Ara Darzi

Christian Schroeder de Witt, Bradley Gram-Hansen, Nantas Nardelli et al.

The COVID-19 pandemic has highlighted the importance of in-silico epidemiological modelling in predicting the dynamics of infectious diseases to inform health policy and decision makers about suitable prevention and containment strategies. Work in this setting involves solving challenging inference and control problems in individual-based models of ever increasing complexity. Here we discuss recent breakthroughs in machine learning, specifically in simulation-based inference, and explore its potential as a novel venue for model calibration to support the design and evaluation of public health interventions. To further stimulate research, we are developing software interfaces that turn two cornerstone COVID-19 and malaria epidemiology models COVID-sim, (https://github.com/mrc-ide/covid-sim/) and OpenMalaria (https://github.com/SwissTPH/openmalaria) into probabilistic programs, enabling efficient interpretable Bayesian inference within those simulators.

Ming-Yao Wang, Alexandros A. Kogkas, Ara Darzi et al.

Patients suffering from quadriplegia have limited body motion which prevents them from performing daily activities. We have developed an assistive robotic system with an intuitive free-view gaze interface. The user's point of regard is estimated in 3D space while allowing free head movement and is combined with object recognition and trajectory planning. This framework allows the user to interact with objects using fixations. Two operational modes have been implemented to cater for different eventualities. The automatic mode performs a pre-defined task associated with a gaze-selected object, while the manual mode allows gaze control of the robot's end-effector position on the user's frame of reference. User studies reported effortless operation in automatic mode. A manual pick and place task achieved a success rate of 100% on the users' first attempt.

T. J. C. Oude Vrielink, Y. W. Pang, M. Zhao et al.

The CYCLOPS is a cable-driven parallel mechanism used for minimally invasive applications, with the ability to be customised to different surgical needs; allowing it to be made procedure- and patient-specific. For adequate optimisation, however, appropriate data on clinical constraints and task-space is required. Whereas the former can be provided through preoperative planning and imaging, the latter remains a problem, primarily for highly dexterous MIS systems. The current work focuses on the development of a task-space optimisation method for the CYCLOPS system and the development of a data collection method in a simulation environment for minimally invasive task-spaces. The same data collection method can be used for the development of other minimally invasive platforms. A case-study is used to illustrate the developed method for Endoscopic Submucosal Dissection (ESD). This paper shows that using this method, the system can be succesfully optimised for this application.

Timo J. C. Oude Vrielink, Ming Zhao, Ara Darzi et al.

Gastrointestinal (GI) cancers account for 1.5 million deaths worldwide. Endoscopic Submucosal Dissection (ESD) is an advanced therapeutic endoscopy technique with superior clinical outcome due to the minimally invasive and en bloc removal of tumours. In the western world, ESD is seldom carried out, due to its complex and challenging nature. Various surgical systems are being developed to make this therapy accessible, however, these solutions have shown limited operational workspace, dexterity, or low force exertion capabilities. The current paper shows the ESD CYCLOPS system, a bimanual surgical robotic attachment that can be mounted at the end of any flexible endoscope. The system is able to achieve forces of up to 46N, and showed a mean error of 0.217mm during an elliptical tracing task. The workspace and instrument dexterity is shown by pre-clinical ex vivo trials, in which ESD is succesfully performed by a GI surgeon. The system is currently undergoing pre-clinical in vivo validation.