ple with lower-limb amputations or
lower-body muscle weakness can use
powered-knee and ankle prostheses to
engage in a range of activities, including everyday locomotion to running
marathons and dancing. Exoskeletons have helped people with muscle
weakness, movement disorders, and
Several advances have been made
recently in how people interface with
these robots. For example, some robot prostheses offer neural integration to provide tactile feedback and
increasingly more intuitive control of
1 Other advances include an
increase in the workspace and range of
motion of wearable robots, as well as
improvements in user comfort.
Outside the body. Robots outside the
body are being used across many clinical application spaces. For clinicians,
(see Nelson et al.
25 for a review.)
In surgical and interventional robotics, a range of advances have been
made that enable clinicians to have
improved dexterity and visualization
inside the body and reduce the degree
of movement during operations.
1 Furthermore, promising advances have
been made in concentric tube (active
cannula) robots. These robots are comprised of precurved, concentrically
nested tubes that can bend and twist
throughout the body. The robots can be
used as small, teleoperated manipulators or as steerable needles. The robots
can enter the body directly, such as
through the skin or via a body opening,
or could be used via an endoscope.
Some future research directions for
in-the-body robots include new means
for intuitive physical and cognitive in-
teraction between the user and robot,
new methods for managing uncertain-
ty, and providing 3D registration in real
time while traversing both deformable
and non-deformable tissue.
On the body. In terms of wearable
robots for DRUs, there have been recent advances in the areas of actuated robot prostheses, orthoses, and
exoskeletons. A prothesis supplants
a person’s missing limb, and acts in
series with a residual limb. An ortho-sis is a device that helps someone who
has an intact limb but an impairment,
and an exoskeleton provides either a
person with intact limbs (DRU or otherwise) assistance or enhancement of
existing physical capability. Orthoses
and exoskeletons act in parallel to an
All of these robots can be used to
enable DRUs to perform tasks. For example, people with forearm-to-shoulder amputations can use wearable
robot prostheses, which can provide
dexterity, reach, and strength. Peo-
Figure 2. Key examples of recent advances in healthcare robotics. Those inside and on the body are primarily intended for direct robot
users, and those outside the body for direct robot users, caregivers, and clinicians. These robots have the potential to be used across
a range of care settings and clinical foci, and can provide both physical and cognitive support. Image credits (clockwise from upper left):
B. Nelson, R. Alterovitz, Mobius, TED, Ekso Bionics, B. Smart, L. Riek, S. Sabanovic, C. Kemp.
rting: Effects of Teleoperator Visibility
bot-Mediated Health Care
Kory Kraft, William D. Smart
d to provide medical
ks, alleviating works longer than abso-ns to this technology
ses related to patients’
n a simulated Ebola
nts trust the robot
h highly infectious
he risk of becoming
significant when the
or extremely lethal. Fig. 1: The robot moves an IV fluid pole during a study session.
[ 6, 78, 33, 34]. In the natural orifice embodiment, transnasal skull base [ 12] and
transoral throat [ 80] applications have been proposed, and it is likely that surgeries
through other natural orifices will be pursued in the future. In the percutaneous,
needle-like embodiment, applications that have been suggested include fetal umbilical cord blood sampling [ 29], ultrasound guided liver targeting and vein cannulation , vascular graft placement for hemodialysis [ 7], thermal ablation of cancer
[ 8, 13], prostate brachytherapy [ 79], retinal vein cannulation [ 87, 91, 88], epilepsy
treatments [ 19], and general soft tissue targeting procedures [ 45, 70, 35].
Of all these applications, the t wo that have been studied most extensively are the
cardiac applications of Dupont et al. and the endonasal applications of Webster et al.
This includes the first ever use of a concentric tube robot in a live animal by Gosline
et al. [ 26, 33]. It also includes the first insertion of a concentric tube robot into a
human cadaver by Burgner et al. [ 16, 12]. Many researchers have also explored the
Fig. 1 A concentric tube robot next to a standard da Vinci laparoscopic tool.
In the body On the body
Outside the body
Microrobots are micro-scale,
untethered robots that can
move through the body and can
per form targeted therapy,
material removal, structural
control, and sensing.
Clinicians can safely
tele-operate mobile robots to
treat patients with highly
infectious diseases such as
Ebola Virus Disease.
Patient simulators. Over
180,000 clinicians annually
train on high fidelity robotic
patient simulators, which can
simulate physiological cues,
and sense and respond to
Mental and Behavioral
Healthcare. Robots can
support people with cognitive
wellness, or provide
Physical task support.
Robots can support people
with motor impairments,
movement disorders, and
brain injuries to provide external
Concentric tube robots (active
cannulas) can be used as small,
teleoperated manipulators or as
steerable needles, and enable
procedures in areas inaccessible
with traditional instruments.
Robotic prostheses and exoskeletons. People with forearm-to-shoulder
amputations can use wearable robot prostheses, which can provide fine-grained
dexterity, reach, and strength. People with lower-limb amputations or lower-body
muscle weakness can use powered-knee and ankle prostheses to do everything
from running marathons to dancing. Exoskeletons have helped people with
muscle weakness, movement disorders, or paralysis locomote.