A robotic system for solo surgery in flexible ureteroscopy: development and evaluation with clinical users.

PURPOSE: The robotic system CoFlex for kidney stone removal via flexible ureteroscopy (fURS) by a single surgeon (solo surgery, abbreviated SSU) is introduced. It combines a versatile robotic arm and a commercially available ureteroscope to enable gravity compensation and safety functions like virtual walls. The haptic feedback from the operation site is comparable to manual fURS, as the surgeon actuates all ureteroscope DoF manually. METHODS: The system hardware and software as well as the design of an exploratory user study on the simulator model with non-medical participants and urology surgeons are described. For each user study task both objective measurements (e.g., completion time) and subjective user ratings of workload (using the NASA-TLX) and usability (using the System Usability Scale SUS) were obtained. RESULTS: CoFlex enabled SSU in fURS. The implemented setup procedure resulted in an average added setup time of 341.7 ± 71.6 s, a NASA-TLX value of 25.2 ± 13.3 and a SUS value of 82.9 ± 14.4. The ratio of inspected kidney calyces remained similar for robotic (93.68 %) and manual endoscope guidance (94.74 %), but the NASA-TLX values were higher (58.1 ± 16.0 vs. 48.9 ± 20.1) and the SUS values lower (51.5 ± 19.9 vs. 63.6 ± 15.3) in the robotic scenario. SSU in the fURS procedure increased the overall operation time from 1173.5 ± 355.7 s to 2131.0 ± 338.0 s, but reduced the number of required surgeons from two to one. CONCLUSIONS: The evaluation of CoFlex in a user study covering a complete fURS intervention confirmed the technical feasibility of the concept and its potential to reduce surgeon working time. Future development steps will enhance the system ergonomics, minimize the users' physical load while interacting with the robot and exploit the logged data from the user study to optimize the current fURS workflow.

German Aerospace Center's advanced robotic technology for future lunar scientific missions.

The Earth's moon is currently an object of interest of many space agencies for unmanned robotic missions within this decade. Besides future prospects for building lunar gateways as support to human space flight, the Moon is an attractive location for scientific purposes. Not only will its study give insight on the foundations of the Solar System but also its location, uncontaminated by the Earth's ionosphere, represents a vantage point for the observation of the Sun and planetary bodies outside the Solar System. Lunar exploration has been traditionally conducted by means of single-agent robotic assets, which is a limiting factor for the return of scientific missions. The German Aerospace Center (DLR) is developing fundamental technologies towards increased autonomy of robotic explorers to fulfil more complex mission tasks through cooperation. This paper presents an overview of past, present and future activities of DLR towards highly autonomous systems for scientific missions targeting the Moon and other planetary bodies. The heritage from the Mobile Asteroid Scout (MASCOT), developed jointly by DLR and CNES and deployed on asteroid Ryugu on 3 October 2018 from JAXA's Hayabusa2 spacecraft, inspired the development of novel core technologies towards higher efficiency in planetary exploration. Together with the lessons learnt from the ROBEX project (2012-2017), where a mobile robot autonomously deployed seismic sensors at a Moon analogue site, this experience is shaping the future steps towards more complex space missions. They include the development of a mobile rover for JAXA's Martian Moons eXploration (MMX) in 2024 as well as demonstrations of novel multi-robot technologies at a Moon analogue site on the volcano Mt Etna in the ARCHES project. Within ARCHES, a demonstration mission is planned from the 14 June to 10 July 2021,1 during which heterogeneous teams of robots will autonomously conduct geological and mineralogical analysis experiments and deploy an array of low-frequency antennas to measure Jovian and solar bursts. This article is part of a discussion meeting issue 'Astronomy from the Moon: the next decades'.