Modern surgery has evolved significantly, moving from lengthy incisions to minimally invasive techniques guided by robotics and artificial intelligence. However, this advancement has come at a cost: surgeons have lost the ability to directly feel tissues during operations. A team of surgeons and engineers from across Europe is addressing this challenge through the development of a soft robotic fingertip, part of an EU-funded initiative known as PALPABLE. This innovative project aims to restore tactile feedback in surgical procedures, enhancing the surgeon’s ability to detect tissue abnormalities.
PALPABLE is set to run until the end of 2026, with the first prototype expected to be tested by surgeons in March 2026. By integrating optical sensing, soft robotics, and artificial intelligence, the team is designing a probe that mimics the sensitivity of a human fingertip. This device will allow surgeons to gently probe organs and create a visual map of tissue stiffness, displayed on a monitor during surgery.
The Importance of Tactile Feedback
The loss of direct touch is a significant concern for many surgeons. Professor Alberto Arezzo from the University of Turin, who specializes in minimally invasive and robotic surgery, noted the transition from open surgery to keyhole techniques over the past three decades. While keyhole surgery has reduced patient trauma and recovery times, it has also diminished tactile feedback, making it harder for surgeons to distinguish between healthy and abnormal tissue.
When operating on cancer patients, the stakes are particularly high. Surgeons must balance the need to remove sufficient tissue to ensure cancer does not recur while preserving surrounding healthy tissue. Dr. Gadi Marom from Hadassah Medical Centre in Jerusalem emphasized the importance of precise tissue margins, stating, “We want it done in one shot.” By translating tactile sensations into visual data, the new technology aims to equip surgeons with the tools they need to make informed decisions during complex operations.
Innovative Technology Behind the Probe
The engineers involved in this research are leveraging light to enhance tactile sensing. The probe features fibre-optic cables embedded in a soft, flexible tip. When the tip makes contact with tissue, it deforms, causing changes in the light transmitted through the fibres. Dr. Georgios Violakis from Hellenic Mediterranean University explained, “A silicone dome presses against soft tissue, allowing us to map both the direction and the magnitude of the applied force.” These variations in light intensity and wavelength help determine tissue stiffness, providing valuable insights during surgery.
The team has already developed early versions of the soft membrane and light-based sensors. Collaborating institutions include Queen Mary University of London, which is refining the membranes, and the Fraunhofer Institute in Germany, focusing on the functional films. Other partners, like Bendabl and Tech Hive Labs in Greece, are advancing the software needed to visualize stiffness and tactile maps. Before it is tested on patients, the prototype will undergo thorough laboratory validation.
As robotic surgery continues to expand, the absence of tactile feedback presents a growing challenge. Professor Arezzo pointed out that while robotic procedures offer advantages such as enhanced 3D vision, they lack the sensory feedback that surgeons traditionally relied upon. “That’s why this work is so important,” he stated.
Dr. Marom highlighted the potential of the new technology to improve patient care significantly. He noted that working closely with engineers has been essential to navigating the intersection of surgery and soft robotics. “The bottom line is that we will be able to give better care to our patients,” he affirmed.
Research in this article was funded by the EU’s Horizon Programme. The views expressed by the interviewees do not necessarily reflect those of the European Commission.
