Concentric tube surgical robots are minimally invasive devices with the advantages of snake-like reconfigurability, long and thin form factor, and placement of actuation outside the patient's body. These robots can also be designed and manufactured to acquire targets in specific patients for treating specific diseases in a manner that minimizes invasiveness. We propose that concentric tube robots can be manufactured using 3-D printing technology on a patient- and procedure-specific basis. In this paper, we define the design requirements and manufacturing constraints for 3-D printed concentric tube robots and experimentally demonstrate the capabilities of these robots. While numerous 3-D printing technologies and materials can be used to create such robots, one successful example uses selective laser sintering to make an outer tube with a polyether block amide and uses stereolithography to make an inner tube with a polypropylene-like material. This enables a tube pair with precurvatures of 0.0775 and 0.0455 mm^-1, which can withstand strains of 20% and 5.5% for the outer and inner tubes, respectively.

Flexible medical robots can improve surgical procedures by decreasing invasiveness and increasing accessibility within the body. Using preoperative images, these robots can be designed to optimize a procedure for a particular patient. To minimize invasiveness and maximize biocompatibility, the actuation units of flexible medical robots should be placed fully outside the patient's body. In this letter, we present a novel, compact, lightweight, modular actuation, and control system for driving a class of these flexible robots, known as concentric tube robots. A key feature of the design is the use of three-dimensional printed waffle gears to enable compact control of two degrees of freedom within each module. We measure the precision and accuracy of a single actuation module and demonstrate the ability of an integrated set of three actuation modules to control six degrees of freedom. The integrated system drives a three-tube concentric tube robot to reach a final tip position that is on average less than 2 mm from a given target. In addition, we show a handheld manifestation of the device and present its potential applications.

Across kingdoms and length scales, certain cells and organisms navigate their environments not through locomotion but through growth. This pattern of movement is found in fungal hyphae, developing neurons, and trailing plants, and is characterized by extension from the tip of the body, length change of hundreds of percent, and active control of growth direction. This results in the abilities to move through tightly constrained environments and form useful three-dimensional structures from the body. We report a class of soft pneumatic robot that is capable of a basic form of this behavior, growing substantially in length from the tip while actively controlling direction using onboard sensing of environmental stimuli; further, the peak rate of lengthening is comparable to rates of animal and robot locomotion. This is enabled by two principles: Pressurization of an inverted thin-walled vessel allows rapid and substantial lengthening of the tip of the robot body, and controlled asymmetric lengthening of the tip allows directional control. Further, we demonstrate the abilities to lengthen through constrained environments by exploiting passive deformations and form three-dimensional structures by lengthening the body of the robot along a path. Our study helps lay the foundation for engineered systems that grow to navigate the environment.

We describe a new series pneumatic artificial muscle (sPAM) and its application as an actuator for a soft continuum robot. The robot consists of three sPAMs arranged radially round a tubular pneumatic backbone. Analogous to tendons, the sPAMs exert a tension force on the robot's pneumatic backbone, causing bending that is approximately constant curvature. Unlike a traditional tendon driven continuum robot, the robot is entirely soft and contains no hard components, making it safer for human interaction. Models of both the sPAM and soft continuum robot kinematics are presented and experimentally verified. We found a mean position accuracy of 5.5 cm for predicting the end-effector position of a 42 cm long robot with the kinematic model. Finally, closed-loop control is demonstrated using an eye-in-hand visual servo control law which provides a simple interface for operation by a human. The soft continuum robot with closed-loop control was found to have a step-response rise time and settling time of less than two seconds.

Robot-assisted minimally invasive surgical systems enable procedures with reduced pain, recovery time, and scarring compared to traditional surgery. While these improvements benefit a large number of patients, safe access to diseased sites is not always possible for specialized patient groups, including pediatric patients, due to their anatomical differences. We propose a patient-specific design paradigm that leverages the surgeon's expertise to design and fabricate robots based on preoperative medical images. The components of the patient-specific robot design process are a virtual reality design interface enabling the surgeon to design patient-specific tools, 3-D printing of these tools with a biodegradable polyester, and an actuation and control system for deployment. The designed robot is a concentric tube robot, a type of continuum robot constructed from precurved, elastic, nesting tubes. We demonstrate the overall patient-specific design workflow, from preoperative images to physical implementation, for an example clinical scenario: nonlinear renal access to a pediatric kidney. We also measure the system's behavior as it is deployed through real and artificial tissue. System integration and successful benchtop experiments in ex vivo liver and in a phantom patient model demonstrate the feasibility of using a patient-specific design workflow to plan, fabricate, and deploy personalized, flexible continuum robots.

Soft continuum robots exhibit access and manipulation capabilities in constrained and cluttered environments not achievable by traditional robots. However, navigation of these robots can be difficult due to the kinematics of these devices. Here we describe the design, modeling, and control of a soft continuum robot with a tip extension degree of freedom. This design enables extremely simple navigation of the robot through decoupled steering and forward movement. To navigate to a destination, the robot is steered to point at the destination and the extension degree of freedom is used to reach it. Movement of the tip is always in the direction tangent to the end of the robot's backbone, independent of the shape of the rest of the backbone. Steering occurs by inflating multiple series pneumatic artificial muscles arranged radially around the backbone and extending along the robot's whole length, while extension is implemented using pneumatically driven tip eversion. We present models and experimentally verify the growing robot kinematics. Control of the growing robot is demonstrated using an eye-in-hand visual servo control law that enables growth and steering of the robot to designated locations.

In nature, tip-localized growth allows navigation in tightly confined environments and creation of structures. Recently, this form of movement has been artificially realized through pressure-driven eversion of flexible, thin-walled tubes. Here we review recent work on robots that "grow" via pressure-driven eversion, referred to as "everting vine robots," due to a movement pattern that is similar to that of natural vines. We break this work into four categories. First, we examine the design of everting vine robots, highlighting tradeoffs in material selection, actuation methods, and placement of sensors and tools. These tradeoffs have led to application-specific implementations. Second, we describe the state of and need for modeling everting vine robots. Quasi-static models of growth and retraction and kinematic and force-balance models of steering and environment interaction have been developed that use simplifying assumptions and limit the involved degrees of freedom. Third, we report on everting vine robot control and planning techniques that have been developed to move the robot tip to a target, using a variety of modalities to provide reference inputs to the robot. Fourth, we highlight the benefits and challenges of using this paradigm of movement for various applications. Everting vine robot applications to date include deploying and reconfiguring structures, navigating confined spaces, and applying forces on the environment. We conclude by identifying gaps in the state of the art and discussing opportunities for future research to advance everting vine robots and their usefulness in the field.