The Ultrasonic Technology Assisted Communicative Tactile Surgical System (UTACTSS) provides novel tactile feedback, characterized by an ultrasound reading and tactile sensation on the surgeon’s fingertips, using piezoelectric micromachined ultrasonic transducers (PMUTs) and incorporates a preexisting force feedback system. The ultrasound reading is based on the interactions of shear waves generated by PMUTs at the end of the robotic arms with tissue at the surgical site. With shear wave elastography, these interactions are used to produce a colored tissue stiffness map that is superimposed onto the ultrasound image. This data is also used to determine the wave patterns of the ultrasonic waves generated by PMUTs in the surgical console. These ultrasonic waves provide accurate tactile sensation on the surgeon’s fingertips that simulates the texture of the surgical site. This tactile feedback facilitates tissue detection and distinction, and the comprehensive haptic feedback prevents the surgeon from exerting excessive pressure on the surgical site.

References

• F. Pugin, P. Bucher, P. Morel. History of robotic surgery: from AESOP® and ZEUS® to da Vinci®. ScienceDirect. 2011. doi:10.1016/j. jviscsurg.2011.04.007.
• What is robotic surgery? UCLA Health. [Accessed 2025 Jul 6]. Available from: https://www.uclahealth.org/medical-services/robotic-surgery/what-robotic-surgery
• Haptic feedback in Intuitive’s da Vinci 5. Intuitive. [Accessed 2025 Jul 6]. Available from: https://www.intuitive.com/en-us/about-us/newsroom/Force%20Feedback
• Y. Ueda, S. Miyahara, K. Tokuishi, H. Nakajima, R. Waseda, T. Shiraishi, T. Sato. Impact of a pneumatic surgical robot with haptic feedback with haptic feedback function on surgical manipulation. Sci Rep. 2023;13:22615. doi:10.1038/s41598-023 49876-7.
• J. Chen, E.H.T. Teo, K. Yao. Electromechanical actuators for haptic feedback with fingertip contact. Actuators. 2023;12(3):104. doi:10.3390/act12030104.
• N. Kastor, B. Dandu, V. Bassari, G. Reardon, Y. Visell. Ferrofluid electromagnetic actuators for high fidelity haptic feedback. Sensors Actuators A Phys. 2023;355:114252. doi:10.1016/j.sna.2023.114252.
• M. Li, S. Luo, T. Nanayakkara, L.D. Seneviratne, P. Dasgupta, K. Althoefer. Multi-fingered haptic palpation using pneumatic feedback actuators. Sensors Actuators A Phys. 2014;218:132–41. doi:10.1016/j.sna.2014.08.003. References
• Understanding haptics: a journey through the history and evolution of haptic technology. TITAN Haptics. [Accessed 2025 Jul 6]. Available from: https://titanhaptics.com/understanding-haptics-a-journey-through-the-history-and-evolution-of-haptic-technology/
• What is haptic technology? Swindon Silicon Systems. [Accessed 2025 Jul 6]. Available from: https://www.swindonsilicon.com/what-is-haptic-technology/ Intuitive engineers evolve the da Vinci system to transform robotic surgery with da Vinci SP. Intuitive. [Accessed 2025 Jul 6]. Available from: https://www.intuitive.com/en-us/about-us/newsroom/the-evolution-of-da-vinci-systems
• A.L.G. Morrell, A.C. Morrell-Junior, A.G. Morrell, J.M.F. Mendes, F. Tustumi, L.G. de Oliveira e Silva, A. Morrell. The history of robotic surgery and its evolution: when illusion becomes reality. Rev Col Bras Cir. 2021;48:e20202798. doi:10.1590/0100 6991e-20202798.
• P. Evans. DC motor explained. The Engineering Mindset. 2020. [Accessed 2025 Jul 6]. Available from: https://theengineeringmindset.com/dc-motor-explained/
• Maximising surgical precision: the role of miniature motors in robotic surgery. Portescap. 2023. [Accessed 2025 Jul 6]. Available from: https://news.dmaeuropa.com/press-releases/maximising-surgical-precision-the-role-of-miniature-motors-in robotic-surgery/
• E. Aksel, L. Jones. Advances in lead-free piezoelectric materials for sensors and actuators. Sensors. 2010;10(3):1935–54. doi:10.3390/s100301935.
• G. Dana, A. Sithole, A. Thapaliya, M. Welsh. Basic principles of ultrasound. In: Ultrasound Physics and its Application in Medicine, Chapter 1. 2024. doi:10.59319/BDXA4939.
• A. Kumar, K.M. Kempski Leadingham, M.J. Kerensky, S. Sankar, N.V. Thakor, A. Manbachi. Visualizing tactile feedback: An overview of current technologies with a focus on ultrasound elastography. Front Med Technol. 2023;5. doi:10.3389/fmedt.2023.1238129.
• A. Massalimova, M. Timmermans, H. Esfandiari, F. Carrillo, C.J. Laux, M. Farshad, K. Denis, P. Fürnstahl. Intraoperative tissue classification methods in orthopedic and neurological surgeries: A systematic review. Front Surg. 2022;9:952539. doi:10.3389/fsurg.2022.952539.
• C.M.I. Quarato, D. Lacedonia, M. Salvemini, G. Tuccari, G. Mastrodonato, R. Villani, L.A. Fiore, G. Scioscia, A. Mirijello, A. Saponara, M. Sperandeo. A review on biological effects of ultrasounds: Key messages for clinicians. Diagnostics (Basel). 2023;13(5):855. doi:10.3390/diagnostics13050855.
• Interaction of ultrasound waves with tissue. EchoCardiography. [Accessed 2025 Jul 6]. Available from: http://www.e-echocardiography.com/courses/etee/basic-principles/interaction-of-ultrasound-waves-with-tissue
• T. Iwai, T. Kanno, T. Miyazaki, D. Haraguchi, K. Kawashima. Pneumatically driven surgical forceps displaying a magnified grasping torque. Int J Med Robot Comput Assist Surg. 2020;16:e2051. doi:10.1002/rcs.2051.
• Z. Long, S. Ye, Z. Peng, Y. Yuan, Z. Li. Phase optimization for multipoint haptic feedback based on ultrasound array. Sensors. 2022;22(6):2394. doi:10.3390/s22062394.
• Piezoelectric haptic actuators. Kemet. [Accessed 2025 Jul 6]. Available from: https://www.kemet.com/en/us/applications/haptic-actuators
• J. Sone. Fingertip tactile sensation via piezoelectric micromachined ultrasonic transducers with an amplified interface. Sci Rep. 2024;14:2629. doi:10.1038/s41598-024-52630-2.
• K. Tai, A.R. El-Sayed, M. Shahriari, M. Biglarbegian, S. Mahmud. State of the art robotic grippers and applications. Robotics. 2016;5(2):11. doi:10.3390/ robotics5020011.
• Taking robotic surgery to the next level with haptic feedback sensors. Surgical Robotics Technology. [Accessed 2025 Jul 6]. Available from: https://www.surgicalroboticstechnology.com/articles/taking robotic-surgery-to-the-next-level-with-haptic-feedback-sensors/
• M. Yu, X. Cheng, S. Peng, Y. Cao, Y. Lu, B. Li, X. Feng, Y. Zhang, H. Wang, Z. Jiao, P. Wang, L. Zhao. A self-sensing soft pneumatic actuator with closed loop control for haptic feedback wearable devices. Mater Des. 2022;223:111149. doi:10.1016/j. matdes.2022.111149