Surgeons Aim to Restore Sense of Touch with Robotic Fingertips

Modern surgical techniques have evolved significantly, shifting from lengthy incisions to minimally invasive procedures guided by advanced robotics and artificial intelligence. However, this progress has come at a cost: surgeons have lost the ability to directly feel the tissues they operate on. A collaborative research effort across Europe aims to address this challenge by developing a robotic “fingertip” that can replicate the sense of touch during surgery.

As part of the EU-funded initiative known as PALPABLE, a team of surgeons and engineers is working on a soft robotic device designed to sense the firmness or softness of tissue during minimally invasive surgeries. This project is set to continue until the end of 2026, with the first prototype anticipated to undergo testing by surgeons in March 2026.

Reintroducing Tactile Feedback in Surgical Procedures

The shift towards keyhole surgery over the past three decades has significantly reduced tactile feedback for surgeons. Professor Alberto Arezzo from the University of Turin, a specialist in minimally invasive procedures, explains that the transition from open surgery to using long instruments has diminished the hands-on experience that was previously integral to surgical practice. “We moved into the era of keyhole surgery, which reduced tactile feedback,” he noted.

While keyhole surgery has provided patients with benefits such as reduced trauma and quicker recovery times, it has made it difficult to discern the characteristics of different tissues. This is particularly critical in cancer surgeries, where the ability to differentiate between healthy and abnormal tissue can determine the success of the operation.

Dr. Gadi Marom, a clinician from Hadassah Medical Centre in Jerusalem involved in the PALPABLE project, emphasized the delicate balance surgeons must maintain when excising tumors. “We don’t want to do that. We want it done in one shot,” he stated, highlighting the importance of precise margins in cancer operations.

Innovative Technology to Enhance Surgical Precision

To restore tactile feedback, the PALPABLE team is developing a probe that incorporates optical sensing and soft robotics. The device features fibre-optic cables embedded in a flexible tip, which deforms upon contact with tissue. The changes in light transmitted through the fibres provide data on the stiffness of the tissue being examined.

“By using a silicone dome that presses against soft tissue, we can map both the direction and the magnitude of the applied force,” explained Dr. Georgios Violakis from Hellenic Mediterranean University. This technology not only aims to enhance the surgeon’s understanding of the tissue but also offers a visual representation of tissue stiffness, which can be displayed on a screen during operations.

Various institutions are contributing to the project, with Queen Mary University of London focusing on membrane design, and the Fraunhofer Institute in Germany working on functional films. Other partners include Bendabl and Tech Hive Labs from Greece, along with the University of Essex in the UK, which are developing the software needed to visualize the tactile maps.

The ultimate goal of this innovative research is to improve patient care. Dr. Marom remarked, “The bottom line is that we will be able to give better care to our patients.” As surgical procedures increasingly incorporate robotic technologies, the importance of tactile feedback becomes even more pronounced.

Both Professor Arezzo and Dr. Marom anticipate that robotic surgery will become the standard in operating theatres, but this transition hinges on providing surgeons with enhanced sensory information. As Arezzo succinctly put it, “Sooner or later, I believe the vast majority of surgeries will be robotic.”

The research conducted under the PALPABLE initiative is funded by the EU’s Horizon Programme, with the opinions expressed by the interviewees not necessarily reflecting those of the European Commission.

This advancement in surgical technology represents a significant step towards merging human skill with robotic precision, potentially transforming surgical outcomes in the future.