# Haptic and Palpation Sensing for Robotic Surgery: Engineering Perspectives on Design and Integration

## TL;DR

Current robotic surgery systems lack touch feedback, but new sensors and AI could improve safety and precision by restoring this capability.

## Contribution

The paper highlights engineering challenges and solutions for integrating palpation and haptic sensing into robotic-assisted surgery.

## Key findings

- Sensor technologies can exceed human tactile sensitivity but face integration and standardization barriers.
- Multimodal sensor fusion with AI and imaging is essential to address variability and noise in tissue assessment.
- Restoring haptic feedback could reduce tissue damage and improve surgeon confidence in minimally invasive procedures.

## Abstract

Robotic-assisted surgery (RAS) lacks clinically integrated palpation and haptic feedback. Emerging force, tactile, vibroacoustic and audio sensors enable quantifiable tissue characterisation. Sensor performance can exceed human tactile sensitivity but remains difficult to integrate clinically. Multimodal sensor fusion with artificial intelligence and imaging is essential to compensate for variability and noise. Palpation-enabled RAS supports improved safety, training efficiency, and progression toward autonomous operation.

What are the main findings?
This perspective identifies the absence of palpation and haptic sensing as a key limitation of current robotic-assisted surgical systems. While multiple sensor technologies are capable of quantitatively capturing tissue mechanical properties, their clinical adoption is restricted by challenges in miniaturisation, sterilisation, robustness, and system integration. The analysis shows that sensor sensitivity already exceeds human tactile thresholds, enabling objective tissue assessment and personalised feedback. However, the lack of standardised benchmarks, clinically grounded validation protocols, and seamless integration into existing RAS platforms remains a major barrier.

This perspective identifies the absence of palpation and haptic sensing as a key limitation of current robotic-assisted surgical systems. While multiple sensor technologies are capable of quantitatively capturing tissue mechanical properties, their clinical adoption is restricted by challenges in miniaturisation, sterilisation, robustness, and system integration. The analysis shows that sensor sensitivity already exceeds human tactile thresholds, enabling objective tissue assessment and personalised feedback. However, the lack of standardised benchmarks, clinically grounded validation protocols, and seamless integration into existing RAS platforms remains a major barrier.

What are the implications of the main findings?
Integrating robust, high-fidelity palpation and haptic feedback into RAS could shorten learning curves, reduce tissue damage, and improve precision and surgeon confidence, particularly in complex minimally invasive procedures. Combining compact, affordable sensing hardware with AI, AR/VR, and imaging is a prerequisite for semi-autonomous and, eventually, autonomous robotic surgery and will require standards, validation studies, and cost-effective designs to achieve broad global adoption.

Integrating robust, high-fidelity palpation and haptic feedback into RAS could shorten learning curves, reduce tissue damage, and improve precision and surgeon confidence, particularly in complex minimally invasive procedures. Combining compact, affordable sensing hardware with AI, AR/VR, and imaging is a prerequisite for semi-autonomous and, eventually, autonomous robotic surgery and will require standards, validation studies, and cost-effective designs to achieve broad global adoption.

Robotic-assisted surgery (RAS) provides enhanced dexterity and visualisation but remains constrained by the absence of clinically meaningful palpation and haptic feedback. This perspective examines palpation sensing in RAS from an engineering and system-integration standpoint, identifying the lack of tactile information as a major contributor to increased cognitive load, prolonged training, and risk of tissue injury. Recent advances in force, tactile, vibroacoustic, audio, and optical sensor technologies enable quantitative assessment of tissue mechanical properties and often exceed human tactile sensitivity. However, clinical translation is limited by challenges in sensor miniaturisation, sterilisation, robustness and integration and the absence of standardised evaluation metrics. The integration of artificial intelligence and multimodal sensor fusion with intra-operative imaging and augmented visualisation is highlighted as a key strategy to compensate for sensor limitations and biological variability. Dedicated robotic palpation devices and wireless or magnetically coupled probes are discussed as promising transitional solutions. Overall, the restoration of palpation sensing is presented as a prerequisite for improving safety and efficiency and enabling higher levels of autonomy in future RAS platforms.