Minimally Invasive Surgery (MIS), which includes both traditional laparoscopic and modern robot-assisted techniques, has become the standard of care due to its profound benefits for patients, such as reduced tissue damage, diminished blood loss, and significantly shorter hospital stays. Despite these advancements, a critical drawback of MIS is the surgeon's inability to directly palpate the internal tissues being operated on. In open surgery, doctors rely heavily on their sense of touch to identify the varying stiffness of tissues, which is essential for locating hidden tumors and defining healthy versus cancerous margins. Because current endoscopic and commercial robotic tools severely restrict degrees of freedom and lack true tactile or haptic feedback, surgeons are forced to rely almost entirely on visual cues.
To address this critical gap, the PALPABLE project aims to revolutionize MIS by developing a first-of-its-kind, multi-sensing tactile probe that effectively restores the surgeon's sense of touch. The consortium's core objective is to create a miniaturized (15 mm diameter), soft, pneumatically actuated end-effector capable of bending and steering within the confined spaces of the body. This probe will house highly advanced but low-cost optical sensing technologies, including a non-planar polymeric photonics circuit and Fiber Bragg Grating (FBG) optical fibers, to simultaneously measure tissue deformation and contact forces. Pressure measurements are fed into a dedicated machine learning algorithm so that the system can identify reconstruct the stiffness profile of the tissue and ultimately display it as an intuitive "stiffness heatmap" overlaid on the surgeon's surgical monitor.
Providing surgeons with real-time stiffness maps will enable them to precisely localize tumors and define their margins, thereby ensuring the complete removal of unhealthy tissue while sparing surrounding healthy nerves and blood vessels. The project is expected to further reduce average hospital stays; for instance, even a half-day reduction in hospital stays for prostate cancer MIS procedures across Europe could yield nearly €90 million in annual savings, significantly freeing up public healthcare resources and reducing clinician burnout.
On a broader strategic level, PALPABLE is positioned to capture a first-mover advantage within the rapidly expanding multi-billion-euro markets for MIS devices, medical robotics, and photonics. While leading commercial robotic systems (such as the da Vinci or Hugo RAS) offer high precision, they still lack true intraoperative tactile feedback—a massive unmet clinical need. Furthermore, the project addresses the European Union’s strategic goal of open autonomy in the healthcare sector.
Through the European Association for Endoscopic Surgery (EAES) and clinical partners, the consortium regularly surveys a diverse community of surgeons to evaluate user acceptance, workflow integration, and usability preferences. The tool's design, such as determining optimal probe diameters, display interfaces, and pricing, is shaped around these practitioner insights. Thus, PALPABLE ensures that the resulting technology is genuinely valuable and seamlessly adoptable by the medical community.
