Meccanica (2015) 50:2855–2863

DOI 10.1007/s11012-015-0261-6

SOFT MECHATRONICS

Design and development of a soft robotic gripper

for manipulation in minimally invasive surgery: a proof
of concept
Giovanni Rateni . Matteo Cianchetti .
Gastone Ciuti . Arianna Menciassi .
Cecilia Laschi

Received: 1 November 2014 / Accepted: 7 August 2015 / Published online: 20 August 2015
 The Author(s) 2015. This article is published with open access at Springerlink.com

Abstract This paper proposes the use of soft mate- Keywords Soft robotics  Minimally invasive
rials for building robotic grippers for delicate and safe surgery  Grasping tools for surgery  Compliance 
interactions. The work includes concept design, fab- Under-actuation
rication and first assessment and characterization of
the proposed soft gripper, a novel robotic end-effector
entirely made up of elastomeric material. As a 1 Introduction
significant case study, it has been specifically adapted
as a grasping tool in Minimally Invasive Surgery, but Over recent years, technological developments in
its design has been conceived in such a way that its robotics have led to novel and less invasive techniques
dimension can be easily scaled, to find application in for surgery. In this framework, open surgery is often
all those fields where a safe interaction with fragile replaced by less invasive techniques, such as laparo-
items or human co-workers is needed. Moreover, the scopy, towards Minimally Invasive Surgery (MIS).
process is flexible for including further features to MIS has brought substantial benefits to the patient,
enrich its behaviour. such as: (1) less traumatization, (2) less risk of
infection, (3) shorter recovery time and (4) a better
cosmetics. In laparoscopic surgery, a single large
This work has been partially supported by the European
incision is replaced by multiple small incisions (from 1
Commission with the STIFF-FLOP IP (287728) and the
ROBOSOFT CA (619319). to 15 mm in diameter) through which physicians
introduce long instruments for performing the medical
G. Rateni  M. Cianchetti  G. Ciuti (&)  procedure [23]. Due to advantage in reducing the
A. Menciassi  C. Laschi surgical trauma, postoperative pain and cosmetic
The BioRobotics Institute, Viale Rinaldo Piaggio, 34,
Pontedera, PI, Italy problems, the laparoscopic approach has been adopted
e-mail: g.ciuti@sssup.it in several medical fields, such as urological, thoracic
G. Rateni and pediatric surgery.
e-mail: g.rateni@sssup.it Although much work has been done to develop
M. Cianchetti dexterous, multi-degree of freedom forceps and grip-
e-mail: m.cianchetti@sssup.it pers, they are still inadequate to grasp, manipulate or
A. Menciassi push aside internal organs. Force feedback or touch
e-mail: a.menciassi@sssup.it sensation is limited in the currently available MIS
C. Laschi tools, thus creating in most cases the potential for
e-mail: c.laschi@sssup.it excessive force application during surgery and

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unintended tissue injury [3, 19, 26]. The risk of in the surgical field. Only a few number of pioneering
complications due to traumatization of soft tissues works exist for soft instruments applied in surgery [6,
while trying to securely grip them is still an unresolved 13, 24], but no one has still ventured into the design of
issue using conventional instruments, often character- a totally soft gripping tool for surgery. The application
ized by sharp edges and no compliant properties. of soft robotics in surgery still represents a challenge,
Current research is focused on improvement of especially for precision tasks, because of the lack of
traditional tools, adding compliant constructive strate- reliable modelling and control algorithms [14].
gies or implementing force-feedback controlled for- This study proposes a method to exploit specific
ceps, to limit the force exerted and preventing soft robotics technologies in the surgical field. The
damages on the tissues [9, 18, 21, 27]. Alternatively, idea at the base of this proposal is to study the
a smart-designed instrument made up of intrinsically feasibility of grasping soft tissues by using a soft
compliant materials would avoid the use of complex instrument based on under-actuated mechanisms. The
force-feedback control or at least would automatically advantages are all related to the intrinsic compliant
avoid possible damages by limiting the maximum properties of the elastomeric material chosen to
applicable force. fabricate the tool, which would allow getting safely
In addition to the robotic surgery field, there exist closer to soft tissues inside the unstructured workspace
different previous inspiring examples on the use of of the abdominal cavity, without the risk of damaging
soft grippers. Here some of them have been reported blood vessels or delicate organs during the manipu-
without the aim of being exhaustive. In 1991 Suzumori lating procedures.
et al. [25] already developed a device based on
pneumatic actuators which is able to manipulate
relatively small objects. More recently, an entire hand 2 Soft Claw Gripper design
with high dexterity and capabilities which resemble
the functionality of a human hand has been developed This section describes the design of the Soft Claw
by Deimel and Brock [7]. In this case, the power Gripper (SCG), a manipulator totally made up of
source is fluidic, which guarantees compliance and silicone material, which exploits its intrinsic compli-
relatively high interaction forces. Using the same ance as a point of strength to achieve shape match. An
principles, a soft gripper inspired by the star fish has adequate shape match increases the contact surface in
been developed by Ilievski et al. [10], where the fluidic grasping without sensing and control integration. It
source is used to close the ‘‘fingers’’ around the also increases the robustness to uncertainties in finger
objects. The main limit on using this actuation control and position, and the model of the environ-
technology is represented by the low capability of ment. The approach is inspired by the biological
miniaturization without a dramatic decrease of model of the octopus.
mechanical performance. Electro Active Polymers In the octopus arm, an active bending requires
(EAP) are also a viable way of approaching miniatur- selectively contracting the longitudinal muscle fibers
ization, but ionic EAP actuation velocity does not along one side of the arm, thus creating an asymmet-
meet the usual timescale needed for surgical opera- rical longitudinal compressional force that shortens
tions (Ionic Polimer Metal Composite based fingers in one side of the arm and thus causes bending [12, 15].
[2]); on the other hand, the high electric fields Inside an elastomer segment, a longitudinal and
necessary for the electric EAP (the Dielectric Elas- eccentric arrangement of sheathed wires along its
tomer Minimum Energy Structure in [1]) do not allow length is assimilable to a muscle longitudinal fiber and
a straightforward use of these technologies. A com- the pulling of a cable produces the selective contrac-
parison between the reviewed existing soft robotic tion of the side subject to the action of the same cable.
grippers and the system proposed in this work is Matching shape of an object without a complex
presented in Table 1. Shape Memory Alloys (SMA), control is possible by implementing an under-actuated
with their outstanding downscaling properties and mechanism, i.e. a mechanical concept with less
high power density, could be a good alternative, but control inputs (active joints) than Degrees Of Freedom
the high temperature and current necessary for their (DOFs). This mechanism allows for an adaptive
activation still represent an unsolved issue for their use closure on the surface of an object and the grasping

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Table 1 Comparison table FMA RBO hand 2 Star fish CSO gripper SCG
between the reviewed soft
robotic grippers and the Actuation Pneumatic Pneumatic Pneumatic EAP Cable-driven
proposed work
Fabrication  ? ?  ??
Control  ? ?  ?
Precision ? ? ?  
Scalability    ?? ??
References [25] [7] [10] [1]
? Figure of merit

of objects in a more natural and more similar way to

the human hand [4, 11].
The kinematic configuration of the finger is auto-
matically determined by external constraints related to
the shape of the object. Here an innovative one-finger
under-actuated strategy extends the shape matching to
3-D curved surfaces (Fig. 1).
The SCG is composed by three finger-like segments
in elastomer material accommodated by a 3D printed
frame. The fingers are positioned sloped with respect
to the palm plane, so the off-position is the open one,
and the pulling of the cables brings to the close
position. Releasing the cables, the material natural
elasticity brings back the fingers to the open position.
The finger profile and the cables arrangement inside it
decreed what will be its actuated behaviour in the
interaction with the environment. A truncated pyramid
shape was chosen, to meet a profile that forces the
structure to bend itself in only one direction and to
increase the stability during grasping (Fig. 2a, b).

Fig. 2 Drawings of the Soft Claw Gripper: a front and

b isometric view in open configuration; c isometric and d top
view in closed configuration; e schematics of the actuator
arrangement

Each finger of the SCG has infinite DOFs actuated

by one cable and shows an under-actuated behaviour
obtained combining the passive deformation property
of the silicone and an innovative strategy of embed-
Fig. 1 Cut sections which show the positioning of the cable ding sheathed cable inside. One nylon cable, previ-
(dashed line) lying parallel to the ventral side of the finger. In ously inserted in a silicone sheath, is placed inside the
particular, in a close-up detail, the distance of 0.2 mm between
the finger ventral surface and the cable is shown. (Color figure
finger with the central part fixed by two points at the
online) tip and the rest running in two parts longitudinally

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down to its base, and coming out from the finger body. 1. Three finger molds, 3 support bases and 1 lodging
The plane containing the cable is parallel to the finger platform for each gripper are CAD-designed and
ventral surface and placed just below it (Fig. 2e). If a 3D-printed (Fig. 3a). The molds are needed to cast
complex-shaped object is grasped, sliding along the the fingers into the desired shape with the cables
sheath path, the gripper can passively adapt its surface properly placed in position. The support bases are
to the object, while the cables tips are fixed to the used to ensure the correct positioning with the
actuation source (e.g. a servomotor). Then, two lodging platform during a second merging cast step;
behaviours can be obtained simultaneously: (1) a 2. Three molds are prepared with their respective
curling motion on the sagittal mid-plane due to the actuation cables internally arranged. The cables
pulling of the cable and (2) a 3-D shape matching
motion due to the relative slide between gripper body
and cable.
This work is devoted to analyze the possible
application in the medical field, as a tool for manip-
ulation of soft tissues in MIS, such as for single port
laparoscopy (SPL) application [16]. To meet the
constraints imposed by the single-port access diameter
(maximum diameter of the skin incision in the
abdomen of 30–35 mm [8]) and in particular to find
an immediate translation in a robotic application for
SPL (integration in the SPRINT robot with arms of 18
mm in diameter [20, 22]), the total diameter of the
system should not exceed 18 mm. It is possible to
insert the system in closed configuration, with a
hindrance of 17 mm (Fig. 2c, d). The total length of
each finger has been fixed at 20 mm, representing it a
reasonable length for a laparoscopic gripper. Each
finger has a cross section of 6  2 mm2 at the distal
part and 6  6 mm2 at the proximal part. The fingers
are mounted so that they have an angle of 45 between
the vertical and the axis of lateral symmetry of the
finger. In this specific case, the SCG has been designed
to meet the aforementioned requirements for a SPL
robotic procedure, but it can be easily designed to fit a
standard trocar-based laparoscopic access port for
standard tools (\15 mm in diameter).

3 Materials and methods

3.1 Fabrication phase

The manufacturing process of the SCG is additive and

uses 3D-printed molds. This makes the customization Fig. 3 a CAD design of all parts used in the casting of the
and combination of actuator shapes simple and gripper; finger molds shown with their respective actuation and
housing cables internally arranged; b realization of cables
supports the implementation of complex deforma- arrangement inside the mold and c placing of the poured finger
tions. The gripper weighs 3 g and is obtained from a in the lodging platform by means of support base; d final silicone
four-step casting procedure of a silicone in molds: prototype

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are previously inserted in silicone sheaths which

are necessary to allow cables to slide with reduced
friction. The sheaths are made of silicone material
that is properly embedded with the structure of the
gripper. The housing of the actuation cable is
performed using another sheathed cable fastened
to the top of the mold. Both cables are put in
tension and fixed around a screw (Fig. 3b);
3. The fingers are casted separately to ensure that the
cables path is straight. The used polymer is a
commercially available silicone (EcoFlex 00-30,
Smooth-on Inc.) which consists of a Part A and a
Part B mixed in ratio 1A : 1B (by volume or
weight), and left to polymerize at ambient tem-
perature. The mixing of the two parts of the
silicone produces bubbles that are eliminated
through degasing the liquid mixture in a vacuum
chamber. After that, silicone is gently deposited in
molds with a needleless syringe (Fig. 3c);
4. The three fingers are then placed together in the
lodging platform by means of three support bases.
The cables are collected and inserted into three holes
in the center of the frame. Finally, a second casting
phase merges the structures. Once the silicone
casting is done, the prototype is ready (Fig. 3d) and
the silicone sheath remains incorporated, so that the
wires can slide with low friction.

In addition to standardized prototypes, there is a

wide range of solutions, reported here such as
examples, which can be implemented to enrich the
behaviour of the gripper:
Fig. 4 a Different anchoring points of the cables from the
• Cable placing at different heights: different defor- fingers’ tips and relative deformation at the same tension value;
mation behaviours can be obtained via anchorages variation provided with Delrin fingernails: b finger and
at different heights inside the mold (Fig. 4a); c corresponding gripper; variation provided with milled layer
on the fingers ventral surface: d finger and e corresponding
• Fingernails: in the human’s hand the nails provide gripper
stability during precision grasping. A variant of
gripper has been realized embedding a Delrin
by casting a thin layer of silicone on a 1:34 mm
rectangular ð5  6  0:5 mm3 Þ fingernail in the
pitch milled grid, pressing above it the ventral part
terminal and dorsal part of it, to stiffen the fingertip
of the finger and then leaving the mixture to
(Fig. 4b and 4c);
polymerize (Fig. 4d, e).
• Grip increasing: to prevent the slippage of objects,
an additional milled layer on the finger ventral
surface increases the contact area and so the A test bench has been specifically set up in order to
tribological interaction between the digital surface perform the prototype characterization in terms of
and the object surface. The layer is highlighted relationship between cables tension and fingertip force
adding a red pigment to the silicone. It is obtained and for evaluating the gripper behaviour (Fig. 5a). It is

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composed of a platform, specifically an anthropomor- A commercial force sensor has been used to acquire
phic robotic arm, which holds the gripper and provides the grasping force (A201, Tekscan FlexiForce Force
its alignment to the force sensor (Fig. 5b). The whole Sensor, South Boston, MA, USA) together with a data
measuring system is constrained on the platform. An processing circuit (Tekscan FlexiForce QuickStart
anthropomorphic robotic arm has been used as the Board) connected to an Arduino Mega microcontroller
testing platform for high flexibility in the positioning board. The sensor has been previously characterized
of the tool and for allowing further experimental tests performing compression tests using a universal testing
on grasping stability. A custom interface between the machine (Instron 4464, Torino, Italy) to derive the
gripper and the robotic arm wrist has been designed, calibration curve. A triangular-based prism (side 25
provided with an inner curved cavity to slide the mm and height 50 mm) has been used as a testing
cables, accompanying them from the frame of the object. The force sensor has been laid on one of the
gripper and bringing them out from the side, where the prism faces, with the active part facing outwards. The
cables are inserted in a 2 mm diameter metal sheath. positioning of the object is centred in respect to the
Real-time cables tension measurements have been gripper and their axis are coincident. The orientation
carried out by means of a force gauge sensor (Alluris of the object is settled in order to put its face parallel to
FMI-210B5, Freiburg, Germany) mounted on a the gripper finger ventral side. Pulling the specific
micrometer slide system. The metal sheath incorpo- cable, the finger bends toward the object, up to
rates the cables up to the sliding plate system, mounted touching the sensor active region (inserts in Fig. 6). In
on the robot elbow. Passing through a double diameter particular, experimental tests with 2 prototypes of the
hole to block the sheath, the cables are finally fixed to standard gripper (Fig. 3d) have been performed
the force gauge sensor interface (Fig. 5c). increasing the cable displacement by steps of
0.5 mm (5 measurements for each step) and measuring
the cable tension and the force exerted by the finger
itself. The test is aimed at evaluating the force
behaviour (i.e., maximum force and data trend)
performed by the 6 fingers belonging to the two
evaluated grippers, on the same testing object, thus
highlighting both intra-gripper and inter-gripper
behaviours of the system.

Fig. 6 Characterization results of 2 standard grippers. Exper-

imental task of fingertip force measurement performed for each
finger, one finger at the time, on gripper 1 (f1g1, f2g1, f3g1) and
Fig. 5 Test bench: a Experimental task of fingertip force gripper 2 (f1g2, f2g2, f3g2). Insets represent the first finger of
measurement, b grasping setup with prism object, force sensor gripper 1 in action at three different levels of contractions.
and board and c slide system with force gauge sensor (Color figure online)

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4 Results and discussion maximum, then it presents a sort of plateau. Plateau

continues for a significant period after which the
The overall results of the experiments are shown in failure of the system occurs; it occurs when the load
Fig. 6. These results refer to loading cycles performed overcomes a certain threshold and the silicone body is
by actuating each fingers, one finger at a time, on two not more able to resist to the internal stress provided by
standard grippers. For gripper 1 the average maximum the cable. As a result, the cable rips the silicone at the
grasping force value is 0.68 N in correspondence of tip, where the system is thinner. The explanation of
15.12 N level of tension, obtained on finger 2 this phenomenon is potentially related to the intrinsic
(medium-width solid line in Fig. 6), whereas for behaviour of the finger. This structure can be assim-
gripper 2 the average maximum grasping force value ilated to a tapered structure (thinner at the tip) that is
is 1.02 N in correspondence of 25.12 N level of subject to an internal pulling force. These kinds of
tension, obtained on finger 2 (medium-width dashed structures tend to deform towards a tensed/contracted
line in Fig. 6). The maximum value of the cable shape (instead of forming a more intuitive circular
tension has been set 50 % of the maximum breaking arc): it means that when the force overcomes a certain
tension (i.e. 50 N); a pilot test allowed to set it, being it threshold it starts shrinking and the tip force is no more
a reasonable value for covering the entire system applied on the object/sensor (as represented in the
behaviour. The reported results indicate that in the inset on the right of Fig. 6); the applied force is
current version of the gripper, the system shows a distributed also on a tangential direction at a charac-
similar behaviour both intra- and inter-gripper. teristic threshold force value on the object/sensor.
Uncontrollable intrinsic elements in the manufactur- Of course part of the structure still directs its force
ing process led to grippers with different embedded toward the internal part of the gripper, so that while
physical behaviours and performances. Indeed, the increasing the tension cable, the force applied by the
process involves critical manual steps, such as the finger increases accordingly, but part of this force is
cables arrangement and tensioning. A fully optimiza- lost on itself and applied on a tangential direction. This
tion will be assessed in order to increase the repeata- result means that by optimizing the design of the
bility of the manufacturing process. The behaviour is fingers it may be possible to set a maximum force
safe, but it is necessary to perform, at this time, a where the gripper is still fully functional (not
calibration of the system before its use. damaged), but an increasing tensile force does not
The system is able to produce a maximum force change the resultant gripping force on the object. The
which lies below the target value: for MIS it this value set presence of the plateau assures a safe and reliable
around 5 N on the tip of the instrument during a surgical control: a maximum grasping force is reached by the
task ([5, 17], excluding retraction of organs). However, system in a broad range of cable tension. In the
since they have the same order of magnitude (i.e. 1 N), surgical environment this is translated into the possi-
some modifications on the structural design (arrange- bility for the surgeon to apply force without the
ment of the cables and geometry) or material (other necessity of a precise control and care for damages.
elastomers with different elastic properties or composite/ The plateau part of the curve self-limits the stress that
anisotropic materials) could improve the robustness and the gripper is able to exert and avoids tissue damages.
allow the application of higher cable tensions. Despite
some precautions included in the measuring setup, the
tensioning mechanism is not optimized and presents 5 Conclusions
sharp curves and not straight paths, which cause high
friction and consequently energy loss. In this paper a proof of concept for a novel early stage
The viscoelastic behaviour of the silicone material surgical tool has been presented. It mainly exploits
determined a scattering dataset of results which is two basic design concepts: the use of solely soft
clearly visible in Fig. 6. A filtering process has been materials and an under-actuated system which is able
applied to underline the trend of the force (moving to adapt the finger shape to the target object and apply
average filter in Curve Fitting toolbox in MathWorks a certain amount of force.
MATLAB environment); also the raw data (dots in the The functionality has been assessed and quantita-
same plot) suggest that the force at the finger reaches a tively evaluated and the results represent a base for

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new possibilities in the use of soft bodied gripper with 8. Galvao Neto M, Ramos A, Campos J (2009) Single port
features which are very suitable in the medical field. laparoscopic access surgery. Tech Gastrointest Endosc
11(2):84–93
They possess intrinsic safety features and self-limiting 9. Gibo TL, Deo DR, Quek ZF, Okamura AM (2014) Effect of
properties which guarantee an extremely safe interac- load force feedback on grip force control during teleoper-
tion with biological tissues. ation: a preliminary study. In: Haptics symposium (HAP-
In this perspective, the impact of the lack of TICS), 2014. IEEE, pp 379–383
10. Ilievski F, Mazzeo AD, Shepherd RF, Chen X, Whitesides
sensorization of surgical instruments, which still GM (2011) Soft robotics for chemists. Angew Chem
represents a limit in terms of force feedback in MIS 123(8):1930–1935
procedures, is minimized and the designed tool, 11. In H, Cho K-J, Kim K, Lee B (2011) Jointless structure and
characterized by a self-regulated mechanism, paves under-actuation mechanism for compact hand exoskeleton.
In: IEEE International Conference on rehabilitation robotics
the way for a paradigm shift in safe surgical (ICORR), 2011. IEEE, pp 1–6
manipulation. 12. Kier WM, Stella MP (2007) The arrangement and function
of octopus arm musculature and connective tissue. J Mor-
Acknowledgments The authors acknowledge the phol 268(10):831–843
contribution of N. Funaro, A. Melani, R. Lazzarini, A. Pratesi, 13. Kundrat D, Schoob A, Kahrs L, Ortmaier T (2014) Rapid
F. Falotico, T. Mazzocchi and C. Quaglia for their help in prototyping of rod-driven continuum robots for medical
system development. applications. In: 4th Joint workshop on new technologies for
computer/robot assisted surgery, pp 139–141
Open Access This article is distributed under the terms of the 14. Laschi C, Cianchetti M (2014) Soft robotics: new perspec-
Creative Commons Attribution 4.0 International License (http:// tives for robot bodyware and control. Front Bioeng
creativecommons.org/licenses/by/4.0/), which permits unre- Biotechnol 2:3
stricted use, distribution, and reproduction in any medium, 15. Laschi C, Cianchetti M, Mazzolai B, Margheri L, Follador
provided you give appropriate credit to the original M, Dario P (2012) Soft robot arm inspired by the octopus.
author(s) and the source, provide a link to the Creative Com- Adv Robot 26(7):709–727
mons license, and indicate if changes were made. 16. Lirici MM (2012) Single site laparoscopic surgery: an
intermediate step toward no (visible) scar surgery or the
next gold standard in minimally invasive surgery? Minim
Invasive Therapy Allied Technol 21(1):1–7
References 17. Madhani AJ (1997) Design of teleoperated surgical instru-
ments for minimally invasive surgery. PhD thesis, Mas-
1. Araromi OA, Gavrilovich I, Shintake J, Rosset S, Richard sachusetts Institute of Technology
M, Gass V, Shea HR (2014) Rollable multisegment 18. Moradi Dalvand M, Shirinzadeh B, Nahavandi S, Smith J
dielectric elastomer minimum energy structures for a (2014) Effects of realistic force feedback in a robotic
deployable microsatellite gripper. Mechatron IEEE/ASME assisted minimally invasive surgery system. Minim Inva-
Trans 20(1):438–446 sive Therapy Allied Technol 1–9
2. Bar-Cohen Y (2000) Electroactive polymers as artificial 19. Munro MG (2002) Laparoscopic access: complications,
muscles-capabilities, potentials and challenges. Handb technologies, and techniques. Curr Opin Obstet Gynecol
Biomim 11(8):1–3 14(4):365–374
3. Bethea BT, Okamura AM, Kitagawa M, Fitton TP, Cattaneo 20. Piccigallo M, Scarfogliero U, Quaglia C, Petroni G, Val-
SM, Gott VL, Baumgartner WA, Yuh DD (2004) Applica- dastri P, Menciassi A, Dario P (2010) Design of a novel
tion of haptic feedback to robotic surgery. J Laparoendosc bimanual robotic system for single-port laparoscopy.
Adv Surg Tech 14(3):191–195 Mechatron IEEE/ASME Trans 15(6):871–878
4. Carrozza MC, Cappiello G, Micera S, Edin BB, Beccai L, 21. Puangmali P, Althoefer K, Seneviratne LD, Murphy D, Das-
Cipriani C (2006) Design of a cybernetic hand for percep- gupta P (2008) State-of-the-art in force and tactile sensing for
tion and action. Biol Cybern 95(6):629–644 minimally invasive surgery. Sens J IEEE 8(4):371–381
5. Cavusoglu MC et al (2000) Telesurgery and surgical sim- 22. Quaglia C, Petroni G, Niccolini M, Caccavaro S, Dario P,
ulation: design, modeling, and evaluation of haptic inter- Menciassi A (2014) Design of a compact robotic manipu-
faces to real and virtual surgical environments. University lator for single port laparoscopy. J Mech Design
of California, Berkeley 23. Stassen HG, Grimbergen CA, Dankelman J (2004) Intro-
6. Cianchetti M, Ranzani T, Gerboni G, De Falco I, Laschi C, duction to minimally invasive surgery. Eng Patient Saf
Menciassi A (2013) Stiff-flop surgical manipulator: mechani- Issues Minim Invasive Proced 2–18
cal design and experimental characterization of the single 24. Stilli A, Maghooa F, Wurdemann H, Athoefer K (2014) A new
module. In: International conference on intelligent robots and bio-inspired, antagonistically actuated and stiffness control-
systems (IROS), 2013 IEEE/RSJ. IEEE, pp 3576–3581 lable manipulator. In: 4th Joint workshop on new technologies
7. Deimel R, Brock O (2014) A novel type of compliant, for computer/robot assisted surgery, pp 112–114
underactuated robotic hand for dexterous grasping. In: 25. Suzumori K, Iikura S, Tanaka H (1991) Development of
Robotics: science and systems flexible microactuator and its applications to robotic

123
Meccanica (2015) 50:2855–2863 2863

mechanisms. In: Proceedings of IEEE International conference 27. Weber B, Schneider S (2014) The effects of force feedback
on robotics and automation, 1991. IEEE, pp 1622–1627 on surgical task performance: a meta-analytical integration.
26. Tholey G, Desai JP, Castellanos AE (2005) Force feedback In: Haptics: neuroscience, devices, modeling, and applica-
plays a significant role in minimally invasive surgery: tions. Springer, Berlin, pp 150–157
results and analysis. Ann Surg 241(1):102

123