Restoring the Surgeon’s Touch: How Soft Robotics and AI are Enhancing Surgical Precision in Europe

Modern surgery has increasingly embraced minimally invasive techniques and robotic assistance, offering patients benefits like reduced trauma and faster recovery. However, a critical element has been lost in this evolution: the surgeon’s ability to physically feel tissue. Now, a collaborative effort across Europe is working to restore this vital aspect of surgery through the development of soft robotic “fingertips” enhanced with optical sensing and artificial intelligence.

The Loss of Tactile Feedback in Modern Surgery

For decades, surgeons relied on palpation – the ability to feel tissue – to detect abnormalities like tumors, which often present as differences in stiffness or texture compared to healthy tissue. The transition to keyhole surgery in the 1990s, while beneficial in many ways, diminished this crucial tactile feedback. As robotic surgery becomes more prevalent, this loss of touch becomes even more pronounced.

PALPABLE: An EU-Funded Initiative

The EU-funded research collaboration, PALPABLE, aims to address this challenge. Running until the end of 2026, the project focuses on developing a soft robotic probe capable of sensing tissue firmness during minimally invasive and robotic procedures. A first prototype is expected to undergo testing by surgeons around March 2026.

How the Technology Works: Mimicking the Human Fingertip

The team is designing a probe that replicates the sensation of a fingertip pressing and feeling during surgery. This is achieved by combining:

• Soft Robotics: A flexible, adaptable probe that can gently interact with tissues.
• Optical Sensing: Fibre-optic cables embedded in a soft tip that detect changes in light as the probe deforms against tissue.
• Artificial Intelligence: Algorithms to translate these light-based measurements into a visual map of tissue stiffness, displayed on a screen for the surgeon.

As Dr. Georgios Violakis at Hellenic Mediterranean University in Heraklion, Crete, explains, a silicone dome presses against soft tissue, allowing the mapping of both the direction and magnitude of applied force. These subtle shifts in light intensity and wavelength are then converted into information about tissue stiffness.

Precision and Safety: Key Design Considerations

The device requires both high accuracy and high resolution to effectively “feel” organs within a patient. Professor Panagiotis Polygerinos, a soft robotics researcher at Hellenic Mediterranean University, notes that while similar sensing technology has been used in large-scale infrastructure monitoring, applying it to the delicate task of sensing human tissue requires a level of precision and affordability that was previously unattainable.

Collaboration and Expertise

The PALPABLE project is a collaborative effort involving multiple institutions across Europe:

• University of Turin (Italy): Specializing in minimally invasive and robotic surgery.
• Hadassah Medical Centre (Jerusalem): Clinicians involved in research and specializing in minimally invasive and robotic surgery.
• Hellenic Mediterranean University (Greece): Leading the development of soft robotics and optical sensing.
• Queen Mary University of London (UK): Designing and refining the probe’s membranes.
• Fraunhofer Institute (Germany): Developing functional films for the sensor.
• Bendabl (Greece), Tech Hive Labs (Greece), and the University of Essex (UK): Advancing the software for visualizing stiffness and tactile maps.

The Future of Robotic Surgery: Enhanced Precision and Patient Care

Surgeons believe that robotics will continue to play an increasingly significant role in the operating room. Professor Alberto Arezzo from the University of Turin predicts that “sooner or later, I believe the vast majority of surgeries will be robotic.” However, this expansion is contingent on providing surgeons with better sensory information.

Dr. Gadi Marom at Hadassah Medical Centre emphasizes the potential for improved patient care: “The bottom line is that we will be able to give better care to our patients.” The development of this soft robotic fingertip represents a significant step towards restoring a crucial element of surgical expertise and enhancing the precision of minimally invasive procedures.