Transbronchial lung biopsy is an effective and less-invasive treatment for the early diagnosis of lung cancer. However, the limited dexterity of existing endoscopic instruments and the complexity of bronchial access prevent the application of such procedures mainly for biopsy and diagnosis. This paper proposes a flexible robot for transbronchial lung biopsy with a cable-driven mechanism-based flexible manipulator. The robotic system of transbronchial lung biopsy is presented in detail, including the snake-bone end effector, the flexible catheters and the actuation unit. The kinematic analysis of the snake-bone end effector is conducted for the master-slave control. The experimental results show that the end effector reaches the target nodule through a narrow and tortuous pathway in a bronchial model. In conclusion, the proposed robotic system contributes to the field of advanced endoscopic surgery with high flexibility and controllability.

Although robotic or robot-assisted surgery has been increasingly used by many surgical disciplines, its application in cranial or skull base surgery is still in its infancy. Master-slave teleoperation setting of these robotic systems enables these surgical procedures to be replicated in a virtual reality environment for surgeon training purposes. A variety of teleoperation modes were previously determined with respect to the motion capability of the surgeon’s hand that wears the ring as the surgeon handles a surgical tool inside the surgical workspace. In this surgery training simulator developed for a robot-assisted endoscopic skull base surgery, a new strategy is developed to identify the preferred motion axes of the surgeon. This simulator is designed specifically for tuning the teleoperation system for each surgeon via the identification. This tuning capability brings flexibility to adjust the system operation with respect to the motion characteristics of the surgeon.

Developed minimally invasive surgical (MIS) robots are large multi-arm, multipurpose systems requiring significant investments that limit their availability in hospitals. A larger distribution of MIS robots with benefit for patients might be achieved improving their modularity and scalability so that smaller hospitals or medical centers could decide for a simpler and lower cost setup for a limited number of treatments only, while centers with higher funding could have more systems dedicated to different classes of operations. In line with this statement the paper proposes the paradigm of lean MIS system comprising a scalable set of modular, agile, small size single-instrument robots with limited life cycle cost. Miniaturization of instruments can further reduce invasiveness of procedures and one promising research direction is needle laparoscopic surgery, which can be applied to classes of operations on small regions requiring small force interaction with the patient. In the paper the development of a lean single-instrument manipulator for needlescopic surgery is presented and a new master concept for accurate restitution of surgical force proposed and discussed.