Researchers are developing wearable robotic tools for minimally invasive surgery designed to give surgeons more natural and dexterous movement than current surgical robots offer. The €4 million research project, which is being funded by the European Commission under HORIZON 2020, says the robotic tools will be worn on the surgeon’s hands and transmit the surgeon’s own movements to a closed surgical interface without restrictions, reducing the overall cognitive, manipulation and training demand.

There are three key pieces of hardware for this new surgical robotic system. First is the exoskeleton that fits over the surgeon’s hands and controls the instruments inside the body. The exoskeleton will act as a new surgical ‘gripper’ that mimics the thumb and two fingers of the hand.

Second is the instrument that goes inside the body. It will have haptic abilities that allow surgeons to feel the tissues and organs inside the body, just like they do during conventional surgery. The sense of touch in this system will be dual: current research in haptic systems mainly focuses on the arm/forearm of the user. The system developed in this project will focus on haptic feedback on the fingers of the surgeon as well.

The third piece is smart glasses that enable the surgeon to have a realistic view of what is taking place inside the body.

Professor Sanja Dogramadzi, of Bristol Robotics Laboratory and the lead researcher on this project, these developments stem from a need for better tools in robot-assisted minimally invasive surgery to support and enhance the surgeon’s performance in urology, cardiovascular and orthopaedic fields and to expand the potential for this technology to more complex surgical procedures.

“In our project the exoskeleton will record the position of the fingers and communicate this to the robotic tools inside the body using tele-operated technology,” Dogramadzi says. “We want to give existing processes a more natural interface – operating surgeons will not have to do any unusual or unnatural movement. They will be able to use their hands as they would in open incision surgery. This also means that training to use the robotic technology for surgery will be quicker.

“The research will use the expertise and feedback of senior surgeons to develop the tools,” Dogramadzi continues. “We will use rapid prototyping to make prototype tools that the surgeons will be able to test and we will incorporate their feedback into the next stage of design. This means we can adapt tools to the needs of different surgical procedures and this user-centred design process places surgeons at the heart of the development of this system.”

Mr Anthony Koupparis, Consultant Urologist of Bristol Urological Institute, (North Bristol NHS Trust) and Professor Raimondo Ascione, Director of TBRC and Professor of Cardiac Surgery and Translational Research in the Faculty of Health Sciences at the University of Bristol, will provide contextual feedback in the urology and cardiovascular fields respectively that is key to develop the new advanced tools.

The three-year research project started in January 2017 and builds on previous work in the theme of Medical Robotics and the recently established REACH (Robotics Engineering and Computing in Healthcare) Group at Bristol Robotics Laboratory. The project is being led by the Bristol Robotics Laboratory (BRL) and UWE Bristol, with nine partners including North Bristol NHS Trust, Bristol Urological Institute and the Translational Biomedical Research Centre (TBRC) at the University of Bristol, led by Director, Professor Raimondo Ascione. Professor Chris Melhuish, Director of BRL is also involved in the project.