IEEE Robotics & Automation Magazine - March 2021 - 24

defined roles. Thus, a robot can potentially assist or replace
some personnel, relieving the annexed workflow and reducing the probability of disease transmission.
Researchers at John Hopkins University designed a Cartesian robot with an integrated camera that enables the remote
control of a ventilator [26]. Airway management in infectious
conditions is a challenge that may greatly benefit from robotic
assistance to make intubation safer and more efficient.
Nonetheless, unintended issues and undesired consequences may arise from the deployment of robots, like reducing the
ergonomics and maneuverability of operators or the introduction of additional contamination sources. Therefore, it is critically important that the use of any additional tool is adequately
considered and handled [27], [28]. Researchers explored general-purpose surgical robotic platforms, such as the Da Vinci surgical system [29], and purposely designed devices to address
specific issues.

(a)

Odroid XU4

Xj
Yj
Arduino
Nano

Actuators
(b)
Figure 8. Robots for intervention and treatment. (a) The Kepler
Intubation System (McGill University, Canada) [29]. (b) REALITI
(ETH Zurich, Switzerland) [33].

IEEE ROBOTICS & AUTOMATION MAGAZINE

MARCH 2021

Ad hoc solutions span the entire spectrum of robotics,
from fully manual teleoperation to assisted sensing and actuation and up to the eventual deployment of fully autonomous
systems [30]. One interesting result is the development of
intubation systems remotely controlled by the user via a joystick. This strategy was embodied in both a fixed platform
[Figure 8(a)] [29] and a portable device, the Remote RobotAssisted Intubation System [31], for hospital and prehospital
treatment, respectively.
Yet the main challenges of robot-assisted intubation are
related to the lack of tactile feedback. Researchers from Columbia University developed InTouch, an advanced laryngoscope
with a tactile sensing blade [32]. Even though it demonstrated a
decrease in the complication rate and the time required for correct intubation, it does not include any automation feature and
still relies on visual recognition of the airway and manual steering by its user. A step further in this direction is taken with a
Robotic Endoscope Automated via Laryngeal Imaging for Tracheal Intubation [REALITI, Figure 8(b)], developed at ETH
Zurich [33]. It handles the task of guiding the tracheal tube into
its correct position by performing the automated detection of
anatomical landmarks within the throat and the automated
steering of endoscopes toward the recognized features. While
this system has been successfully tested on mannequins, there
is a long way to go before it can be effectively deployed on
human subjects.
A key challenge is the necessity of a robust method for accurately identifying the anatomical features in a large and multifaceted population, whereby variations in airway anatomy, local
pathologies, and other particular conditions may hinder regular
tracheal intubation. To this extent, significant improvements
might derive from the constantly progressing tools of computer
vision and AI. Other opportunities come from the enhancement
of sensing and actuation technologies. Besides visual feedback,
force sensing is crucial to enhance the reliability of robotic intubation. Its success rate could significantly benefit from distributed
and accurate force/pressure sensors, made possible by advancements in stretchable electronics. From the actuation perspective,
a promising approach could derive from the achievements of soft
robotics. A vine-inspired robot, for instance, may represent a feasible way to create a conduit to the lungs via a failsafe and easy-touse device, with the ability to grow into multiple branches to deal
with different morphologies [35].
Robots for Home Care
The COVID-19 pandemic is causing an overwhelming load
in health facilities, requiring intensive employment of the hospital workforce. Doctors and nurses strive to work extra shifts
to save lives [36]. Additionally, direct contact with infectious
patients puts them in the critical condition of being regularly
exposed to the risk of contracting the disease. Therefore,
robots capable of performing typical assistance tasks would
enormously benefit the daily medical care of patients during
similar circumstances.
This situation is not confined to hospitals; nursing assistance is also a fundamental service in nursing homes and

IEEE Robotics & Automation Magazine - March 2021

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