
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Israel, Jeffrey F., Donielle D. Campbell, Jennifer H. Kahn, and T. George Hornby. "Metabolic Costs and Muscle Activity Patterns During Robotic- and Therapist-Assisted Treadmill Walking in Individuals With Incomplete Spinal Cord Injury." Physical Therapy 86, no. 11 (November 1, 2006): 1466–78. http://dx.doi.org/10.2522/ptj.20050266.

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AbstractBackground and Purpose. Robotic devices that provide passive guidance and stabilization of the legs and trunk during treadmill stepping may increase the delivery of locomotor training to subjects with neurological injury. Lower-extremity guidance also may reduce voluntary muscle activity as compared with compliant assistance provided by therapists. The purpose of this study was to investigate differences in metabolic costs and lower-limb muscle activity patterns during robotic- and therapist-assisted treadmill walking. Subjects. Twelve ambulatory subjects with motor incomplete spinal cord injury participated. Methods. In 2 separate protocols, metabolic and electromyographic (EMG) data were collected during standing and stepping on a treadmill with therapist and robotic assistance. During robotic-assisted walking, subjects were asked to match the kinematic trajectories of the device and maximize their effort. During therapist-assisted walking, subjects walked on the treadmill with manual assistance provided as necessary. Results. Metabolic costs and swing-phase hip flexor EMG activity were significantly lower when subjects were asked to match the robotic device trajectories than with therapist-assisted walking. These differences were reduced when subjects were asked to maximize their effort during robotic-assisted stepping, although swing-phase plantar-flexor EMG activity was increased. In addition, during standing prior to therapist- or robotic-assisted stepping, metabolic costs were higher without stabilization from the robotic device. Discussion and Conclusion. Differences in metabolic costs and muscle activity patterns between therapist- and robotic-assisted standing and stepping illustrate the importance of minimizing passive guidance and stabilization provided during step training protocols.
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Kanellakis, Christoforos, and George Nikolakopoulos. "Guidance for Autonomous Aerial Manipulator Using Stereo Vision." Journal of Intelligent & Robotic Systems 100, no. 3-4 (August 16, 2019): 1545–57. http://dx.doi.org/10.1007/s10846-019-01060-8.

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AbstractCombining the agility of Micro Aerial Vehicles (MAV) with the dexterity of robotic arms leads to a new era of Aerial Robotic Workers (ARW) targeting infrastructure inspection and maintenance tasks. Towards this vision, this work focuses on the autonomous guidance of the aerial end-effector to either reach or keep desired distance from areas/objects of interest. The proposed system: 1) is structured around a real-time object tracker, 2) employs stereo depth perception to extract the target location within the surrounding scene, and finally 3) generates feasible poses for both the arm and the MAV relative to the target. The performance of the proposed scheme is experimentally demonstrated in multiple scenarios of increasing complexity.
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Allaq, Aiman Al, Nebojsa Jaksic, Hussein Ali Al-Amili, and Dhuha Mohammed Mahmood. "The The Application of Virtual Reality to (Mechatronics Engineering) by Creating an Articulated Robotic Work Cell Using EON Reality V9.22.24.24477." Al-Khwarizmi Engineering Journal 17, no. 2 (June 1, 2021): 18–30. http://dx.doi.org/10.22153/kej.2021.04.001.

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Virtual reality, VR, offers many benefits to technical education, including the delivery of information through multiple active channels, the addressing of different learning styles, and experiential-based learning. This paper presents work performed by the authors to apply VR to engineering education, in three broad project areas: virtual robotic learning, virtual mechatronics laboratory, and a virtual manufacturing platform. The first area provides guided exploration of domains otherwise inaccessible, such as the robotic cell components, robotic kinematics and work envelope. The second promotes mechatronics learning and guidance for new mechatronics engineers when dealing with robots in a safe and interactive manner. And the third provides valuable guidance for industry and robotic based manufacturing, allowing a better view and simulating conditions otherwise inaccessible.
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35

Sommer, F., M. Scheithauer, J. Greve, T. Hoffmann, P. Schuler, and D. Friedrich. "An Innovate Robotic Endoscope Guidance System for Transnasal Sinus and Skull Base Surgery: Proof of Concept." Journal of Neurological Surgery Part B: Skull Base 78, no. 06 (July 21, 2017): 466–72. http://dx.doi.org/10.1055/s-0037-1603974.

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Objective Advanced transnasal sinus and skull base surgery remains a challenging discipline for head and neck surgeons. Restricted access and space for instrumentation can impede advanced interventions. Thus, we present the combination of an innovative robotic endoscope guidance system and a specific endoscope with adjustable viewing angle to facilitate transnasal surgery in a human cadaver model. Materials and Methods The applicability of the robotic endoscope guidance system with custom foot pedal controller was tested for advanced transnasal surgery on a fresh frozen human cadaver head. Visualization was enabled using a commercially available endoscope with adjustable viewing angle (15–90 degrees). Results Visualization and instrumentation of all paranasal sinuses, including the anterior and middle skull base, were feasible with the presented setup. Controlling the robotic endoscope guidance system was effectively precise, and the adjustable endoscope lens extended the view in the surgical field without the common change of fixed viewing angle endoscopes. Conclusion The combination of a robotic endoscope guidance system and an advanced endoscope with adjustable viewing angle enables bimanual surgery in transnasal interventions of the paranasal sinuses and the anterior skull base in a human cadaver model. The adjustable lens allows for the abandonment of fixed-angle endoscopes, saving time and resources, without reducing the quality of imaging.
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Li, Yingda, and Michael Y. Wang. "Robotic-Assisted Endoscopic Laminotomy: 2-Dimensional Operative Video." Operative Neurosurgery 20, no. 5 (January 14, 2021): E361. http://dx.doi.org/10.1093/ons/opaa441.

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Abstract Endoscopy and robotics represent two emerging technologies within the field of spine surgery, the former an ultra-MIS approach minimizing the perioperative footprint and the latter leveraging accuracy and precision. Herein, we present the novel incorporation of robotic assistance into endoscopic laminotomy, applied to a 27-yr-old female with a large caudally migrated L4-5 disc herniation. Patient consent was obtained. Robotic guidance was deployed in (1) planning of a focussed laminotomy map, pivoting on a single skin entry point; (2) percutaneous targeting of the interlaminar window; and (3) execution of precision drilling, controlled for depth. Through this case, we illustrated the potential synergy between these 2 technologies in achieving precise bony removal tailored to the patient's unique pathoanatomy while simultaneously introducing safety mechanisms against human error and improving surgical ergonomics.1,2 The physicians consented to the publication of their images.
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37

REN, HONGLIANG, and MAX Q. H. MENG. "INVESTIGATION OF THE ESSENTIALS FOR INTEGRATING OFF-THE-SHELF INDUSTRIAL ROBOTICS IN PRECISE COMPUTER-ASSISTED SURGERY." Journal of Mechanics in Medicine and Biology 11, no. 05 (December 2011): 1113–23. http://dx.doi.org/10.1142/s0219519411004289.

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Off-the-shelf industrial robotic technologies have achieved significant advancements in the past several decades in terms of mechanics and automation performances. We are expecting to take advantage of the industrial robots for assisting surgeons in surgeries and quick prototyping a robotic surgery system. In precise computer-assisted surgeries (CASs), such as pelvic-acetabular surgery, eye surgery, or neurosurgery, it is extremely important to position the tools accurately and precisely for surgical operations. Some of the industrial robotics arms are able to achieve good repeatability and dexterity while positioning the surgical tools. To enable the application of industrial robots in the surgical rooms, there are several other essential modules to be integrated to the robotic surgery systems, such as real-time navigation system, surgical planning system, and surgeon-guidance system. In this paper, we review the existing studies on the medical robots including the ones using industrial robots, and then investigate the essentials for using industrial robots in computer-integrated surgery.
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38

Dohner, J. L. "A Guidance and Control Algorithm for Scent Tracking Micro-Robotic Vehicle Swarms." Journal of Dynamic Systems, Measurement, and Control 120, no. 3 (September 1, 1998): 353–59. http://dx.doi.org/10.1115/1.2805409.

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Cooperative micro-robotic scent tracking vehicles are designed to collectively “sniff out” locations of high scent concentrations in unknown, geometrically complex environments. These vehicles are programed with guidance and control algorithms that allow inter cooperation among vehicles. In this paper, a cooperative guidance and control algorithm for scent tracking micro-robotic vehicles is presented. This algorithm is comprised of a sensory compensation sub-algorithm using point source cancellation, a guidance sub-algorithm using gradient descent tracking, and a control sub-algorithm using proportional feedback. The concepts of social rank and point source cancellation are new concepts introduced within. Simulation results for cooperative vehicles swarms are given. Limitations are discussed.
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39

Fernandez-Bussy, Sebastian, David Abia-Trujillo, Adnan Majid, Erik E. Folch, Neal M. Patel, Felix J. F. Herth, and Janani S. Reisenauer. "Management of Significant Airway Bleeding during Robotic Assisted Bronchoscopy: A Tailored Approach." Respiration 100, no. 6 (2021): 547–50. http://dx.doi.org/10.1159/000514830.

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Robotic assisted bronchoscopy represents a major turning point in bronchoscopic history. The management strategies to address significant airway bleeding in this “robotic era” are not well documented, and further guidance is required. We present a case report that exemplifies our approach and management strategy using a combined and simultaneous flexible/robotic bronchoscopy if this complication is encountered.
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40

Schaufler, Anna, Alfredo Illanes, Ivan Maldonado, Axel Boese, Roland Croner, and Michael Friebe. "Surgical Audio Guidance: Feasibility Check for Robotic Surgery Procedures." Current Directions in Biomedical Engineering 6, no. 3 (September 1, 2020): 571–74. http://dx.doi.org/10.1515/cdbme-2020-3146.

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AbstractIn robot-assisted procedures, the surgeon controls the surgical instruments from a remote console, while visually monitoring the procedure through the endoscope. There is no haptic feedback available to the surgeon, which impedes the assessment of diseased tissue and the detection of hidden structures beneath the tissue, such as vessels. Only visual clues are available to the surgeon to control the force applied to the tissue by the instruments, which poses a risk for iatrogenic injuries. Additional information on haptic interactions of the employed instruments and the treated tissue that is provided to the surgeon during robotic surgery could compensate for this deficit. Acoustic emissions (AE) from the instrument/tissue interactions, transmitted by the instrument are a potential source of this information. AE can be recorded by audio sensors that do not have to be integrated into the instruments, but that can be modularly attached to the outside of the instruments shaft or enclosure. The location of the sensor on a robotic system is essential for the applicability of the concept in real situations. While the signal strength of the acoustic emissions decreases with distance from the point of interaction, an installation close to the patient would require sterilization measures. The aim of this work is to investigate whether it is feasible to install the audio sensor in non-sterile areas far away from the patient and still be able to receive useful AE signals. To determine whether signals can be recorded at different potential mounting locations, instrument/tissue interactions with different textures were simulated in an experimental setup. The results showed that meaningful and valuable AE can be recorded in the non-sterile area of a robotic surgical system despite the expected signal losses.
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Carbone, Marina, Giuseppe Turini, Gianluigi Petroni, Marta Niccolini, Arianna Menciassi, Mauro Ferrari, Franco Mosca, and Vincenzo Ferrari. "Computer guidance system for single-incision bimanual robotic surgery." Computer Aided Surgery 17, no. 4 (June 11, 2012): 161–71. http://dx.doi.org/10.3109/10929088.2012.692168.

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42

Onogi, Shinya, Toshio Yoshida, Yuki Sugano, Takashi Mochizuki, and Kohji Masuda. "Robotic Ultrasound Guidance by B-scan Plane Positioning Control." Procedia CIRP 5 (2013): 100–103. http://dx.doi.org/10.1016/j.procir.2013.01.020.

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43

Lu, Cheng-Kai, Yi-Che Huang, and Cheng-Jung Lee. "Adaptive guidance system design for the assistive robotic walker." Neurocomputing 170 (December 2015): 152–60. http://dx.doi.org/10.1016/j.neucom.2015.03.091.

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44

Park, S. J., M. Gazzola, K. S. Park, S. Park, V. Di Santo, E. L. Blevins, J. U. Lind, et al. "Phototactic guidance of a tissue-engineered soft-robotic ray." Science 353, no. 6295 (July 7, 2016): 158–62. http://dx.doi.org/10.1126/science.aaf4292.

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45

Kaye, Deborah R., Dan Stoianovici, and Misop Han. "Robotic ultrasound and needle guidance for prostate cancer management." Current Opinion in Urology 24, no. 1 (January 2014): 75–80. http://dx.doi.org/10.1097/mou.0000000000000011.

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46

Mehrandezh, M., M. N. Sela, R. G. Fenton, and B. Benhabib. "Proportional navigation guidance for robotic interception of moving objects." Journal of Robotic Systems 17, no. 6 (June 2000): 321–40. http://dx.doi.org/10.1002/(sici)1097-4563(200006)17:6<321::aid-rob3>3.0.co;2-s.

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47

Matsumoto, Y., H. Kami, T. Ino, J. Ido, H. Tani, K. Goto, and T. Ogasawara. "2A1-A12 User-Carrying Robotic Terminal for Library Guidance." Proceedings of JSME annual Conference on Robotics and Mechatronics (Robomec) 2001 (2001): 40. http://dx.doi.org/10.1299/jsmermd.2001.40_7.

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48

Moreno, Juan C., Filipe Barroso, Dario Farina, Leonardo Gizzi, Cristina Santos, Marco Molinari, and José L. Pons. "Effects of robotic guidance on the coordination of locomotion." Journal of NeuroEngineering and Rehabilitation 10, no. 1 (2013): 79. http://dx.doi.org/10.1186/1743-0003-10-79.

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49

Fujishiro, Takashi, Yoshiharu Nakaya, Shingo Fukumoto, Shu Adachi, Atsushi Nakano, Kenta Fujiwara, Ichiro Baba, and Masashi Neo. "Accuracy of Pedicle Screw Placement with Robotic Guidance System." SPINE 40, no. 24 (December 2015): 1882–89. http://dx.doi.org/10.1097/brs.0000000000001099.

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50

YOON, Siyeop, Sangkyun SHIN, Hyunchul CHO, Youngjun KIM, Laehyun KIM, Deukhee LEE, and Gunwoo NOH. "Enhanced markerless surgical robotic guidance system for keyhole neurosurgery." Journal of Advanced Mechanical Design, Systems, and Manufacturing 11, no. 4 (2017): JAMDSM0046. http://dx.doi.org/10.1299/jamdsm.2017jamdsm0046.

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