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A robotic system for percutaneous renal access.

PURPOSE: Percutaneous renal access can be challenging, particularly when the collecting system is not distended. Precise entry into a selected calyx facilitates subsequent percutaneous manipulations, but this skill requires extensive experience. In an attempt to improve accuracy while decreasing technical challenges, we developed a robotic system that automates the task of fluoroscopic image-guided percutaneous needle placement. MATERIALS AND METHODS: The prototype system consisted of a three degree-of-freedom robot with a needle injector end-effector. Imaging was provided by a biplanar fluoroscope. After correction of image distortion and fluoroscope calibration, robot to image-space registration was completed. To validate the system's ability to insert a needle into a calyx, ex vivo porcine kidneys suspended in agarose gel and distended with iodinated contrast solution were used as a model. In situ renal access tests with three 20 kg. pigs were performed. Access was confirmed by passing a flexible wire or aspirating iodinated contrast from the collecting system. RESULTS: The diameter of target calyces ranged from 3 to 7 mm. The in vitro accuracy of final needle tip positioning was 0.43 mm. In the ex vivo model, successful "one stick" access occurred on 10 of 12 attempts (83%). In situ access on the first attempt was successful for 6 of 12 target calyces (50%). Needle or tissue deflection accounted for each failure. CONCLUSION: The feasibility of a robotic system to assist in the percutaneous access of small and delicate renal calyces has been demonstrated. Additional work in reducing procedural steps and correcting for tissue deflection during needle passage is necessary to improve accuracy and to allow for clinical application.

Animals↗

A robot system for evaluating plaque removal efficiency of toothbrushes in vitro.

A robot system simulating three-dimensional brushing motions as a function of time has been developed. In association with a typodont and either artificial plaque or chromogenic stain, the robot system can be used to assess the plaque removal efficiency or the cleaning effectiveness of toothbrushes. In particular, the influence of different brush head designs of powered toothbrushes was examined. The study compared the plaque removal efficiency of a cup-shaped brush head (Braun Oral-B EB 5) and a modified brush head (Braun Oral-B EB 9) that incorporates longer filaments on the outer ring, designed for additional interdental penetration. A specially designed artificial plaque was applied to the plastic teeth of typodonts. Artificial teeth were cleaned by the robot system for a 2-minute period with a wet brush head without a dentifrice. The remaining plaque was assessed visually by two independent examiners, with a modification of the global Plaque Index. In comparison to the EB 5, the new brush head significantly reduced artificial plaque overall. In vitro data demonstrated the ability of the robot system to reveal reproducible significant differences of the cleaning effectiveness of powered toothbrushes.

Dental Plaque↗

[The robotization of neurosurgery: state of the art and future outlook].

Neurosurgery is by excellence a field of application for robots, based on multimodal image guidance. Specific motorized tools have been already developed and routinely applied in stereotaxy to position a probe holder or in conventional neurosurgery to hold a microscope oriented towards a given target. The potentialities of these approaches have triggered industrial developments currently commercially available. These systems use data bases, primarily coming from multimodal numerical images from X-ray radiology to magnetic resonance imaging. These spatially encoded data are transferred through digital networks to workstations where images can be processed and surgical procedures are preplanned, then transferred to the robotic systems to which they are connected. We have been using a stereotactic robot since 1989 and a microscope robot since 1995 in various surgical routine procedures. The future of these applications mainly rely on the technical progress in informatics, about image recognition to adapt the preplanning to the actual surgical situation, to correct brain shifts for instance, about image fusion, integrated knowledge such such as brain atlases, as well as virtual reality. The future developments, covering surgical procedure, research and teaching, will sure be far beyond our wildest expectations.

Forecasting↗

[Digital imaging and robotics in endoscopic surgery].

The introduction of endoscopical surgery has among other things influenced technical developments in surgery. Owing to digitalisation, major progress will be made in imaging and in the sophisticated technology sometimes called robotics. Digital storage makes the results of imaging diagnostics (e.g. the results of radiological examination) suitable for transmission via video conference systems for telediagnostic purposes. The availability of digital video technique renders possible the processing, storage and retrieval of moving images as well. During endoscopical operations use may be made of a robot arm which replaces the camera man. The arm does not grow tired and provides a stable image. The surgeon himself can operate or address the arm and it can remember fixed image positions to which it can return if ordered to do so. The next step is to carry out surgical manipulations via a robot arm. This may make operations more patient-friendly. A robot arm can also have remote control: telerobotics. At the Internet site of this journal a number of supplements to this article can be found, for instance three-dimensional (3D) illustrations (which is the purpose of the 3D spectacles enclosed with this issue) and a quiz (http:@appendix.niwi. knaw.nl).

Computer Communication Networks↗

Beyond da Vinci: a systematic review of next-generation multiport robotic platforms in pediatric surgery.

As robotic surgery expands beyond the da Vinci platform, the relevance of new-generation systems to pediatric patients remains uncertain. This review examined the technical characteristics, applications, and perioperative outcomes of alternative multiport robotic platforms in children. PubMed/MEDLINE, Web of Science, Scopus, and the Cochrane Library were searched through 28 February 2026 in accordance with PRISMA 2020. Owing to clinical heterogeneity, findings were synthesized narratively, with Wilson 95% confidence intervals for key binary outcomes. Six studies reported 166 patients across 27 procedure types. Senhance accounted for 164 patients, while Hugo RAS and Hinotori were each represented by one patient. Ages ranged from 15 days to 17 years and weights from 3.8 to more than 100 kg. Senhance was the only platform used with 3-mm robotic instruments. Conversion or planned escalation occurred in 19 patients (11.4%; 95% CI, 7.5-17.2%). Four intraoperative complications were reported (2.4%; 95% CI, 0.9-6.0%). Across all reports, 20 patients experienced postoperative complications (12.0%; 95% CI, 7.9-17.9%). In the largest cohort, seven patients required reintervention (4.6%; 95% CI, 2.2-9.2%) and seven were readmitted (4.6%; 95% CI, 2.2-9.2%). No deaths or comparative pediatric studies were reported. Published experience remains sparse and is almost entirely limited to Senhance. Current evidence describes early clinical use without establishing comparative safety, effectiveness, or platform superiority. Prospective multicenter studies with standardized reporting are needed.

Humans↗

What does robotics offer animal behaviour?

There is a growing body of robot-based research that makes a serious claim to be a new methodology for biology. Robots can be used as models of specific animal systems to test hypotheses regarding the control of behaviour. At levels from learning algorithms to specific dendritic circuits, implementing a proposed controller in a robotic device tests it against real environments in a way that is difficult to simulate. This often provides insight into the true nature of the problem. It also enforces complete specifications and combines bodies of data. Current work can sometimes be criticized for drawing unjustified conclusions given the limited evaluation and inevitable inaccuracies of robot models. Nevertheless, this approach has led to novel hypotheses for animal behaviour and seems likely to provide fruitful results in the future. Copyright 2000 The Association for the Study of Animal Behaviour.

Journal Article↗

Evolving grounded communication for robots.

The computational and robotic synthesis of language evolution is emerging as a new exciting field of research. The objective is to come up with precise operational models of how communities of agents, equipped with a cognitive apparatus, a sensori-motor system, and a body, can arrive at shared grounded communication systems. Such systems may have similar characteristics to animal communication or human language. Apart from its technological interest in building novel applications in the domain of human-robot or robot-robot interaction, this research is of interest to the many disciplines concerned with the origins and evolution of language and communication.

Journal Article↗

Is imitation learning the route to humanoid robots?

This review investigates two recent developments in artificial intelligence and neural computation: learning from imitation and the development of humanoid robots. It is postulated that the study of imitation learning offers a promising route to gain new insights into mechanisms of perceptual motor control that could ultimately lead to the creation of autonomous humanoid robots. Imitation learning focuses on three important issues: efficient motor learning, the connection between action and perception, and modular motor control in the form of movement primitives. It is reviewed here how research on representations of, and functional connections between, action and perception have contributed to our understanding of motor acts of other beings. The recent discovery that some areas in the primate brain are active during both movement perception and execution has provided a hypothetical neural basis of imitation. Computational approaches to imitation learning are also described, initially from the perspective of traditional AI and robotics, but also from the perspective of neural network models and statistical-learning research. Parallels and differences between biological and computational approaches to imitation are highlighted and an overview of current projects that actually employ imitation learning for humanoid robots is given.

Journal Article↗

The revolution of computer-aided surgery - the dawn of robotic surgery.

Endoscopic surgery has rapidly changed the performance of surgical procedures in a wide range of surgical specialities, but difficulties with endoscopic manipulation remain. The next step in the revolution initiated by the introduction of endoscopic surgery will be achieved by the introduction of robotics, tele-mentoring systems and telepresence surgery. Primary capabilities brought to surgery by robotic manipulators can be summarised as surgical assistance, image-guided therapy and dexterity enhancement. Using computer-aided systems, such as robotics and image-guided surgery, the next generation of surgical systems will be more sophisticated, and will permit surgeons to perform surgical procedures beyond the current limitation of human performance — on the microscale, or on moving organs. Industry is focusing currently on developing manipulators for endoscopic microsurgery, and several devices have already entered clinical use. Taking advantage of one such robotic system, we have developed a new method of endoscopic cholecystectomy, which is performed without leaving foreign bodies and using a procedure that prevents adhesions after surgery. Some new endoscopic procedures have also become feasible, although these are currently performed only by open surgery, without this system. It seems to be highly probable that master–slave manipulators will soon be in routine surgical use for selected indications.

Journal Article↗

Current status and future prospects for robotic technology in health care delivery.

The main reason for using robotic technology to assist functionally limited individuals is that it could enable them to have increased control of their own lives. Evaluation of one prototype voice-controlled robotic aid has shown the feasibility of robotic-assisted tasks in four areas: activities of daily living, vocation, recreation, and physical therapy. Creation of a product, however, will require careful investigation of utility and potential marketability issues (such as safety and training) that will determine the acceptance of robotic technology in health and human service applications.

Adolescent↗

Sensor scheduling in mobile robots using incomplete information via Min-Conflict with Happiness.

This paper develops and applies a variant of the Min-Conflict algorithm to the problem of sensor allocation with incomplete information for mobile robots. A categorization of the types of contention over sensing resources is provided, as well as a taxonomy of available information for the sensor scheduling task. The Min-Conflict with Happiness (MCH) heuristic algorithm, which performs sensor scheduling for situations in which no information is known about future assignments, is then described. The primary contribution of this modification to Min-Conflict is that it permits the optimization of sensor certainty over the set of all active behaviors, thereby producing the best sensing state for the robot at any given time. Data are taken from simulation experiments and runs from a pair of Nomad200 robots using the SFX hybrid deliberative/reactive architecture. Results from these experiments demonstrate that MCH is able to satisfy more sensor assignments (up to 142%) and maintain a higher overall utility of sensing than greedy or random assignments (a 7-24% increase), even in the presence of sensor failures. In addition, MCH supports behavioral sensor fusion allocations. The practical advantages of MCH include fast, dynamic repair of broken schedules allowing it to be used on computationally constrained systems, compatibility with the dominant hybrid robot architectural style, and least-disturbance of prior assignments minimizing interruptions to reactive behaviors.

Journal Article↗

Adaptive dynamic surface control of flexible-joint robots using self-recurrent wavelet neural networks.

A new method for the robust control of flexible-joint (FJ) robots with model uncertainties in both robot dynamics and actuator dynamics is proposed. The proposed control system is a combination of the adaptive dynamic surface control (DSC) technique and the self-recurrent wavelet neural network (SRWNN). The adaptive DSC technique provides the ability to overcome the "explosion of complexity" problem in backstepping controllers. The SRWNNs are used to observe the arbitrary model uncertainties of FJ robots, and all their weights are trained online. From the Lyapunov stability analysis, their adaptation laws are induced, and the uniformly ultimately boundedness of all signals in a closed-loop adaptive system is proved. Finally, simulation results for a three-link FJ robot are utilized to validate the good position tracking performance and robustness against payload uncertainties and external disturbances of the proposed control system.

Journal Article↗

A swimming robot actuated by living muscle tissue.

Biomechatronics is the integration of biological components with artificial devices, in which the biological component confers a significant functional capability to the system, and the artificial component provides specific cellular and tissue interfaces that promote the maintenance and functional adaptation of the biological component. Based upon functional performance, muscle is potentially an excellent mechanical actuator, but the larger challenge of developing muscle-actuated, biomechatronic devices poses many scientific and engineering challenges. As a demonstratory proof of concept, we designed, built, and characterized a swimming robot actuated by two explanted frog semitendinosus muscles and controlled by an embedded microcontroller. Using open loop stimulation protocols, the robot performed basic swimming maneuvers such as starting, stopping, turning (turning radius ~400 mm) and straight-line swimming (max speed >1/3 body lengths/second). A broad spectrum antibiotic/antimycotic ringer solution surrounded the muscle actuators for long term maintenance, ex vivo. The robot swam for a total of 4 hours over a 42 hour lifespan (10% duty cycle) before its velocity degraded below 75% of its maximum. The development of functional biomechatronic prototypes with integrated musculoskeletal tissues is the first critical step toward the long term objective of controllable, adaptive and robust biomechatronic robots and prostheses.

Journal Article↗

Recent trends in robot-assisted therapy environments to improve real-life functional performance after stroke.

Upper and lower limb robotic tools for neuro-rehabilitation are effective in reducing motor impairment but they are limited in their ability to improve real world function. There is a need to improve functional outcomes after robot-assisted therapy. Improvements in the effectiveness of these environments may be achieved by incorporating into their design and control strategies important elements key to inducing motor learning and cerebral plasticity such as mass-practice, feedback, task-engagement, and complex problem solving. This special issue presents nine articles. Novel strategies covered in this issue encourage more natural movements through the use of virtual reality and real objects and faster motor learning through the use of error feedback to guide acquisition of natural movements that are salient to real activities. In addition, several articles describe novel systems and techniques that use of custom and commercial games combined with new low-cost robot systems and a humanoid robot to embody the " supervisory presence" of the therapy as possible solutions to exercise compliance in under-supervised environments such as the home.

Editorial↗

The nonreciprocating robot: effects on verbal discourse, social play, and social referencing at two years of age.

2-year-old children interacted with a robot in a large playroom while their mother sat quietly in the corner. Identical vocalizations from the robot had very different effects on 3 dimensions of the children's behavior when the vocalizations were embedded in reciprocating and nonreciprocating social structures. The reciprocating robot produced (1) more topic-maintaining verbal dialogue, (2) less physical and more linguistically mediated social play, and (3) gender-specific effects on the children's tendency to visually reference their mother during the play session. The data are discussed with reference to the frequently encountered assumption that reciprocal social structures have an impact on children's behavior when the quantity and other qualitative dimensions of social stimulation are held constant, and with reference to the children's attributions about the robot as a social partner.

Child, Preschool↗

Applications of artificial intelligence in robot-assisted surgery: a systematic review.

To characterize applications of artificial intelligence (AI) in robot-assisted surgery, summarize technical and clinical performance, and assess the quality of the available evidence. PubMed, Web of Science Core Collection, and Scopus were searched for English-language journal articles published from 1 January 2020 through 31 October 2025. Randomized, observational, model-development, validation, and feasibility studies evaluating AI in robot-assisted surgery or closely related image-guided minimally invasive workflows were eligible. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessment. Owing to heterogeneity in surgical procedures, AI tasks, analytical units, validation strategies, and outcomes, findings were synthesized descriptively without statistical pooling. The review was registered in the International Prospective Register of Systematic Reviews (CRD420251175699). Seventeen studies were included: seven clinical prediction or decision-support studies, eight intraoperative recognition, segmentation, or image-guided studies, and two training or workflow studies. Five prediction studies reported area-under-the-curve values of 0.74-0.95. Technical studies reported F1 or Dice scores of 0.525-0.995 and task-specific accuracies of 0.840-0.998. Two randomized studies suggested benefits for personalized suturing feedback and automated camera control, but neither established improved patient outcomes. Only one study had low overall risk of bias; the remaining studies were at high or unclear risk or raised some concerns. AI applications in robot-assisted surgery show promise for prediction, intraoperative perception, training, and workflow support. Evidence primarily demonstrates technical feasibility rather than established clinical effectiveness. Independent multicenter validation and prospective evaluation of patient, educational, and workflow outcomes are required before widespread implementation.

Robotic Surgical Procedures↗

Robot-Assisted Stereotactic Aspiration of a Parietal Brain Abscess With Metagenomic Identification of Fusobacterium nucleatum.

Robot-assisted stereotactic aspiration offers a minimally invasive approach to brain abscesses near the eloquent cortex. We report a rare case of a left parietal abscess caused by Fusobacterium nucleatum in an immunocompetent adult, managed successfully with this approach. The patient, a 52-year-old man, presented with right-sided limb numbness. MRI and contrast-enhanced CT revealed a cystic, ring-enhancing lesion with diffusion restriction in the left parietal lobe. Despite empiric broad-spectrum antibiotics, neurological deterioration occurred due to progressive mass effect. Robot-assisted stereotactic aspiration enabled single-stage, precise drainage of the abscess. Metagenomic next-generation sequencing identified F. nucleatum , prompting adjustment of antibiotics to ceftriaxone plus metronidazole, followed by metronidazole monotherapy. The patient improved clinically, and a 6-month MRI confirmed complete resolution, underscoring the precision of robotic stereotaxy for eloquent-region abscesses and highlighting the diagnostic value of metagenomic sequencing in detecting anaerobic pathogens.

Humans↗

Machining and accuracy studies for a tibial knee implant using a force-controlled robot.

Total knee arthroplasty requires accurate preparation of the bone surfaces to maximize bone implant contact area in cementless surgery and to obtain proper joint kinematics and ligament balancing. Robots can make the cuts with the necessary high precision. The purpose of this article is threefold: to propose an alternative method for intraoperative registration using an intramedullary rod and an alternative method for force control using the hybrid force-velocity control scheme; to demonstrate that the accuracy and the surface flatness of the cuts machined by a robot are better than in a conventional operation; and to monitor the machining process and to try to derive some information about the local bone quality from it. The results of the laboratory study are promising: the surface flatness of the tibial plateau, calculated using a least squares method, is 0.1-0.2 mm, which is significantly better than in conventional surgery; and the high angular accuracy of the robot allows the bone cuts to be located precisely. Further, an exponential relation between milling forces and local bone density was established, so measurements of the milling forces can provide the surgeon with on-line information about the local bone quality.

Animals↗