This paper presents a visual feedback available robotic gait training system for motor recovery of hemiplegic stroke survivors. The system is composed of a treadmill consisting of two split belts, a pelvic support manipulator assisting patient's pelvic movement, and a visual interface feedbacking patient's gait phase. The split-belt treadmill allow patient to walk in different velocities between sound side and affected side legs, and detect patient's gait phase by current value of DC motor. The pelvic support manipulator provides three active actuations to assist patient's leg swinging during walk training. The virtual walking scenario gives visual feedback for patient while providing patient's gait phase calculated from motor current of the treadmill. One subject with simulated stroke participated in this study. Experiment results indicate gait phase of the virtual model can well track that of patient's walking, verify the feasibility of the proposed system to improve gait recovery during rehabilitation.

Eye-tracking technology has been applied to surgical skill improvement and can observe differences in gaze data between the experienced and novice surgeon. Some eye trackers can even detect pupil diameter. We hypothesized that differences in technical proficiency among surgeons affect the extent of changes in pupil diameter, because the higher mental workload a laparoscopic task requires, the larger the person's pupil diameter dilates. In this study, we recorded the pupil diameters of pediatric surgeons while they performed a suturing task in a dry box environment. The more proficient surgeons exhibited a smaller distribution in pupil diameter than did the less proficient surgeons. Our data indicate that an individual's suturing proficiency is closely related to the degree of dispersion of pupil diameter.

Minimally invasive surgery (MIS) is commonly used in pediatric operations. This method greatly benefits patients because of the reduced surgical trauma. To perform such surgery smoothly, doctors must be highly skilled. To reduce operating difficulties, a great deal of research on surgical systems have been carried out. However, in some cases, smaller workspaces limit the application of MIS. For example, the workspace of infant congenital esophageal atresia (ICEA) surgery is only around 30×30×30 mm. Until now, most ICEA surgeries have been manually performed with traditional instruments. This paper presents a smart surgical robot (SSR) for ICEA surgery. The robot is composed of two slave arms, each consisting of a positioning manipulator and a surgical tool manipulator. The positioning manipulator uses a selective compliance assembly robot arm (SCARA) and a screw-pair mechanism to achieve translational movement in 3D space, and the surgical tool manipulator uses a “double screw drive + universal joint” structure to allow an omni directional bending motion. During surgery, the surgeon first creates the workspace manually to explore the target esophagus. The SSR system is then applied to perform operation. The configuration of the SSR means it can perform tissue manipulation under endoscopic view in a small workspace. Experimental results show that the endoscopic view permits the SSR system to be operated intuitively and accurately in the target workspace.

Remote operation is commonly used in modern robotic assisted surgery. A surgeon sits beside the console to operate an input device to control the slave robotic instrument performing tissue manipulation, while guided by visual feedback. Most people have high more dexterity on one hand than in the other. Humans prefer to use their more dexterous hand to do important tasks, such as holding a needle for suturing, while the other hand is used to assist. However, surgeons need to perform important task using both hands on a surgery. For example, they sometimes need use left hand to hold scalpels or needles for vital tissue intervention even if they are right-handed. This paper presents a novel smart surgical robotic system for surgical application. The robotic system is composed of two slave arms and two visual modules. Each slave arm consists of a 8 degree of freedom dexterous manipulator. Each visual module is composed of a 3 DOF manipulator and a flexible endoscope. The two slave arms and the two vision modules are closely located in a rectangular frame. Two phantom Omnis are used for tele-control of the two slave arms for tissue manipulation. The correspondence between the phantom Omnis and the slave arms could be swapped depending on the surgical requirement. Therefore, the user could always use the most dexterous hand for vital tasks. The two visual modules, located in the front and the back of the two slave arms respectively are used for visual feedback. Based on the different correspondence between the master and the slave arms, only one visual module will be selected to show its image in a monitor. As a result, the operator could always drive the slave arms for tissue manipulation with good eye-hand coordination. The preliminary experiment shows that the surgical robotic system is adequate.

Recently, a large amount of stroke survivors are suffering from motor impairment. However, existed therapy interventions have limited effects to restore normal motor function. Thus, we proposed a novel control strategy for gait rehabilitation of hemiplegic patients. The whole system consists of a Functional Electrical Stimulation (FES) device and Treadmill-Walk system. FES contributes to improve the quality of the gait based on real-time adjustment of gait pattern. During gait, the electrical stimuli from separate output channels of an FES device are launched to stimulate two lower extremity muscles (Tibialis Anterior (TA) and Hamstrings). Stimulus launching procedure is based on identifying subject's gait state (stance and swing phases). According to the current variation of treadmill motor, gait phase and muscle activation of lower limbs can be determined during walking on Treadmill-Walk. Three able-bodied subjects simulated hemiplegic patients in the experiment. The results indicated that the proposed method is a safe, feasible and promising intervention.

The clinical target of this study is intratracheal balloon occlusion from minimally invasive fetal surgery for Congenital Diaphragmatic Hernia (CDH). The target for the surgery is prenatal temporary tracheal occlusion which enlarges the fetal lungs, and this procedure is promising for severe cases. A balloon is supposed to be inserted for tracheal occlusion using the manipulator. We propose a novel robotic manipulator for intrauterine fetal surgery for tracheal occlusion. In this study, a prototype of the robotic manipulator using a wire-driven mechanism has been developed. The manipulator is thin in structure and has multiple degrees of freedom to avoid damage to the fragile cells of the fetus. Specifically, we describe our development of the 3-unit robotic manipulator with ball joint-shaped arthroses and shaft diameter of 2.4 mm. The mechanism of the robotic manipulator was designed for providing the bending motion and controlling the contact force at its tip by the tension of the driven wires. Results of the experiment suggested that the contact force was controlled to under 0.04 N to insert the manipulator through the mouth of the fetus into the trachea without causing damage to the fetal tissues or changing the fetal attitude in the uterus.

The clinical target of this study is intratracheal balloon occlusion from minimally invasive fetal surgery for Congenital Diaphragmatic Hernia (CDH). The target for the surgery is a prenatal temporary tracheal occlusion, which enlarges the fetal lungs, and is a promising procedure for severe cases. A balloon is supposed to be inserted for tracheal occlusion using the manipulator. We propose a novel robotic manipulator for intrauterine fetal surgery for tracheal occlusion. In this study, the 3-unit robotic manipulator with ball joint-shaped arthroses and a shaft diameter of 2.4 mm using a wire-driven mechanism has been developed to approach the fetal trachea without the risk of damage to fetal tissue. The robotic manipulator has a thin structure and 7 degrees of freedom to avoid damage to the fragile fetal cells. However, the positioning control of the robotic manipulator is very difficult. In this paper, the mechanism of the robotic manipulator positioning control was confirmed by measuring the motion of each unit through the experiment. Additionally, a simulation was developed to estimate the mechanism of the robotic manipulator positioning control, and an approach method was considered. The results of the evaluation experiment suggested that the robotic manipulator could approach the fetal trachea through the mouth, and that the contact force was controlled to under 0.05 [N].

A bending laser manipulator of 2.4 mm in diameter has been developed for intrauterine fetal surgery. This manipulator deflects a laser fiber in any direction thorough 90 degrees. The results of a positioning test and in vitro/in vivo tests are reported. Meanwhile, creep tests for fetal rat tissue of 16 to 20 days in gestation were performed to evaluate fetal tissue fragility. Unique features of fetal rat tissue compared to other soft organs are discussed and a viscoelastic model of the fetal rat tissue was proposed. The result of the modeling will be used not only for fabricating fetal tissue phantom but also for the force control of robotic application for fetal surgery.