IEEE ROBOTICS AND AUTOMATION LETTERS, VOL. 5, NO.
2, APRIL 2020
Automatic Design of Compliant Surgical Forceps
With Adaptive Grasping Functions
Yilun Sun , Student Member, IEEE, Yuqing Liu, Lingji Xu, Yunzhe Zou, Angela Faragasso , Member, IEEE,
and Tim C. Lueth, Senior Member, IEEE
Abstract—In this paper, we present a novel method for achiev-
ing automatic design of compliant surgical forceps with adaptive
grasping functions. Compliant forceps are much easier to assem-
ble and sterilize than conventional rigid-joint forceps, hence their
use is spreading from traditional open surgery to robot-assisted
minimally invasive applications. However, many compliant forceps
still perform stiff grasping, and thus can damage sensitive organs
and tissues during the operation. Adaptive grasping function is
therefore required for safe manipulation of vulnerable structures.
Currently, it is difficult and time consuming to use empirical meth-
ods for designing adaptive compliant forceps for different surgical
robotic applications. To cope with this problem, we developed
a topology-optimization-based method able to synthesize adap-
tive compliant forceps automatically. Simulation and experimental
tests were conducted to evaluate the adaptive grasping function
of designed surgical forceps. The results demonstrated that the
developed method greatly simplifies the design process and makes
it possible to efficiently realize task-specific compliant forceps.
Index Terms—Medical robots and systems, mechanism design,
surgical robotics: laparoscopy.
I. INTRODUCTION
N RECENT years, numerous research studies have been
I focusing on the design of novel mechanisms and instru-
ments able to improve the performance of both, traditional
and robot-assisted surgical procedures [1]–[5]. Among these
work, the design of surgical forceps, which are widely used
in various surgical interventions, has attracted great attention.
Although the conventional rigid-joint-based forceps are stable
and robust, limitations related to the material strength and the
accuracy, when fabrication is performed in micro-scale, make
their miniaturization cumbersome and hence, their adaptation
to minimally invasive surgery (MIS) applications difficult [6].
Manuscript received September 10, 2019; accepted January 10, 2020. Date
of publication January 20, 2020; date of current version January 30, 2020. This
letter was recommended for publication by Associate Editor P. R. Culmer and
Editor P. Valdastri upon evaluation of the reviewers’ comments. This work
was supported by the Munich School of Robotics and Machine Intelligence,
Technical University of Munich, Munich, Germany. (Corresponding author:
Yilun Sun.)
Y. Sun, Y. Liu, L. Xu, Y. Zou, and T. C. Lueth are with the Institute of
Micro Technology and Medical Device Technology, Technical University of
Munich, 80333 Munich, Germany (e-mail: yilun.sun@tum.de; yuqing.liu@
tum.de; lingji.xu@tum.de; zouyunzhe@gmail.com; tim.lueth@tum.de).
A. Faragasso is with the Service Robotics Laboratory, Department of Pre-
cision Engineering, The University of Tokyo, Tokyo 113-8656, Japan (e-mail:
faragasso@robot.t.u-tokyo.ac.jp).
This letter has supplementary downloadable material available at https:
//ieeexplore.ieee.org, provided by the authors.
Digital Object Identifier 10.1109/LRA.2020.2967715
2377-3766 © 2020 IEEE. Personal use is permitted, but republication/redistribution requires IEEE permission.
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1095
To cope with these problems, compliant mechanisms, which
encompass fewer mechanical components than rigid-joint-based
tools, are often used in the design of surgical forceps as they
are much easier to assemble and sterilize [7]. Many research
studies have been exploring the use of compliant mechanisms
for designing surgical forceps. For instance, Lan et al. developed
a constant-force forceps for robot-assisted surgery by using
compliant mechanism [8]. In [9], a compliant forceps for la-
paroscopic surgery has been designed by Nakamura et al. with
shape memory alloy (SMA). Another SMA-actuated compliant
MIS grasper was realized by authors in [4] with origami-inspired
structure. Other studies have also tried to include force sensing
capability into surgical robotic systems by using compliant for-
ceps, as in the 2-DOF compliant MIS forceps proposed by Hong
and Jo [10] and the 3-DOF micro-forceps developed by Gonenc
et al. [11]. However, despite all these research efforts, most of
the proposed compliant forceps have very stiff gripper jaws,
which may damage vulnerable tissues, such as blood vessels or
nerves, during the surgery. To deal with this problem, researchers
have been developing fin-ray-inspired forceps able to perform
adaptive grasping of sensitive tissues, which is an isosceles
triangular structure with multiple parallel stabilizers between its
elastic sides [12], [13]. Although fin-ray-effect can be efficiently
employed in the design of adaptive compliant forceps, its adapt-
ability to different surgical applications is complicated and time
consuming. Therefore, advanced design methods for realizing
adaptive compliant forceps for different surgical applications are
highly desirable.
Over the last decades, topology optimization has become
a popular method for achieving optimal design of compliant
mechanisms [14], [15]. The essence of topology optimization
lies in mimicking the evolutionary process of living creatures in
nature which always pursue the optimal structure to adapt to their
environment. In [16], Nishiwaki et al. presented a procedure
for obtaining the optimal topology of compliant mechanisms
with small displacement by using the mutual energy formulation
and homogenization method. For the design of task-specific
mechanisms, Pedersen et al. proposed a topology optimization
based method in [17] for synthesizing path-generating compli-
ant mechanisms automatically. Other studies have also tried to
use topology optimization to improve the design of compliant
instruments for surgical robotic applications. In [7], Kota et al.
developed a topology optimized compliant manipulator for po-
sitioning and manipulating kidneys in robot-assisted surgery.
Authors in [18] also employed topology optimization for
1096
Fig. 1. Overview of automatically designed adaptive surgical forceps: a)
Adaptive compliant forceps for different medical applications, b) Adaptive
grasping effect of the forceps when gripping a rigid cylinder.
designing a multifunctional compliant forceps which combines
grasping and cutting functions. De Lange et al. [19] realized
a statically balanced compliant laparoscopic grasper by using
topology optimization in the automatic design of the gripper.
However, all these previous studies didn’t consider adaptive
grasping function in their design. In [20], [21], several topology-
optimization-based methods for creating adaptive compliant
grippers for industrial robots, in which the geometric advantage
and mechanical advantage of the grippers were respectively
maximized, have been proposed. Nonetheless, the objective
functions of these methods are very complicated and still contain
many design parameters which must be manually determined.
On the other hand, in most of the current topology optimization
methods, the solid modeling, the finite element analysis (FEA)
and the updating scheme of the optimization algorithms, are
usually performed in different developing environments and
software, and thus, it is required to have additional interfaces
between different platforms and this makes the process ineffi-
cient [20]–[22]. In the current state of the art, although some
studies have realized automatic design process by using one
platform, it is still complicated to create very complex initial
design domain for the topology optimization process [23], [24].
In this paper, we present an efficient method for achieving
automatic design of adaptive surgical forceps by using topology
optimization techniques. The entire solid modeling and topology
optimization process have been implemented in our Solid Geom-
etry (SG) Library [25], a design platform we realized in Matlab.
The SG Library can perform complex solid modeling and inte-
grate different evaluation methods, such as FEA and multi-body
simulation [26]. With the automatic design method proposed in
this paper, the design process of task-specific compliant forceps
can be greatly simplified. An overview of the fabricated adaptive
compliant forceps for different surgical applications is shown in
Fig. 1.
The remainder of the paper is organized as follows: Section II
analyzes the automatic design process, introduces the solid
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IEEE ROBOTICS AND AUTOMATION LETTERS, VOL. 5, NO. 2, APRIL 2020
Fig. 2. Flowchart of the developed topology optimization method for achiev-
ing automatic design of adaptive compliant forceps.
modeling method in the SG Library and presents the devel-
oped topology optimization technique for designing adaptive
compliant forceps automatically. Section III presents the de-
sign of adaptive compliant forceps for open surgery and MIS.
Experimental evaluations are conducted in Section IV where,
to validate the proposed solution, the automatically designed
adaptive forceps are compared with conventional surgical for-
ceps. Section V discusses the automatic design method in terms
of design efficiency and outlines the future work. Conclusions
are drawn in Section VI.
II. DESIGN METHOD
A. Overview of the Automatic Design Method
The workflow of our automatic design method is shown in
Fig. 2. Firstly, the design problem is defined by importing the
initial design domain and the boundary conditions. Then, during
the topology optimization process, FE-analysis is performed in
each step to calculate the objective function. With the calculated
value of the objective function, an updating scheme iteratively
modifies the density of the material in the design domain until
the topology optimization process converges. Finally, a post-
processing algorithm is executed to realize a smooth and 3D-
printable forceps.
B. Solid Modeling With SG Library
Currently, two types of construction methods are used for
solid modeling, the Constructive Solid Geometry (CSG) and the
Boundary Representation (B-rep) [27]. The standard file for 3D
printing is a B-rep-based file in which a large number of triangles
are used to represent the surface of a solid. Since the SG Library
has been developed with the aim of enhancing the automatic
design process of 3D printable structures, it also employs B-rep
format for solid modeling. The basic data structure of 2D con-
tours and 3D solids in the SG Library are called Closed Polygon
List (CPL) and Solid Geometry (SG). The CPL is implemented
as a Matlab’s array in which the exterior boundary vertices of the
contour are listed in counterclockwise direction and the interior
boundary vertices in the clockwise direction (see Fig. 3a). The
SG is implemented as a struct which contains a Vertex List (VL)
and a Facet List (FL) to represent the boundary surface of a solid
(see Fig. 3b). The CPL and SG can be easily realized by using
SUN et al.: AUTOMATIC DESIGN OF COMPLIANT SURGICAL FORCEPS WITH ADAPTIVE GRASPING FUNCTIONS 1097

Fig. 4. Design problem for the proposed topology optimization method. In

this case, an example for open surgery is used for illustration.

where ρ is the design variable. Ee of the element is correlated

to its density ρe by employing the Solid Isotropic Material with
Penalization (SIMP) method [28]. E0 and p are respectively the
Fig. 3. Construction of 2D contour and 3D solid geometry with the SG Library:
a) An example of CPL. The red and blue arrows indicate the listing directions Young’s modulus of the solid material and the penalty parameter,
of the vertices on the exterior and interior boundary respectively, b) A 3D solid while ρmin is a prescribed minimum density used to avoid
extruded by the CPL. singularity in the FEA process. L is a sparse vector mainly
composed of zeros except on the elements related to the degree of
freedom (DOF) for the output displacement uout of the forceps
a modeling function in our SG Library with short and concise tip. ve and V0 are the material volume of an element and the entire
modeling commands [25]. initial design domain, respectively. The parameter g defines a
prescribed volume fraction which controls the final volume of
the design result. Fig. 4 illustrates the general design problem for
C. Topology Optimization Method for Designing Adaptive
the proposed method with an example for open surgery. Since
Compliant Forceps
forceps are normally symmetric, a predefined 2D contour is
Since the realized compliant forceps are 2D structures, the 2D used as half of the initial domain, as the CPL from Fig. 3a)
finite element method (FEM) implemented in the SG Library is in this example. In the figure, the gray region ΩD depicts the
employed in the topology optimization process. The 2D-FEM design domain. The black region ΩC represent the geometrical
algorithm utilizes triangular element for meshing [13]. The dis- constraints in which the density of the elements is predefined as
placement U of all nodes in the discretized 2D solid continuum 1 and cannot be modified during the optimization process. These
can be calculated by solving the linear equation system for solid constrains express the functionality of the forceps handle, which
mechanics [14]: has to hold the structure, and the one of the contact surface of the
gripper jaw, which has to grasp tissues. A displacement-based

N
load Fin is applied on the forceps handle as input load to
KU = F with K = Ke (Ee ) (1)
simulate the gripping force of human fingers. uout is defined
e=1
as the y-displacement of the forceps tip. To achieve adaptive
where K is the global stiffness matrix of the continuum and grasping function, two linear springs with stiffness kout and
F is the load vector. K can be calculated by assembling the ktissue are applied on the tip and the middle region of the gripper
N stiffness matrices Ke which are correlated to the Young’s jaw respectively. This makes it possible to simulate the external
modulus Ee of the element. The goal of the topology optimiza- resistances during the grasping movements. We assumed that
tion method, used to synthesize the compliant forceps, is to ktissue is greater than kout so that the sensitive tissue becomes
find an optimal void-solid (0 or 1) material distribution ρ of the main external resistance for the forceps to overcome. The
the 2D continuum which will allow to achieve the maximum proposed topology optimization process of compliant mecha-
displacement of the forceps tip with a given input load. The nisms always tries to achieve the maximum output displacement
optimization problem is described by the following objective while overcoming the internal and external resistance, hence the
function f (ρ): deformation of the tissue during grasping will also be minimized
⎫ in the optimization process. In general, the proposed method
max : f (ρ) = uout = LT U ⎪
⎪ requires 11 predefined design parameters to start the automatic
ρ
N ⎪
⎪
subject to: V (ρ) = e=1 ve ρe ≤ V0 g ⎬ design process.
(2) The topology optimization problem in (2) has been solved by
: KU = F ⎪
⎪
⎪
⎪ using the Optimality-Criteria (OC) method proposed in [14].
⎭
: Ee = E0 ρpe , 0 < ρmin ≤ ρe ≤ 1 The updating scheme of the design variables ρ can be

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1098 IEEE ROBOTICS AND AUTOMATION LETTERS, VOL. 5, NO. 2, APRIL 2020

written as:
⎧
−
⎪
⎨ρe , if ρe Beη ≤ ρ−
e
ρnew = ρe Beη , if ρ− < ρ η +
e e < ρe
B (3)
e
⎪
⎩ +
e
ρe , if ρ+
e ≤ ρe Be
η

⎫
ρ−
e = max(ρmin , ρe − m)⎪ ⎪
⎬
ρ+ = min(1, ρ e + m) (4)
e
⎪
⎪
⎭
ρ0e = g in ΩD
− ∂ρ
∂f
− ∂ρ
∂f
Be = e
= e
(5)
λ1 ∂ρ
∂V λ1 v e
e

where m is a move limit of the design variable ρe in each step

and η is a prescribed parameter for damping. ρnew
e is the updated
design variable. The initial design variable ρ0e in the design
domain ΩD is set to the prescribed volume fraction g. Be in (5)
can be obtained from the optimality condition problem which
considers both the objective function f (ρ) and the volume con-
straint condition (V (ρ) − V0 g ≤ 0). The Lagrangian multiplier
λ1 can be determined by a bisection algorithm when solving the
∂f
optimality condition problem [23]. The sensitivity function ∂ρ e
with respect to ρe in (5) can be formulated as:

∂f ∂f ∂Ee ∂f
= = pE0 ρp−1
e (6)
∂ρe ∂Ee ∂ρe ∂Ee Fig. 5. Topology optimization process of the adaptive compliant forceps for
open surgery: a) The trend of the objective function f during the optimization
∂f ∂K
= − λT
2 U (7) process, b) The evolution process during some iterations. The final topology of
the forceps is reached at the 99th iteration.
∂E ∂E
Kλ2 = L (8)

where λ2 can be calculated by solving the adjoint problem

represented by the system of linear equations in (8). E is the
vector containing all Young’s modulus Ee of the elements and
L is defined as in (2).
The design variables ρ reach a completely void-solid (0 or
1) material distribution, when the objective function f con-
verges within a certain tolerance ε. The checkerboard prevention
filter from [23] is then implemented, with mesh-size-based
filter radius, to ensure a reasonable and continuous topology
of the design result. In the post-processing algorithm, also
implemented in the SG Library, we use the iso-contour method
proposed in [29] to extract the boundary (a CPL) of the final
design proposal and smooth it for constructing a solid in B-rep
format. The aim of this step is to realize the optimization results
compatible with 3D printing technology.
III. APPLICATIONS TO SURGICAL FORCEPS DESIGN
This section presents the design of two adaptive complaint
forceps realized by using the proposed automatic design method.
In particular, the first forceps has been designed for traditional
open surgery while the second one has been realized for robot-
assisted MIS. All the calculations were executed on a computer
equipped with an Intel Core i7 CPU at 2.9 GHz and 16 GB of
RAM.
A. Adaptive Compliant Forceps for Open Surgery
The design problem described in Section II-C (see Fig. 4) was
used to perform the automatic design process of open surgery
forceps. The maximum length and width of the initial design
domain were respectively 100 mm and 60 mm. The design
domain was meshed into triangular elements with a maximum
size of 0.4 mm. The forceps was printed with selective laser
sintering (SLS) by using polyamide (PA2200) [30] as material.
E0 and ν for the FEA process were set to 1700 MPa and 0.3 [30]
while the displacement-based input load was 5 mm. To mimic the
elasticity of humans’ artery, ktissue was set to 0.75 N/m [31].
The value of kout was selected as 0.5 N/m, and thus, smaller
than ktissue . The prescribed volume fraction g was set to 0.3
while the move limit of the design variable ρe in each iteration
was 0.05 and the damping factor η in the updating scheme was
0.5. The topology optimization process converged at the 99th
iteration within a tolerance ε of 0.005. The convergence time
was 51.94 s. Fig. 5a) shows the trend of the objective function f
over the iterations. It can be noticed that f reaches its maximum,
9.15 mm, at the end of the process. The evolution process of the
forceps topology in some iterations is illustrated in Fig. 5b).
As mentioned in Section II, the boundary CPL of the optimiza-
tion result was derived by using the iso-contour method. The
extracted CPL and its symmetrical duplicate were merged and

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SUN et al.: AUTOMATIC DESIGN OF COMPLIANT SURGICAL FORCEPS WITH ADAPTIVE GRASPING FUNCTIONS 1099

Fig. 6. Design of the adaptive forceps for open surgery: a) The surface model
of the forceps in the SG Library and the 3D-printed prototype, b) FE-simulations
of the deformed compliant forceps showing the adaptive grasping function and
stress distribution. The red arrows indicate the applied load.

then extruded into a solid with thickness of 5 mm. Fig. 6a) shows
the constructed SG and the SLS-printed prototype of the adaptive
compliant forceps. The adaptive grasping function is shown in
the FE-simulations presented in Fig. 6b). The simulation is based
on the geometrically non-linear FE-methods implemented in
the SG Library [13]. In both simulations, a symmetrical load is
applied on each handle pair to shorten their distance by 10 mm. In
the first case, no external resistance is applied on the gripper jaw.
In the second case, a rigid cylinder with the diameter of 12 mm
is placed between the gripper jaws of the forceps. From the
simulation results it can be noticed that, the optimized compliant
forceps deforms its gripper jaws to fit the shape of the grasped
object, as illustrated in Fig. 6b). The figure also shows how large
stresses emerged at the most deformed part of the forceps.

B. Adaptive Compliant Forceps for Robot-Assisted Minimally

Invasive Surgery
Different from open surgery forceps, most MIS forceps have
millimeter-scale size and are usually actuated by a cable. There-
fore, to create a consistent model, we used our automatic design
method to synthesize a cable-driven forceps head. The design
settings are illustrated in Fig. 7a) and 7b). The maximum length
and width for initial design domain of the entire forceps head
were chosen as 20 mm and 12 mm, respectively. The maximum
element size of the FE-meshing was 0.1 mm. The left boundary
of the design domain was defined as fixed in the FEA process.
The dragging force of the cable was applied on the symmetric
axis of the design domain with a distance of 7.5 mm to the
left boundary and the displacement-based load Fin was set
to 2 mm. The values of ktissue and kout were chosen as the
Fig. 7. Automatic design of adaptive forceps head for minimally invasive
one of the forceps realized for open surgery, i.e. 0.75 N/m and surgery: a) A CPL constructed with the SG Library as initial design domain, b)
0.5 N/m. The contact surface of the gripper jaw was defined as A schematic diagram illustrating the design domain and boundary conditions
a constrained domain ΩC . The volume fraction g was 0.4. The for the optimization problem, c) The trend of objective function during the
optimization process, d) The evolution process during some iterations. The final
material property of the forceps and realization process were also topology of the forceps is reached at the 75th iteration., e) FE-simulations of the
the same of the one used for the open surgery forceps presented deformed compliant forceps showing the adaptive grasping function and stress
in the previous section. distribution. The red arrows indicate the applied load.

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1100 IEEE ROBOTICS AND AUTOMATION LETTERS, VOL. 5, NO. 2, APRIL 2020

Fig. 8. SLS-printed laparoscopic manipulator for robotic MIS. Adaptive

grasping can be achieved by using the automatically designed forceps.

The topology optimization process converged at the 75th Fig. 9. Experimental setup: Elastic tubes with different ratios of internal and
external diameter are used as test samples to evaluate the grasping effect of
iteration within a tolerance ε of 0.005. The convergence time conventional and adaptive forceps. A digital microscope measures deformation
was 28.67 s. Fig. 7c) shows the trend of the objective function f , of the tubes.
which has a maximum value of 5.78 mm. The evolution process
of the forceps topology is illustrated in Fig. 7d). FE-simulations
were also performed to show the adaptive function of the forceps
head. The results are shown in Fig. 7e). In this case, large
stresses also emerged in the thin structure of the flexure hinges.
Additionally, the SLS-printed prototype of the adaptive forceps
head was embedded into a laparoscopic manipulator and used
for grasping phantom organs and tissues. The entire system
was realized with our SG Library. A soft robot structure was
integrated in the mechanism to increase the dexterity of the
manipulator and also to show the potential of the forceps for
robot-assisted MIS. The bending movements of the soft robotic
structure were actuated by two rotating wheels in the handle as
shown in Fig. 8.

IV. EXPERIMENTS Fig. 10. Different forceps and elastic tubes used in the experiments.
This section compares the grasping effect of the realized
adaptive compliant forceps with conventional surgical forceps effect. In particular:
and presents its adaptation in robot-assisted MIS.
dint
kie = (9)
A. Experimental Setup dext
3D-printed elastic tubes, which emulate the elastic property of dy,def ormed tube
kd = (10)
organs and tissues, were used to test the grasping effect of our dx,def ormed tube
prototypes. The cylindrical tubes were modeled using the SG
where the y axis was defined as the direction in which the
Library and fabricated with the stereolithography (SLA) printer
gripping force is applied on the tube and the x axis was its
(Formlabs Form2) [32]. A material with silicone-like properties
orthogonal axis. The loads were applied on the forceps handle to
(Elastic Resin) [32], which is suitable for mimicking humans’
achieve complete closure of both forceps tips. With conventional
tissues, was used for printing the parts. A digital microscope
forceps, which perform stiff grasping, the elastic tubes were
(Conrad DP-M17) [33] was used to measure the size of the de-
sometimes fully squeezed before complete closure of forceps
formed tubes during the tests. An overview of the experimental
tips was achieved. For these cases, where the piece prevents full
setup is shown in Fig. 9.
closure of the forceps, kd was calculated based on the shape of
The commercially available Cambridge Endo laparoscopic
the fully deformed part. The external diameter of the tubes for
manipulator [34], which is also equipped with a soft robotic
open surgery forceps and MIS forceps were 15 mm and 6 mm,
bending mechanism as in the SLS-printed manipulator, and the
respectively.
Kelly Hemostatic forceps [35], have been used to compare and
evaluate the grasping effect of our adaptive compliant forceps
B. Experimental Results
(see Fig. 10). The tubes were constructed with different ratios
of internal and external diameter, kie , to imitate blood vessels of Experimental tests were carried out to evaluate the grasping
different thickness. The ratio kd of the diameter of the deformed effect of the developed adaptive compliant forceps and compare
tube in x and y axis was calculated to evaluate the grasping them with conventional forceps. Each test was repeated three

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SUN et al.: AUTOMATIC DESIGN OF COMPLIANT SURGICAL FORCEPS WITH ADAPTIVE GRASPING FUNCTIONS
Fig. 11. Experimental results: a) Experiment of open surgery forceps, b) Trend
of the deformations of the tubes over the ratio of the internal and external
diameters. The tube is less deformed when using the adaptive forceps (blue)
than the Kelly Hemostatic forceps (red), c) Experiment of MIS forceps, d)
Trend of the deformations of the tubes over the ratio of the internal and external
diameters. The tube is less deformed by the adaptive MIS forceps (blue) than
the conventional MIS forceps (red).
times. Mean value of the results is reported in Fig. 11. kd
was higher when the tube was slightly deformed. Hence, the
objective of the adaptive grasping function was to make kd
always close to 1, independent from the object to be grasped.
As is shown in Fig. 11b) and Fig. 11d), the kd values of
our adaptive compliant forceps are much closer to 1 than the
conventional rigid-joint-based forceps. Even for very thin tubes
(kie > 0.7), both compliant forceps were still able to perform
adaptive grasping (kd > 0.6). These results haven shown the
robustness of the realized adaptive grasping function. While,
for very thick tubes (kie < 0.2), which are very stiff and hard to
deform, the kd value of all forceps was close to 1. This situation
is similar to the case of diseased and blocked blood vessels.
C. Endoscopic Experiment in Training Box
To evaluate the grasping effect of the adaptive forceps head
of the robot-assisted laparoscopic manipulator, we have also
conducted an experiment in a training box equipped with an
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1101
Fig. 12. Endoscopic experiment in a training box: a) Setup of the test com-
posed of a training box, an endoscopic camera, a laparoscopic manipulator and a
monitor, b) Images taken by the endoscopic camera showing the grasping effect
of the conventional and adaptive MIS forceps.
endoscopic camera (Depstech Endoscope) [36]. The experimen-
tal setup is shown in Fig. 12a). An artificial artery printed with
the SLA-printer Form2 and imitating the material properties of
the soft tissues, was used during the test. Grasping of the elastic
artery in the training box was performed with the Cambridge
Endo laparoscopic manipulator and our SLS-printed manipula-
tor. With the equipped soft robot structure, both manipulators can
also perform bending movements during grasping. The proposed
MIS forceps could successfully perform adaptive grasping in
the training box while the conventional forceps squeezed the
artificial artery completely, as shown in Fig. 12b). The adaptive
grasping function of our robot-assisted MIS forceps was thus,
also successfully verified in a MIS setup.
V. DISCUSSION
The work presented in this letter aims at improving the design
efficiency of adaptive compliant forceps, for both, open surgery
and robot-assisted MIS. The proposed solution consistently
simplifies the design process, as it requires only 11 initial de-
sign parameters and one developing environment. Our solution
outperforms previous methods [20], [21], in which over 30
design parameters must be predefined in order to trigger the
automatic design process and at least 2 developing environments
are used in the implementation of the entire design process.
Besides, the proposed design framework is very agile and can
also be modified for designing other task-specific instruments.
For example, it is possible to remove the spring of ktissue in the
design problem in Fig. 4 and Fig. 7b) to automatically synthesize
compliant forceps with stiff grasping functions. The potential
and applicability of the proposed adaptive forceps in surgical
robotic systems was demonstrated by the endoscopic experiment
presented in Section IV.
1102
Nevertheless, the method can still be improved in several
aspects. As is shown in Fig. 6b) and Fig. 7e), some thin flexure
hinges have emerged in the final topologies of the design which
may result in large stresses during grasping movements. This
problem could be solved by introducing additional stress con-
straints into the design problem, and will be further analyzed in
the future. On the other hand, although no tubes were slipped
from the forceps during the experimental tests, additional in-
vestigations are required to analyze the clamping force of the
adaptive forceps and ensure stable clamping of the tissues during
the operation. In future work, we plan to use other materials,
such as titan and nitinol, to fabricate the realized forceps and
deeply explore the benefit of using the proposed automatic
design method in laparoscopy and robot-assisted MIS.
VI. CONCLUSION
In this paper, we proposed a novel method for achieving
automatic design of adaptive compliant forceps which can be
used for different surgical applications. Several examples have
been presented to illustrate the design principle and analytical
procedure. The adaptive grasping function of the automatically
designed forceps was validated by a series of FE-simulations and
experiments. Results demonstrated that the proposed method
can greatly simplify the design process of task-specific compli-
ant forceps for both open surgery and robot-assisted MIS.
ACKNOWLEDGMENT
The authors would like to thank all reviewers and Nicholas
Moser for their constructive criticism of the manuscript.
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