Colorectal cancer (CRC) represents a significant proportion of malignant diseases. Interventions are often carried out during the latter stages of development, leading to low patient survival rates and poor quality of life. In 2022 a European Commission report stated that “colonoscopy-based screening has higher sensitivity than testing for blood in stool, but it is less acceptable to participants”. At the same time, effective methods to treat polyps in the colon are limited. Current approaches are often associated with unsafe oncological margins and high complication rates, requiring life-changing surgery. EndoTheranostics will usher in a new era for screening colonoscopy, advancing the frontiers of medical imaging and robotics. A tip- growing or eversion robot with a sleeve-like structure will be created to extend deep into hollow spaces while perceiving the environment through multimodal imaging and sensing. It will also act as a conduit to transfer miniaturised instruments to the remote site within the colon for diagnosis and therapy (theranostics). With these capabilities, the system will be able to offer: 1. painless colon cleansing in preparation for endoscopy; 2. real-time polyp detection and tissue characterisation through AI-assisted multimodal imaging; 3. effective removal of polyps by conveying a “miniature mobile operating chamber” equipped with microsurgical tools to the target through the lumen of the eversion robot. The unique technical and clinical challenges will be tackled by the PIs, each bringing complementary skills, backed by their institutions with wide expertise and exceptional facilities. The synergy and added value evident in this team will lead to breakthroughs not possible through independent research. The outcomes of EndoTheranostics will revolutionise the theranostics of CRC, impacting the quality of life of millions of individuals. Ultimately it will launch a new era for endoluminal intervention with applications beyond medicine.

Fit4MedRob aims to revolutionize current rehabilitation and assistive models for people with reduced or absent sensory or cognitive motor functions. We will develop new (bio)robotic and digital technologies and continuum of care paradigms that can benefit from new technologies in all phases of the rehabilitation process, from prevention to home assistance in the chronic phase. This will be possible by carefully identifying the unmet needs of patients and healthcare professionals. Such needs will be addressed with current and new (bio)robotic/bionic technologies, through multi-centre clinical studies jointly designed by bioengineers, neuroscientists, physiatrists, psychologists and functional specialists/preventive surgeons of arts. Fit4MedRob will focus on both already available technologies that have not yet been fully validated, and emerging technologies or breakthrough ideas to be explored in the course of the project. Fundamental studies, involving new materials, algorithms, smart sensing and actuation technologies, and sustainable energy sources, will try to overcome the limitations of current robotic solutions, which have prevented their massive diffusion as providers of physical assistance. The ambitious goal of the project is to pave the way for the next generation of biomedical robotic systems. Last but not least, clinical, scientific and technological efforts will be matched on the political, regulatory and organizational side to accelerate the creation of an adequate framework to (sustainably) incorporate current and future technologies and protocols into the healthcare system while supporting the innovation they will bring.

The project aims to enhance the research infrastructures on surgical robotics and to create a new infrastructure for biorobotics thanks to the creation of a new laboratory: Biomimetic and Biohybrid Robotics Lab (B2RL). B2RL will provide a framework for the design and fabrication of prosthetics and exoskeletons as biological interfaces for communicating with the human body. This includes the adoption and composition of biohybrid and biomimetic materials and design methods, biocompatible actuators and sensors, and the development of appropriate shared human-machine control strategies.

PACMAN is a proof-of-concept project aimed at reducing the time-to-market of the patent of a new laparoscopic instrument with a spherical wrist capable of grasping and rolling a suture needle. Some of the most critical and delicate tasks in minimally invasive robotic surgery are found in reconstructive procedures due to the time and high dexterity required, as well as the risks of organ and tissue damage related to poorly performed sutures. This happens more frequently when the orientation of the needle is not fully under surgeon's control. The mechanism for a needle holder is capable of imprinting rolling motions on a circular cross-sectional object by adding a pulley to operate an additional degree of freedom responsible for the rolling motion of the object. This solution is fully compatible with the latest generation of da Vinci robot tools, such as the da Vinci Xi, which is equipped with an additional actuator for advanced tools.

HARMONY develops robotic mobile manipulation technologies for assisting staff in hospital environments. Europe’s ageing population along with higher numbers of people in the healthcare system will require increased care and staffing levels. Automation will become a quality and precision must and a medical business fact. However, the reality is that our current robotic automation solutions only offer “islands of automation” where either mobility or manipulation is dealt with in isolation. The project aims to fill this gap in knowledge on combining both robotic mobility and manipulation modalities in complex, human-centred environments. Through demonstrators and open software modules, robotic mobile manipulation systems can be seamlessly integrated into our existing processes and spaces to meet growing needs in the healthcare industry and beyond.

Prostate cancer is the most frequent malignant neoplasm and the second cause of cancer death among men, with a steady increase in trend due to the overall length of life expectancy. Despite the technological progress of radiological instrumental investigation and the ultrasound systems needed to perform the biopsy, a false negative rate remains that swings around 30%. This project aims at effectively increasing the diagnostic capacity of prostate biopsy. To achieve this goal, an advanced biopsy robotic system is developed for high-precision testing and integration of an autonomous control, an optical fiber probe, an image fusion software, and a predictive software for detecting prostate cancer and its aggressiveness. The expected improvements concern a reduction of: the number of prostate tissue samples, the number of biopsies for the patient, the risk of complications associated with biopsy, the direct and indirect costs of healthcare expenditure to diagnose prostate cancer.

Prostate cancer (PCa) is the most frequent malignancy in men, with a worldwide incidence of 60-99 new cases/100,000 a year. In Italy, PCa represents 18% of male cancers and accounts for 8% of mortality. The aim of this project is to design and develop new medical devices to improve our ability to diagnose and cure PCa. First, we want to generate a high-precision device for prostate cancer biopsy, based on the implementation of a robotic arm allowing targeted bioptic sampling based on the information gained from magnetic resonance and ultrasound images. Second, we want to develop an advanced prototype for treatment of PCa, exploiting the selective effects of micro-mechanical vibration stress on tumor cells, thus killing them while sparing neighbour healthy cells. The robotic system for prostate-guided needle biopsy is conceived as a system capable of self-learning through the storage and processing of maps derived from prostatic imaging.

MUSHA aims at creating future generations of bio-inspired tools and advanced bio-aware manipulation paradigms toward breakthrough mini-invasive surgical instruments and android robotic hands. Bio-inspired mechanical design leads to reduction of tools’ weight and dimension by limiting the number of actuators while preserving dexterity and manipulation capabilities. A fiber optic sensor is to be integrated to measure the contact forces exchanged with the environment and the temperature of the touched materials. MUSHA arises from the need to replicate human manipulation capabilities in various fields where robotics can help to improve life. These include unstructured environments in which a humanoid robot must replace the human being or parts of the body to address daily-life tasks, as well as minimally invasive robotic surgery where the surgeon is unable to use hands to manipulate organs and tissues while feeling their anatomy, consistency and temperature.