EPSRC-NIHR HTC Partnership Award Plus Funds: Technology Network-Plus on Devices for Surgery and Rehabilitation

Lead Research Organisation: Imperial College London
Department Name: Institute for Global Health

Abstract

Improving outcomes, minimising re-admissions, prioritising hospital resources and expanding home or community-based management are major objectives of the NHS. Patient care needs to be considered for the entire recovery process of patients and potential impact on life-long health and wellbeing. The future of surgery is therefore moving towards precision intervention, increasingly driven by focus on quality-of-life after surgery, as well as the need for taking a systems approach towards surgery. The aim of the proposed network is to establish a forum for surgical innovation with seamless integration of engineering research, clinical translation and industrial development by aligning EPSRC healthcare technologies with NIHR Healthcare Technology Co-operatives (HTCs) to accelerate the development and clinical adoption of new surgical and assistive devices that can improve the treatment, functional restoration, rehabilitation and quality-of-life for patients. The network is supported by NIHR HTCs, KTN, and a number of academic, NHS, industrial and healthcare stakeholders.

The research and clinical bases to be covered by the proposed Technology Network include the following three areas: 1) Sensing for improved peri-operative care - which is a determining factor for mitigating against post-operative complications; 2) Smart surgical devices - for surgery with increased consistency and accuracy, streamlining intraoperative surgical decision making and circumventing potential post-operative complications and revisions; 3) Assistive devices and robots - to facilitate remote monitoring and managed rehabilitation in community or home care settings. The three areas share common engineering research challenges but need to be pursued under different clinical context.

The planned activities of the network include 1) Network Events: Symposia and Focused Workshops; 2) Strategic Roadmap events and User Forums; 3) Support for Interdisciplinary Mobility and Industrial Secondment; 4) Proof-of-Concept Projects and Design Competitions; 5) Exhibitions and Patient/Public Engagement; and 6) Online Engagement, Web Forum and Social Media; and 7) Health Policy and High Level Engagement. The benefits for those involved in the proposed network include partnership with extensive industrial and clinical connections already established by the partnering HTCs, host institutions, clinically aligned research and development pathways addressing the future of surgery, engagement of healthcare stakeholders and policy makers, access to research expertise and young talents in this highly interdisciplinary area, early end-user involvement, and tapping into design expertise, access to user group feedback, deliver rapid results through HTCs' clinical network, match evidence to needs of NICE, strong commercial engagement.

Planned Impact

The proposed network will foster new interdisciplinary research for establishing a critical mass around UK's research strengths in sensing, robotics and surgical devices by bridging EPSRC and NIHR research activities with significant industrial involvement and a clear translational focus. Through planned activities as detailed in the Case-for-Support, the proposed network will:

- Facilitate knowledge transfer of surgical device innovation, experimental techniques, scientific insights, promote mobility between academe, universities and industry;

- Initiate, facilitate and lead major multidisciplinary collaborative grants and development programmes through close interaction among the engineering research community, science, technology, industrial groups, and healthcare technologies stakeholders;

- Provide a platform for clinicians, engineers and industrialists to exchange ideas and forge new collaborative agreements and joint development programmes;

- Raise the awareness of key challenges and opportunities of surgical technologies and create an opportunity for researchers to work together and learn from the leaders in the field and gain an in depth knowledge of advanced surgical technologies;

- Strengthen public engagement, inspire, educate and connect young professionals in research to achieve excellence in their career and contribute to the industry and society;

- Maintain strong relationships with partner institutions and foster long-term collaborations between clinicians and engineers to translate research into advances for the benefit of the patients and improve quality of life;

- Influence healthcare policy in the effective use of new technology for addressing health challenges associated with demographic, environmental, social and economic changes.

With respect to the Impact and Translation tool, the proposed project addresses:

- Ethics: The project will go through ethical approval for all feasibility studies involving patients and the appropriate licences to perform preclinical experiments with the system prototypes; these will be acquired prior project start. The use of animal models for preclinical evaluation will be approved by Home Office and we will adhere strictly to the 3R principle of animal research.

- Health economics and evaluation: Health economic analysis will be performed as one of the impact activities. Through collaboration with the Centre for Health Policy at Imperial College, the Network has access to health economists to ensure the affordability of the proposed technology is feasible.

- Public engagement: The research will involve extensive public and end-user engagement as part of our impact activities in public communication.

- Regulation: With our network partners, issues regarding device safety and regulatory pathways will be addressed.

- Research project design: The project will focus on preclinical and precompetitive stage of research involving all impact partners; academic results will be put into the public domain; likewise, regulatory issues will be investigated for the new devices to be proposed.

- Responsible innovation: The project aims to follow the AREA framework as part of the network activities and engagement plan.

- User engagement: The network partakes in significant patient and public engagement through conferences, focussed user group workshops, open days and online forums. User engagement though the partners involved will have a wide reach of the activities and it will ensure appropriate end users, experts are involved as needed to maximise opportunities and impact of the Network.

Publications

10 25 50
 
Description Since its formation, the Network Plus has organised/contributed to high profile events at the annual Hamlyn Symposium; focused workshops on surgical imaging in partnership with Enteric HTC; focused workshops on Wearable and Assistive Robots in partnership with Trauma management HTC; organised the third International Surgical Robot Challenge with industrial support from Intuitive Surgical, Kuka, and Applied Dexterity
Exploitation Route -Facilitate knowledge transfer
-Initiate major multidisciplinary collaborative grants
-Provide a platform for clinicians, engineers and industrialists to exchange ideas and forge new collaborative agreements and joint development programmes;
-Maintain strong relationships with partner institutions and foster long-term collaborations between clinicians and engineers
-Influence healthcare policy in the effective use of new technology for addressing health challenges
Sectors Digital/Communication/Information Technologies (including Software),Education,Electronics,Healthcare,Government, Democracy and Justice,Manufacturing, including Industrial Biotechology,Pharmaceuticals and Medical Biotechnology

URL http://hamlyn.doc.ic.ac.uk/htc/
 
Description We have taken part in the Imperial Festival to inform patients and public of our research in these areas. In the last year we ran a series of workshops on Medical Robotics as part of the Hamlyn Symposium 2017. The conference and workshops bring clinicians together with researchers in academia and industry to exchange ideas on the current state-of-the-art and future trends in these areas. For example, wearable robots, actuated prostheses and exoskeletons have made significant inroads in recent years for functional rehabilitation, restoration of natural mobility and enhancing musculoskeletal strength and endurance. Assistive robots also play a key role in managing the ageing population for general activities of daily living and remote presence for linking to specialist centres. We have run School Robot Challenge 2017 to inspire children with the natural world and robotics. This is a national competition that teaches schoolchildren about the basics of 3D computer aided design.
First Year Of Impact 2017
Sector Digital/Communication/Information Technologies (including Software),Healthcare,Manufacturing, including Industrial Biotechology,Pharmaceuticals and Medical Biotechnology
Impact Types Cultural

 
Title Master Manipulator for Robot-Assisted Endovascular Intervention 
Description This is a compact hands on robotic manipulator to perform robot-assisted endovascular interventions. 
Type Support Tool - For Medical Intervention
Current Stage Of Development Initial development
Year Development Stage Completed 2018
Development Status Under active development/distribution
Impact Robot-assistance and force feedback are provided for both linear (push-pull) and rotational (twist) manoeuvers of the catheter/guidewire. By mimicking the manipulation of a manual catheter/guidewire, it allows for more intuitive control of the robotic catheter/guidewire while the skills of the operator are retained and enhanced with motion scaling and haptic feedback. 
 
Title Slave Robot for Robot-Assisted Endovascular Intervention 
Description Slave robot to perform robot assisted endovascular interventions. This device works in conjunction with a robotic master manipulator (MM) to manipulate commercially available catheters/guidewires. It consists of two servomotors that can push, pull and twist the catheter/guidewire based on the motion commands generated by the surgeon manipulating the MM. The catheter/guidewire is translated by a pair of friction wheels that are coupled to one of the servomotors. The steering is achieved by rotating the frame that holds the catheter/guidewire. 
Type Support Tool - For Medical Intervention
Current Stage Of Development Initial development
Year Development Stage Completed 2017
Development Status Under active development/distribution
Impact This device, in conjunction with the MM, augment the surgical capabilities through motion scaling and intuitive control. It is compact, ergonomic and low-cost. It allows the manipulation of commercially available instruments (catheters and guidewires). 
 
Description Hamlyn Centre Christmas Showcase 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact The Hamlyn Christmas Showcase was an event for collaborators and affiliates of the Hamlyn Centre that showcased the latest research outputs of the Hamlyn Centre. The aim was to communicate our research findings and encourage deeper collaboration.
Year(s) Of Engagement Activity 2017
 
Description Hamlyn Centre Induction Day 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Study participants or study members
Results and Impact The Hamlyn Centre Induction Day was an event for creating better connectivity within the Hamlyn team of over 80 researchers. With talks, networking activities and discussions, this event enabled MRes students, PhD students, researchers and support staff to engage and share ideas for development of Hamlyn initiatives.
Year(s) Of Engagement Activity 2017
 
Description Hamlyn Winter School on Surgical Imaging and Vision 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact The Winter School focuses on both technical and clinical aspects of Surgical Imaging and Vision, with invited lectures, hands-on demonstrations, workshops, and mini-projects.
Year(s) Of Engagement Activity 2017
URL http://hamlyn.doc.ic.ac.uk/winterschool/
 
Description Rehabilitation and Assistive Technologies Workshop (London) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Workshop run as part of 9th Hamlyn Symposium on Medical Robotics
Following the presentations, discussions took place to discuss future collaborations and joint grant applications.
Year(s) Of Engagement Activity 2016
URL http://hamlyn.doc.ic.ac.uk/hsmr/sites/default/files//HSMR-Prog-2016-FULL-FINAL.pdf
 
Description Robotic Sewing and Suturing: What Can We Learn From Each Other? 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact There are many similarities in the automation of needle and thread handling in the manufacturing and clinical fields and by bringing together these highly related specialisms, we asked: what can we learn from each other? The workshop aim was to stimulate discussion and encourage cross-fertilisation of new ideas in this niche yet increasing important area in surgery and innovative manufacturing. There were approximately 35 attendees from around the world, from industry, academia, and healthcare. Of particular interest was the involvement of a 3D embroidery artist, with knowledge shared between the various audience types and changes in views reported.
Year(s) Of Engagement Activity 2016
URL http://hamlyn.doc.ic.ac.uk/hsmr/robotic-sewing-and-suturing-what-can-we-learn-each-other
 
Description School Robot Challenge 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact The challenge will be run jointly by any interested UK-RAS partner universities, and is aimed at teams of schoolchildren of ages up to 16 (year 11). It will be published in the UK-RAS Robotics Week 2018 brochure and on the website, and will be distributed via each participating university's local schools' network.

The challenge will consist of 2 separate activities: the first involves schools working independently to develop and then submit a design(s) for a robot system to help older people. The deadline for submissions for this activity is 18/05/2018.

The best entries will then be chosen, with one winning team selected by each participating university (the proximity of school to university may or may not influence the decision), which will then invite that team to a special one-day event on 26/06/2018 (that is, the Tuesday of UK Robotics Week). After a tour of the robot labs, the teams will be set another similar care-themed challenge using whatever basic, programmable robotics equipment is to hand (e.g., Lego Mindstorms - there is no requirement for the same equipment to be used at each university). This activity will last from 10.30am until 3.30pm with a working lunch provided, and if possible live streaming of video from the other participating sites (also shown on the UK-RAS website). The goal of each team will be to produce a smartphone video of no longer than 1 minute's duration that describes the problem, the concept and design of their suggested solution, and - hopefully - shows their solution in action.

The videos will be uploaded to YouTube or similar. A panel of judges - one from each participating university - will view each of the videos, and then confer to select an overall winning team. (Some of) the winning team will then be invited to the UK Robotics Week Showcase event on Thursday 21st June, where they will receive a prize (budget permitting) on behalf of their school.

The suggested text publicising the challenge is below. (Note that it is not intended to be as explicit as the above text to allow for some flexibility in the format to take into account the number and quality of submissions, budget available, participating universities, etc., and all dates are subject to confirmation.)


The UK-RAS Health and Social Care Challenge 2018

We invite schools to submit their designs for a robotic system that addresses the challenge of how to help older people stay healthy and live independent lives. Submissions should be the work of teams of up to 8 children aged 16 or under. Entries can be in any format, should be no longer than 1000 words (or equivalent) in length, and each school may submit an unlimited number of entries.

The closing date for submissions is Friday 18th May. The judging panel will then select the best entries, with submissions being judged according to their usefulness, practicality and creativity. The winning teams will be invited to a special one-day event on Tuesday 26th June at their nearest UK-RAS University, during which they will visit our robotics facilities to learn more about our research, and then get to develop and test their own robots.
Year(s) Of Engagement Activity 2018
URL http://hamlyn.doc.ic.ac.uk/uk-ras/events/school-robot-challenge
 
Description School Robot Challenge at Imperial Festival 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact An interactive activity was provided at the Imperial Festival 2017, based on the School Robot Challenge organised by the Hamlyn Centre and the UK-RAS Network. This activity encouraged schoolchildren to be inspired by robotics and nature and create their own digital robotic insect. The children drew a robotic insect on paper and were then shown how to turn it into a 3D computer model.
Year(s) Of Engagement Activity 2017
URL http://hamlyn.doc.ic.ac.uk/uk-ras/robotics-week-2018
 
Description Surgical Imaging Workshop at Hamlyn Symposium 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The Surgical Imaging Workshop at the Hamlyn Symposium in 2012, 2013, 2014, 2015 and 2016 brought together clinicians, computer scientists and engineers from academia and industry to share the latest developments in the fields of surgical imaging, image guidance and
augmented reality in surgery. The scope was broad, covering imaging technologies (including clinical
systems and applications) as well as the technical aspects of registration, modelling and visualisation.
Through the development and fusion of imaging modalities, and the enhancement of the surgeon's
sensory experience, participants in this exciting area of research hope to transform surgical practice.
Year(s) Of Engagement Activity 2012,2013,2014,2015,2016
URL http://www.hamlyn-robotics.org/
 
Description Surgical Imaging, Guidance and Augmented Reality (London) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Workshop took place as part of 9th Hamlyn Symposium on Medical Robotics.
Further discussions took place on future collaboration and grant applications.
Year(s) Of Engagement Activity 2016
URL http://hamlyn.doc.ic.ac.uk/hsmr/sites/default/files//HSMR-Prog-2016-FULL-FINAL.pdf
 
Description Surgical Robot Challenge 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact The aim of this challenge is to exploit the unique expertise of the consortium in medical robotics to develop low-cost robot-assisted surgical and diagnostic devices that can benefit the NHS as well as be used as solutions for global health.
Year(s) Of Engagement Activity 2017
URL http://hamlyn.doc.ic.ac.uk/hsmr/events/surgical-robot-challenge-2017
 
Description Surrey University: To host the 18th TAROS 2017 as an official event of UK Robotics Week 2017 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact TAROS is a platform for RAS researchers from worldwide, and welcomes paper submissions on a wide range of topics related to the principles and practice of robotics, including but not limited to:

Advanced applications of autonomous robots (industrial and research)
Advanced medical robotics; Robots for surgery; Assistive robotics; Intelligent prostheses
Applications development, hardware issues, devices and techniques, advanced sensors and actuators
Autonomous assembly robotics; Modular reconfigurable robots; Evolutionary robotics
Autonomous vehicles; driverless cars
Bio-mimetic and bio-inspired robotics; Bio-hybrid robotic systems; Humanoid robotics
Cognitive robotics; Developmental robotics
Ethical and societal issues in robotics; Robots in education, the arts and entertainment; Personal robotics
Field robotics, Space and planetary robotics
Human-robot interaction and interfaces
Learning and adaptation
Long-term interaction and operation
Modelling and analysis of robot models
Navigation, localization, map building and path planning; Analysis of robot-environment interaction
Robot autonomy including energy self-sufficiency; Robot control architectures; Robot vision, sensing and perception
Robot communication and language
Safety, verification and validation for robotic applications
Service robotics
Soft robotics
Swarm robotics; Collective robots
Year(s) Of Engagement Activity 2017
URL http://www.surrey.ac.uk/taros2017
 
Description UK Robotics Week 2017 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Acting autonomously or in close collaboration with humans, Robotics and Autonomous Systems (RAS) have a broad range of new and established applications. As the underlying technologies are further developed and translated from laboratory settings to real-world applications, RAS is playing an increasingly important role in the UK's economy and it's future growth.

The UK-RAS Network was established with the mission to provide academic leadership, expand collaboration with industry and integrate and coordinate activities at the EPSRC funded RAS capital facilities, Centres for Doctoral Training (CDTs) and partner universities across the UK.

We are delighted with last year's inaugural UK Robotics Week and proud to build on its success with this year's event. The UK Robotics Week provides a spotlight on the UK's technology leadership in RAS, and engages the nation's schools, colleges and universities in developing the digital skills needed to drive the UK's future economy.

The UK Robotics Week also acts as a forum for discussion of technological, commercial, legal, ethical and social aspects of robotics. The wide range of events covered, from symposia, workshops, conferences, festivals, competitions and hackathons, contribute to a thriving programme across the country. We endeavour to provide promotion to other robotics related events in the calendar and aim to ensure robotics remains high on the government's agenda as one of the transformative technologies of the present and future.
Year(s) Of Engagement Activity 2017
URL http://hamlyn.doc.ic.ac.uk/roboticsweek2017/welcome
 
Description Workshop on Human-Robot Interactions Applied to Health 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact As part of the Hamlyn Symposium 10th anniversary on Medical Robotics, a workshop was run. This workshop was for academics, industry and show casing the latest technologies for medical robotics and latest research.
Year(s) Of Engagement Activity 2017
URL https://www.dropbox.com/s/5uobgz4tjq7c1ue/HSMR17_programme-FINAL.pdf?dl=0
 
Description Workshop on Image Guided Therapies 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact As part of the Hamlyn Symposium 10th anniversary on Medical Robotics, a workshop was run. This workshop was for academics, industry and show casing the latest technologies for medical robotics and latest research.
Year(s) Of Engagement Activity 2017
URL https://www.dropbox.com/s/5uobgz4tjq7c1ue/HSMR17_programme-FINAL.pdf?dl=0
 
Description Workshop on Micro-Robotics and Micro-Fabrication 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact As part of the Hamlyn Symposium 10th anniversary on Medical Robotics, a workshop was run. This workshop was for academics, industry and show casing the latest technologies for medical robotics and latest research.
Year(s) Of Engagement Activity 2017
URL https://www.dropbox.com/s/5uobgz4tjq7c1ue/HSMR17_programme-FINAL.pdf?dl=0
 
Description Workshop on Next Generation Continuum Robots 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact As part of the Hamlyn Symposium 10th anniversary on Medical Robotics, a workshop was run. This workshop was for academics, industry and show casing the latest technologies for medical robotics and latest research.
Year(s) Of Engagement Activity 2017
URL https://www.dropbox.com/s/5uobgz4tjq7c1ue/HSMR17_programme-FINAL.pdf?dl=0
 
Description Workshop on Robotic Catheters 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact As part of the Hamlyn Symposium 10th anniversary on Medical Robotics, a workshop was run. This workshop was for academics, industry and show casing the latest technologies for medical robotics and latest research.
Year(s) Of Engagement Activity 2017
URL https://www.dropbox.com/s/5uobgz4tjq7c1ue/HSMR17_programme-FINAL.pdf?dl=0
 
Description Workshop on Robotically Assisted Paediatric Interventions 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact As part of the Hamlyn Symposium 10th anniversary on Medical Robotics, a workshop was run. This workshop was for academics, industry and show casing the latest technologies for medical robotics and latest research.
Year(s) Of Engagement Activity 2017
URL https://www.dropbox.com/s/5uobgz4tjq7c1ue/HSMR17_programme-FINAL.pdf?dl=0
 
Description Workshop on Soft Robotics Across Scales 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact As part of the Hamlyn Symposium 10th anniversary on Medical Robotics, a workshop was run. This workshop was for academics, industry and show casing the latest technologies for medical robotics and latest research.
Year(s) Of Engagement Activity 2017
URL https://www.dropbox.com/s/5uobgz4tjq7c1ue/HSMR17_programme-FINAL.pdf?dl=0
 
Description Workshop on Surgical Robotics: First in Human - What does it take? 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact As part of the Hamlyn Symposium 10th anniversary on Medical Robotics, a workshop was run. This workshop was for academics, industry and show casing the latest technologies for medical robotics and latest research.
Year(s) Of Engagement Activity 2017
URL http://hamlyn.doc.ic.ac.uk/hsmr/surgical-robotics-first-human-what-does-it-take
 
Description Workshop on Surgical Work?ow and Process Modelling 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact As part of the Hamlyn Symposium 10th anniversary on Medical Robotics, a workshop was run. This workshop was for academics, industry and show casing the latest technologies for medical robotics and latest research.
Year(s) Of Engagement Activity 2017
URL https://www.dropbox.com/s/5uobgz4tjq7c1ue/HSMR17_programme-FINAL.pdf?dl=0