In-line with Challenge-2 – Cognitive systems and robotics, this STIFF-FLOP aims to find clearer answers to a series of questions such as how low level motor control programs deal with the dilemma of exposing the brain to the stochastic phenomena in the natural world as they are vs. controlling the stiffness of the body to iron out much of the unwanted complexity in the physical world, whether such interactions lead to the synthesis of task specific associations or more generic physical laws of nature, what are the functional characteristics of primitive substrates of cognition that help to build either of the above associations, how various primitives gathered in different uncertain contexts are organized in long term memory, and how they interact among each other to orchestrate higher order cognition, etc. Developing a variable stiffness robotic system poses many design challenges in cognitive robotics,

novel mechanism design, manipulation and grasping in an uncertain environment, bio-inspired design and control, machine learning, and cognitive development through physical interactions.

About 20 years ago the introduction of the laparoscopic technique upset surgery, so that in few years most of the common benign digestive diseases (cholecystectomy, reflux disease, etc) and even abdominal neoplastic lesions became indications to minimally invasive approach. Today there is a common feeling that a further step forward towards less invasiveness will be represented by transorgan approach to the abdominal cavity through natural orifices. This technique allows, in fact, to avoid or further minimize skin scars with positive consequencs on the less postoperative pain feeling, but even probably a less injury to the immune system. Actual limits to the spread diffusion of

the technique consist of the lack of dedicated surgical endoscopic instruments, as they are adapted from those in use for standard surgical and flexible endoscopy. This makes the technique extremely difficult in practice and in a way even dangerous.
For this reason it is necessary to create a new technology platform with the aim of surgical application for flexible endoscopy. This should allow a stabile vision of the operating field, surgical manipulation of tissues and structures, and a human – instrument interface the most ergonomic and intuitive. This is possible today due to the opportunities offered by micro-systems technology, that starting from common mechanical applications today offers more complex solutions such as integrations of sensors, videocameras, etc. This allows miniaturization of a system with surgical characteristics, allowing effectiveness and safety at the same time.
Several options are available: decrease the number of instruments, gather ports in the same incision, use multiple instruments through the same port or use an operative scope through a single port. With the aim to limit the need of invasive radical treatment, we conceive a surgical concept for minimally invasive surgery or endoscopic endoluminal interventions that allows a surgical approach to become even more minimally invasiveness. Taking inspiration from nature, the goal is to mimic a situation in which actuators could be significantly long, stiff or soft on demand, possibly positioned in spatial coordinates despite the limit of introduction through a single transparietal access.
A variable stiffness robot arm will have many potential applications such as minimally invasive surgery, including endoluminal surgery and particularly Natural Orifice Transluminal Endoscopic Surgery (NOTES) and we believe the outcome of this project will also be beneficial for varied areas such as bomb defusing in a confined space, disaster response and rescue operations, maintenance and inspection of complex engineering systems, etc. We will use a minimally invasive robotic surgery application to demonstrate the feasibility of the proposed system.
This multi-disciplinary consortium which is made up of leading experts in a wide range of research fields including internationally renowned engineers at world-class universities, advanced robot hardware developers at an SME internationally-known for their advancement in the technology of artificial anthropomorphic hands, world-leading cardiologists and urologists at leading hospitals (Guy’s and St Thomas’ Hospitals, London, The Guildford Clinic, Surrey), a leading medical institute (MATTU), an internationally renowned manufacturer of medical tools (Karl Storz Endoscopes) and the European Association for Endoscopic Surgery (EAES) is most suited to conduct the research and

technology development outlined in this proposal.