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Editorial article, editorial: translational research in medical robotics—challenges and opportunities.

• 1 Robotics and Mechatronics, University of Twente, Enschede, Netherlands
• 2 Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
• 3 Department of Mechanical Engineering, University College London, London, United Kingdom

Editorial on the Research Topic Translational research in medical robotics—challenges and opportunities

In the last few decades, emerging medical technologies and the growing number of commercial robotic platforms have supported diagnosis and treatment of both acute and chronic diseases of the human body, improving the clinical outcome, reducing trauma, shortening the patient recovery time, and increasing postoperative survival rates ( Troccaz et al., 2019 ). Medical robots–including surgical robots, rehabilitation and assistive robots, and hospital automation robots–with improved safety, efficacy and reduced costs, robotic platforms will soon approach a tipping point, moving beyond early adopters to become part of the mainstream clinical practice, defining the future of smart hospitals and home-based patient care. Surgical robots promise to enhance minimally invasive surgery with precise instrument control, intuitive hand-eye coordination, and superior dexterity within tight spaces ( Dupont et al., 2021 ). Rehabilitation robotics facilitates robot-assisted therapy and automated recovery training ( Xue et al., 2021 ). Assistive robots aid individuals with physical limitations, either enhancing or compensating for functions, promoting independence, and lessening the burden on caregivers ( Trainum et al., 2023 ). Additionally, robotic systems can automate hospital operations, spanning service robots aiding clinicians to robots in labs for high-throughput testing ( Kwon et al., 2022 ). These technologies aim to revolutionize healthcare, offering improved patient care and operational efficiency.

The commercial success of medical robotic platforms, is the outcome of continuous efforts in translational research on novel medical devices. This pathway usually starts with an initial idea related to a clinical need or challenge and targets its long-term translation into a clinically approved device. Selected milestones along this path predominantly aim at increased technical maturity of existing laboratory demonstrators or proofing feasibility in relevant preclinical/clinical environments involving end users. These steps are essential building blocks for prospective clinical clearance and approval processes.

Although properties of translational roadmaps are comparable among projects, individual contributions to requirements, timelines, resources, costs and procedures may differ significantly. Yet, major challenges in translational research not only arise from securing long-term project funding, but also from holistic consideration of complex and dynamic ethical and regulatory aspects ( Yang et al., 2018 ).

This Research Topic provides a useful overview of some key aspects involved in the translational journey of medical robots, including human-robot interaction and robot autonomy, benchtop trials, clinical testing, and validation challenges. The goal is to provide a roadmap for successful clinical translation, addressing clinical opportunities, technical requirements and regulatory challenges for translating robots to practical clinical use.

Translating medical robots into practice requires the systems to be easily integrated in the clinical workflow and to cooperate with the clinical teams. Typically, robotic platforms that offer little or no autonomy and are controlled remotely by the clinician are more readily accepted. However, for certain intricate or monotonous tasks, it may be possible to assign complete responsibility to the robot. McDonald-Bowyer et al. developed sensing and control strategies to perform autonomous intra-operative ultrasound scans on kidneys using the da Vinci system during robot-assisted partial nephrectomy. The hypothesis the authors present is that automating this challenging sub-task may reduce the cognitive load for the surgeon improving patient outcomes. The study demonstrates the approach feasibility through benchtop experiments conducted on an artificial kidney phantom.

Benchtop trials serve as a crucial initial step to evaluate a newly developed technology; however, clinical trials are indispensable in order to validate and implement the technology in a real-world clinical setting. Barria et al. have developed the RobHand a robotic neuromotor rehabilitation exoskeleton that assists in performing flexion and extension movements of the fingers. The authors have tested the RobHand on four chronic stroke patients, to evaluate the safety, rehabilitation capabilities and usability of the robot. While the trials demonstrated the device safety, no statistically significant improvements were found in manual motor function due to the low number of patients recruited. In future studies, the scope will be expanded to include a larger sample size. Additionally, there is a possibility of involving patients with various nervous and musculoskeletal conditions, such as spinal cord injury, peripheral neural injuries, as well as individuals undergoing rehabilitation for traumatic and post-operative musculoskeletal hand injuries.

One of the significant challenges in the translation of medical robot prototypes is ensuring the reproducibility and benchmarking of testing results. This step is crucial to obtain the required regulatory approval for market introduction. Faragasso and Bonsignorio highlight the need for developing new tools and putting in place a community effort to allow the transition to more reproducible research and hence faster progress in research. The authors have selected 10 relevant published manuscripts on surgical robotics to analyze their clinical applicability and underline the problems related to reproducibility of the reported experiments. The study showed that the selected experimental papers are very often missing features that would allow independent researchers to reproduce the described work and compare the results, showing a need to overcome this limitation to avoid flaws and inconsistencies.

This Research Topic provided an insight into selected technical and clinical challenges that need to be resolved, striving to further consolidate the collaboration between the clinical, engineering and regulatory communities.

Author contributions

GD: Conceptualization, Writing–original draft, Writing–review and editing. DK: Conceptualization, Writing–review and editing. PM: Conceptualization, Writing–review and editing. HW: Writing–review and editing. MA: Writing–review and editing.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

The authors declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Dupont, P. E., Nelson, B. J., Goldfarb, M., Hannaford, B., Menciassi, A., O’Malley, M. K., et al. (2021). A decade retrospective of medical robotics research from 2010 to 2020. Sci. Robot. 6, eabi8017. doi:10.1126/scirobotics.abi8017

PubMed Abstract | CrossRef Full Text | Google Scholar

Kwon, H., An, S., Lee, H.-Y., Cha, W. C., Kim, S., Cho, M., et al. (2022). Review of smart hospital services in real healthcare environments. Healthc. Inf. Res. 28, 3–15. doi:10.4258/hir.2022.28.1.3

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Trainum, K., Tunis, R., Xie, B., and Hauser, E. (2023). Robots in assisted living facilities: scoping review. JMIR Aging 6, e42652. doi:10.2196/42652

Troccaz, J., Dagnino, G., and Yang, G.-Z. (2019). Frontiers of medical robotics: from concept to systems to clinical translation. Annu. Rev. Biomed. Eng. 21, 193–218. doi:10.1146/annurev-bioeng-060418-052502

Xue, X., Yang, X., Deng, Z., Tu, H., Kong, D., Li, N., et al. (2021). Global trends and hotspots in research on rehabilitation robots: A bibliometric analysis from 2010 to 2020. Front. Public Health 9, 806723. doi:10.3389/fpubh.2021.806723

Yang, G.-Z., Bellingham, J., Dupont, P. E., Fischer, P., Floridi, L., Full, R., et al. (2018). The grand challenges of Science Robotics. Sci. Robot. 3, eaar7650. doi:10.1126/scirobotics.aar7650

Keywords: medical robotics, translational research, user studies, clinical studies, results reproducibility

Citation: Dagnino G, Kundrat D, Moreira P, Wurdemann HA and Abayazid M (2023) Editorial: Translational research in medical robotics—challenges and opportunities. Front. Robot. AI 10:1270823. doi: 10.3389/frobt.2023.1270823

Received: 01 August 2023; Accepted: 22 September 2023; Published: 04 October 2023.

Edited and reviewed by:

Copyright © 2023 Dagnino, Kundrat, Moreira, Wurdemann and Abayazid. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Giulio Dagnino, [email protected]

This article is part of the Research Topic

Translational Research in Medical Robotics – Challenges and Opportunities

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• 24 June 2020

Medical robotics in China: the rise of technology in three charts

• Sarah O’Meara 0

Sarah O’Meara is a freelance journalist based in London.

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A da Vinci surgical robot system performs heart surgery in 2017 at a hospital in Hefei, China. Credit: Shutterstock

In 2006, China highlighted the importance of robotics in its 15-year plan for science and technology. In 2011, the central government fleshed out these ambitions in its 12th five-year plan, specifying that robots should be used to support society in a wide range of roles, from helping emergency services during natural disasters and firefighting, to performing complex surgery and aiding in medical rehabilitation.

Part of Nature Spotlight on medical robotics in China

Guang-Zhong Yang, head of the Institute of Medical Robotics at Shanghai Jiao Tong University, says that China’s robotics research output has been growing steadily for two decades, driven by three major factors: “The clinical utilization of robotics; increased funding levels driven by national planning needs; and advances in engineering in areas such as precision mechatronics, medical imaging, artificial intelligence and new materials for making robots.”

Yang points out that funding levels for medical robotics from the National Natural Science Foundation of China and the Ministry of Science and Technology began to increase more sharply in 2011 compared to the previous decade.

The accompanying rises in research output are closely related to the introduction of specialized robotics equipment in medical-research facilities, says Yao Li, a research scientist at Stanford Robotics Laboratory in California and founder of the company Borns Medical Robotics, based in both Chengdu, China, and Silicon Valley, California.

Source: Web of Science

Between 1999 and 2019, the number of papers published by at least one Chinese author in the combined fields of biomedical engineering and robotics increased from 142 to 4,507, and spiked twice during that period (see ‘Published papers’), according to data from the Web of Science. One peak was in 2008, two years after a robotic system for minimally invasive operations called da Vinci was first deployed to hospitals in China. The second was in 2017, a year after the first Chinese-designed robot for minimally invasive spinal surgery was approved for sale.

Source: Jian-Kun Hu/Intuitive Surgical–Fosun Medical Technology (Shanghai)

In 2019, the number of da Vinci systems installed in Chinese hospitals that year leapt to 59, up from only 8 installations in 2018 (see ‘Spike in hospital robotics’). This surge followed a 2018 government push to encourage research on robotics technology and its clinical application, according to Jian-Kun Hu, director of the department of gastrointestinal surgery at West China Hospital in Chengdu. The central government’s plan included an intention to purchase 154 new surgical robot systems by the end of 2020, and a breakdown of how the systems would be allocated nationwide (see ‘Surgical robots across China’).

Source: Natl Health commission, PRC

Nature 582 , S51-S52 (2020)

doi: https://doi.org/10.1038/d41586-020-01795-7

This article is part of Nature Spotlight on medical robotics in China , an editorially independent supplement. Advertisers have no influence over the content.

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A decade retrospective of medical robotics research from 2010 to 2020

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Robotics is a popular branch of Machine Learning that has grown the interest of researchers for many years. Machine learning is used for developing various robotic systems which find their applications in different sectors specially in medical domain. This paper shows how robotics have evolved over the years and how robots are helping doctors as a medical assistant in their everyday work like surgeries, medical imaging, healthcare, manufacturing Prosthetics and patients aids, rehabilitation etc. Even major surgeries like Eye Surgery, Heart Surgery, Soft Surgery Operations, Abdominal Surgeries, and Orthopaedics etc. can be done by medical robots to make life easier for both doctors and patients. The main reasons of increasing robotic helps in healthcare sector are (a) robots are tireless, (b) they don’t take stress, (c) their hand never shakes, (d) can do repetitive work effortlessly, (e) can perform precise surgeries. Here, we have reviewed few of robotics application in medical field and discussed all the merits, demerits and future aspects in this regards.

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Halder Roy, A., Ghosh, S. & Gupta, B. Robotics in Medical Domain: The Future of Surgery, Healthcare and Imaging. Wireless Pers Commun 132 , 2885–2903 (2023). https://doi.org/10.1007/s11277-023-10747-z

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