Research in surgical robotics has an established track record at Imperial College, and a number of research and commercial surgical robot platforms have been developed over the years. The Hamlyn Centre is a champion for technological innovation and clinical adoption of robotic, minimally invasive surgery. We work in partnership with major industrial leaders in medical devices and surgical robots, as well as developing our own platforms such as the i-Snake® and Micro-IGES platforms. The Da Vinci surgical robot is used extensively for endoscopic radical prostatectomy, hiatal hernia surgery, and low pelvic and rectal surgery, and in 2003, St Mary’s Hospital carried out its first Totally Endoscopic Robotic Coronary Artery Bypass (TECAB).

The major focus of the Hamlyn Centre is to develop robotic technologies that will transform conventional minimally invasive surgery, explore new ways of empowering robots with human intelligence, and develop[ing miniature 'microbots' with integrated sensing and imaging for targeted therapy and treatment. We work closely with both industrial and academic partners in open platforms such as the DVRK, RAVEN and KUKA. The Centre also has the important mission of driving down costs associated with robotic surgery in order to make the technology more accessible, portable, and affordable. This will allow it to be fully integrated with normal surgical workflows so as to benefit a much wider patient population.

The Hamlyn Centre currently chairs the UK Robotics and Autonomous Systems (UK-RAS) Network. The mission of the Network is to to provide academic leadership in Robotics and Autonomous Systems (RAS), expand collaboration with industry and integrate and coordinate activities across the UK Engineering and Physical Sciences Research Council (EPSRC) funded RAS capital facilities and Centres for Doctoral Training (CDTs).

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  • Journal article
    Modi HN, Singh H, Fiorentino F, Orihuela-Espina F, Athanasiou T, Yang G-Z, Darzi A, Leff DRet al., 2019,

    Association of residents' neural signatures with stress resilience during surgery

    , JAMA Surgery, Vol: 154, ISSN: 2168-6254

    Importance: Intraoperative stressors may compound cognitive load, prompting performance decline and threatening patient safety. However, not all surgeons cope equally well with stress, and the disparity between performance stability and decline under high cognitive demand may be characterized by differences in activation within brain areas associated with attention and concentration such as the prefrontal cortex (PFC). Objective: To compare PFC activation between surgeons demonstrating stable performance under temporal stress with those exhibiting stress-related performance decline. Design, Setting, and Participants: Cohort study conducted from July 2015 to September 2016 at the Imperial College Healthcare National Health Service Trust, England. One hundred two surgical residents (postgraduate year 1 and greater) were invited to participate, of which 33 agreed to partake. Exposures: Participants performed a laparoscopic suturing task under 2 conditions: self-paced (SP; without time-per-knot restrictions), and time pressure (TP; 2-minute per knot time restriction). Main Outcomes and Measures: A composite deterioration score was computed based on between-condition differences in task performance metrics (task progression score [arbitrary units], error score [millimeters], leak volume [milliliters], and knot tensile strength [newtons]). Based on the composite score, quartiles were computed reflecting performance stability (quartile 1 [Q1]) and decline (quartile 4 [Q4]). Changes in PFC oxygenated hemoglobin concentration (HbO2) measured at 24 different locations using functional near-infrared spectroscopy were compared between Q1 and Q4. Secondary outcomes included subjective workload (Surgical Task Load Index) and heart rate. Results: Of the 33 participants, the median age was 33 years, the range was 29 to 56 years, and 27 were men (82%). The Q1 residents demonstrated task-induced increases in HbO2 across the bilateral ventrolateral PFC (VLPFC) and right dorsolateral P

  • Conference paper
    Freer D, Deligianni F, Yang G-Z, 2019,

    Adaptive riemannian BCI for enhanced motor imagery training protocols

    , IEEE 16th International Conference on Wearable and Implantable Body Sensor Networks (BSN), Publisher: IEEE, ISSN: 2376-8886

    Traditional methods of training a Brain-Computer Interface (BCI) on motor imagery (MI) data generally involve multiple intensive sessions. The initial sessions produce simple prompts to users, while later sessions additionally provide realtime feedback to users, allowing for human adaptation to take place. However, this protocol only permits the BCI to update between sessions, with little real-time evaluation of how the classifier has improved. To solve this problem, we propose an adaptive BCI training framework which will update the classifier in real time to provide more accurate feedback to the user on 4-class motor imagery data. This framework will require only one session to fully train a BCI to a given subject. Three variations of an adaptive Riemannian BCI were implemented and compared on data from both our own recorded datasets and the commonly used BCI Competition IV Dataset 2a. Results indicate that the fastest and least computationally expensive adaptive BCI was able to correctly classify motor imagery data at a rate 5.8% higher than when using a standard protocol with limited data. In addition it was confirmed that the adaptive BCI automatically improved its performance as more data became available.

  • Journal article
    Berthelot M, Henry FP, Hunter J, Leff D, Wood S, Jallali N, Dex E, Ladislava L, Lo B, Yang GZet al., 2019,

    Pervasive wearable device for free tissue transfer monitoring based on advanced data analysis: clinical study report

    , Journal of Biomedical Optics, Vol: 24, Pages: 067001-1-067001-8, ISSN: 1083-3668

    Free tissue transfer (FTT) surgery for breast reconstruction following mastectomy has become a routineoperation with high success rates. Although failure is low, it can have a devastating impact on patient recovery,prognosis and psychological well-being. Continuous and objective monitoring of tissue oxygen saturation (StO2) hasshown to reduce failure rates through rapid detection time of postoperative vascular complications. We have developeda pervasive wearable wireless device that employs near infrared spectroscopy (NIRS) to continuously monitor FTTviaStO2measurement. Previously tested on different models, this paper introduces the results of a clinical study. Thegoal of the study is to demonstrate the developed device can reliably detectStO2variations in a clinical setting: 14patients were recruited. Advanced data analysis were performed on theStO2variations, the relativeStO2gradientchange, and, the classification of theStO2within different clusters of blood occlusion level (from 0% to 100% at 25%step) based on previous studies made on a vascular phantom and animals. The outcomes of the clinical study concurwith previous experimental results and the expected biological responses. This suggests the device is able to correctlydetect perfusion changes and provide real-time assessment on the viability of the FTT in a clinical setting.

  • Journal article
    Marques MJ, Hughes MR, Vyas K, Thrapp A, Zhang H, Bradu A, Gelikonov G, Giataganas P, Payne CJ, Yang G-Z, Podoleanu Aet al., 2019,

    En-face optical coherence tomography/fluorescence endomicroscopy for minimally invasive imaging using a robotic scanner.

    , Journal of Biomedical Optics, Vol: 24, Pages: 1-15, ISSN: 1083-3668

    We report a compact rigid instrument capable of delivering en-face optical coherence tomography (OCT) images alongside (epi)-fluorescence endomicroscopy (FEM) images by means of a robotic scanning device. Two working imaging channels are included: one for a one-dimensional scanning, forward-viewing OCT probe and another for a fiber bundle used for the FEM system. The robotic scanning system provides the second axis of scanning for the OCT channel while allowing the field of view (FoV) of the FEM channel to be increased by mosaicking. The OCT channel has resolutions of 25  /  60  μm (axial/lateral) and can provide en-face images with an FoV of 1.6  ×  2.7  mm2. The FEM channel has a lateral resolution of better than 8  μm and can generate an FoV of 0.53  ×  3.25  mm2 through mosaicking. The reproducibility of the scanning was determined using phantoms to be better than the lateral resolution of the OCT channel. Combined OCT and FEM imaging were validated with ex-vivo ovine and porcine tissues, with the instrument mounted on an arm to ensure constant contact of the probe with the tissue. The OCT imaging system alone was validated for in-vivo human dermal imaging with the handheld instrument. In both cases, the instrument was capable of resolving fine features such as the sweat glands in human dermal tissue and the alveoli in porcine lung tissue.

  • Journal article
    Troccaz J, Dagnino G, Yang G-Z, 2019,

    Frontiers of Medical Robotics: From Concept to Systems to Clinical Translation.

    , Annu Rev Biomed Eng

    Medical robotics is poised to transform all aspects of medicine-from surgical intervention to targeted therapy, rehabilitation, and hospital automation. A key area is the development of robots for minimally invasive interventions. This review provides a detailed analysis of the evolution of interventional robots and discusses how the integration of imaging, sensing, and robotics can influence the patient care pathway toward precision intervention and patient-specific treatment. It outlines how closer coupling of perception, decision, and action can lead to enhanced dexterity, greater precision, and reduced invasiveness. It provides a critical analysis of some of the key interventional robot platforms developed over the years and their relative merit and intrinsic limitations. The review also presents a future outlook for robotic interventions and emerging trends in making them easier to use, lightweight, ergonomic, and intelligent, and thus smarter, safer, and more accessible for clinical use. Expected final online publication date for the Annual Review of Biophysics Volume 48 is May 3, 2019. Please see for revised estimates.

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