Accurate motion control of surgical robots is critical for the efficiency and safety of both state-of-the-art teleoperated robotic surgery and the ultimate autonomous robotic surgery. However, fine motion control for a flexible endoscopic surgical robot is highly challenging because of the shape-dependent and speed-dependent motion hysteresis of tendon-sheath mechanisms (TSMs) in the long, tortuous, and dynamically shape-changing robot body. Aiming to achieve precise closed-loop motion control, we propose a small and flexible sensor to directly sense the large and sharp rotations of the articulated joints of a flexible endoscopic surgical robot. The sensor-a Fiber Bragg Grating (FBG) eccentrically embedded in a thin and flexible epoxy substrate-can be significantly bent with a large bending angle range of [-62.9°, 75.5°] and small bending radius of 6.9 mm. Mounted in-between the two pivot-connected links of a joint, the sensor will bend once the joint is actuated, resulting in the wavelength shift of the FBG. In this study, the relationship between the wavelength shift and the rotation angle of the joint was theoretically modeled and then experimentally verified before and after the installation of the sensor in a robotic endoscopic grasper. The sensor, with the calibrated model, can track the rotation of the robotic joint with an RMSE of 3.34°. This small and flexible sensor has good repeatability, high sensitivity (around 147.5 pm/degree), and low hysteresis (7.72%). It is suitable for surgical robots and manipulators whose articulated joints have a large rotation angle and small bending radius.

Perforations in flexible endoscopy are life-threatening. Defect closure or suturing in flexible endoscopy has long been a critical challenge due to the confined space of the access routes and surgical sites, high dexterity and force demands of suturing tasks, as well as critical size and strength requirements of wound closure. This paper introduces a novel robotic suturing system for flexible endoscopic surgery. This system features a flexible, through-the-scope, five-degree-of-freedom robotic suturing instrument. This instrument allows the surgeon to endoscopically manipulate a needle via a master console to create running stitches and knots in flexible endoscopy, which is not possible with existing devices. Successful ex-vivo trials were conducted inside porcine colons to show how surgical stitches and knots can be endoscopically created and secured in a completely new way. This new technology will change the way how surgeons close defects or perforations in flexible endoscopic surgery.

When performing some surgical tasks inside colon with NOTES technology, colon tissue could block the task space and occlude the endoscopic vision. In order to solve this problem, we developed a pneumatically driven deployable and undeployable structure which can distend collapsing tissue and can be delivered through a 4.5 mm endoscopic channel. The structure is designed to be flexible enough to pass through colon's tortuous pathway. Also, it is designed to hold its shape without continually applying air pressure after deployment. This allows to make use of an endoscopic channel for the other surgical instruments. Besides, due to the compliant nature of the device, it is safe to deploy inside a smaller space than its maximum deployable size. The functionality of the device was verified with an in-vitro experiment. The structure was successfully deployed inside a pig's colon with an inner diameter of 60 mm by applying 3.5 bars of air pressure and created a sufficient task space for surgical operations.

Accurate haptic feedback is a critical challenge for surgical robots, especially for flexible endoscopic surgical robots whose transmission systems are Tendon-Sheath Mechanisms (TSMs) with highly nonlinear friction profiles and force hysteresis. For distal end haptic sensing of TSMs, this paper, for the first time, proposes to measure the compression force on the sheath at the distal end so that the tension force on the tendon, which equals the compression force on the sheath, can be obtained. A new force sensor, i.e., a nitinol tube attached with an optical Fiber Bragg Grating (FBG) fiber, is proposed to measure the compression force on the sheath. This sensor, with similar diameter and configuration (hollow) as the sheath, can be compactly integrated with TSMs and surgical end-effectors. In this paper, mechanics analysis and verification tests are presented to reveal the relationship between the tension force on the tendon and the compression force on the sheath. The proposed force sensor was calibrated in tests with a sensitivity of 24.28 pm/N and integrated with a tendon-sheath driven grasper to demonstrate the effectiveness of the proposed approach and sensor. The proposed approach and sensor can also be applied for a variety of TSMs-driven systems, such as robotic fingers/hands, wearable devices, and rehabilitation devices.

Variable stiffness for robotics is attracting increasing attention from researchers in the field of surgical robots. A surgical robot that can access the human colon or stomach via natural orifices must be flexible enough to pass through tortuous paths and to work in a confined space. Meanwhile, the robot must also be stiff enough to ensure pushability and to hold high payloads during the surgery. Thus, surgical robots with variable stiffness are desirable. This paper presents a new design concept for variable stiffness manipulators using a thermoplastic material - Polyethylene Terephthalate (PET) - and a flexible stainless steel sheath as a heating solution. The stiffness of PET can be flexibly adjusted through temperature. Experiments and validations were carried out at different conditions. The results showed that our proposed design is at least as flexible as a typical commercial endoscope when flexibility is desired and meanwhile at least 9 times stiffer than the endoscope when stiffness is desired (Flexural modulus was compared). A tendon-driven manipulator based on the proposed concept was also developed. Validation tests showed that the manipulator in compliant mode can be significantly bent through cable actuation, and the manipulator in stiff mode is able to maintain its shape against considerably large loads.