Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Origami-inspired miniature manipulator for teleoperated microsurgery


The use of a structure with a remote fixed point around which a mechanism can rotate is called remote centre of motion (RCM). The technique is widely used in minimally invasive surgery to avoid excess force on the incision site during the robot’s motion. Here we describe the design, fabrication and characterization of an origami-inspired miniature RCM manipulator for teleoperated microsurgery (the mini-RCM has mass 2.4 g and size 50 mm × 70 mm × 50 mm), which is actuated by three independently controlled linear actuators with concomitant sensing (each mini-LA has mass 0.41 g and size 28 mm × 7 mm × 3.6 mm). The mini-RCM has a payload capacity of approximately 27 mN and attains a positional precision of 26.4 μm. We demonstrate its potential utility as a precise tool for teleoperated microsurgery by performing 0.5-mm-square tracing and micro-cannulation teleoperated microsurgical procedures under a microscope. Teleoperation using the mini-RCM reduced the deviation from the desired trajectory by 68% compared to manual operation. In addition, the mini-RCM allows gravity compensation and back drivability for safety. Its compact, simple structure facilitates manufacture.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Fig. 1: The mini-RCM.
Fig. 2: The fabrication process and the kinematics of the mini-RCM.
Fig. 3: The actuation and displacement sensing mechanisms of the mini-LA.
Fig. 4: The result of the mini-LA’s characterization.
Fig. 5: Characterization of the mini-RCM.
Fig. 6: Example tasks that utilize the mini-RCM’s performance under teleoperated control.

Data availability

The source data for the figures presented in this paper can be found in the Supplementary information. Source data are provided with this paper.

Code availability

Motion control code is available from the corresponding authors upon reasonable request.


  1. 1.

    Taylor, R. H. A perspective on medical robotics. Proc. IEEE 94, 1652–1664 (2006).

    Article  Google Scholar 

  2. 2.

    Jung, M., Morel, P., Buehler, L., Buchs, N. C. & Hagen, M. E. Robotic general surgery: current practice, evidence, and perspective. Langenbeck’s Arch. Surg. 400, 283–292 (2015).

    Article  Google Scholar 

  3. 3.

    Menaker, S. A. et al. Current applications and future perspectives of robotics in cerebrovascular and endovascular neurosurgery. J. Neurointerv. Surg. 10, 78–82 (2018).

    Article  Google Scholar 

  4. 4.

    Das, H., Zak, H., Johnson, J., Crouch, J. & Frambach, D. Evaluation of a telerobotic system to assist surgeons in microsurgery. Comput. Aided Surg. 4, 15–25 (1999).

    Article  Google Scholar 

  5. 5.

    Maddahi, Y. et al. Treatment of glioma using neuroarm surgical system. BioMed Res. Int. 2016, 9734512 (2016).

    Article  Google Scholar 

  6. 6.

    van Mulken, T. J. M. et al. First-in-human robotic supermicrosurgery using a dedicated microsurgical robot for treating breast cancer-related lymphedema: a randomized pilot trial. Nat. Commun. 11, 757 (2020).

    Article  Google Scholar 

  7. 7.

    Edwards, T. L. et al. First-in-human study of the safety and viability of intraocular robotic surgery. Nat. Biomed. Eng. 2, 649–656 (2018).

    Article  Google Scholar 

  8. 8.

    Gijbels, A. et al. In-human robot-assisted retinal vein cannulation, a world first. Ann. Biomed. Eng. 46, 1676–1685 (2018).

    Article  Google Scholar 

  9. 9.

    Aksungur, S. Remote center of motion (RCM) mechanisms for surgical operations. Int. J. Appl. Math. Electron. Comput. 3, 119 (2015).

    Article  Google Scholar 

  10. 10.

    Vander Poorten, E. et al. Robotic retinal surgery. In Handbook of Robotic and Image-Guided Surgery (ed. Abedin-Nasab, M. H.) 627–672 (Elsevier, 2020).

  11. 11.

    Kuo, C.-H., Dai, J. & Dasgupta, P. Kinematic design considerations for minimally invasive surgical robots: an overview. Int. J. Med. Robot. 8, 127–145 (2012).

    Article  Google Scholar 

  12. 12.

    Kim, U. et al. S-surge: novel portable surgical robot with multiaxis force-sensing capability for minimally invasive surgery. IEEE/ASME Trans. Mechatron. 22, 1717–1727 (2017).

    Article  Google Scholar 

  13. 13.

    Kim, C. et al. Three-degrees-of-freedom passive gravity compensation mechanism applicable to robotic arm with remote center of motion for minimally invasive surgery. IEEE Robot. Autom. Lett. 4, 3473–3480 (2019).

    Article  Google Scholar 

  14. 14.

    Felton, S. Origami for the everyday. Nat. Mach. Intell. 1, 555–556 (2019).

    Article  Google Scholar 

  15. 15.

    Whitney, J. P., Sreetharan, P. S., Ma, K. Y. & Wood, R. J. Pop-up book MEMS. J. Micromech. Microeng. 21, 115021 (2011).

    Article  Google Scholar 

  16. 16.

    Wood, R. J., Avadhanula, S., Sahai, R., Steltz, E. & Fearing, R. S. Microrobot design using fiber reinforced composites. J. Mech. Des. 130, 52304–52311 (2008).

    Article  Google Scholar 

  17. 17.

    McClintock, H., Temel, F. Z., Doshi, N., Koh, J.-s & Wood, R. J. The milliDelta: a high-bandwidth, high-precision, millimeter-scale delta robot. Sci. Robot. 3, eaar3018 (2018).

    Article  Google Scholar 

  18. 18.

    York, P. A., Jafferis, N. T. & Wood, R. J. Mesoscale flextensional piezoelectric actuators. Smart Mater. Struct. 27, 15008 (2017).

    Article  Google Scholar 

  19. 19.

    York, P. A. & Wood, R. J. Nitinol living hinges for millimeter-sized robots and medical devices. In 2019 Int. Conf. on Robotics and Automation (ICRA) 889–893 (IEEE, 2019).

  20. 20.

    Gafford, J. B., Wood, R. J. & Walsh, C. J. Self-assembling, low-cost, and modular mm-scale force sensor. IEEE Sens. J. 16, 69–76 (2016).

    Article  Google Scholar 

  21. 21.

    Zhang, Z. G., Ueno, T. & Higuchi, T. Magnetostrictive actuating device utilizing impact forces coupled with friction forces. In 2010 IEEE Int. Symp. on Industrial Electronics 464–469 (IEEE, 2010).

  22. 22.

    Henderson, D. A. Simple ceramic motor . . . inspiring smaller products. In 10th Int. Conf. on New Actuators Vol. 50 (ICNA, 2006).

  23. 23.

    Hemsel, T. & Wallaschek, J. Survey of the present state of the art of piezoelectric linear motors. Ultrasonics 38, 37–40 (2000).

    Article  Google Scholar 

  24. 24.

    Morita, T. Miniature piezoelectric motors. Sens. Actuat. A 103, 291–300 (2003).

    Article  Google Scholar 

  25. 25.

    Mohammadi, F., Kholkin, A. L., Jadidian, B. & Safari, A. High-displacement spiral piezoelectric actuators. Appl. Phys. Lett. 75, 2488–2490 (1999).

    Article  Google Scholar 

  26. 26.

    Conway, N. J., Traina, Z. J. & Kim, S.-G. A strain amplifying piezoelectric MEMS actuator. J. Micromech. Microeng. 17, 781–787 (2007).

    Article  Google Scholar 

  27. 27.

    Poikselkä, K. et al. Novel genetically optimised high-displacement piezoelectric actuator with efficient use of active material. Smart Mater. Struct. 26, 95022 (2017).

    Article  Google Scholar 

  28. 28.

    Breguet, J. & Clavel, R. Stick and slip actuators: design, control, performances and applications. In Proc. 1998 Int. Symp. on Micromechatronics and Human Science 89–95 (IEEE, 1998).

  29. 29.

    Okamoto, Y. & Yoshida, R., S., M. The Development of a Smooth Impact Drive Mechanism (SIDM) Using a Piezoelectric Element: Technology Report 23–26 (Konica Minolta, 2004).

  30. 30.

    Nishimura, T., Hosaka, H. & Morita, T. Resonant-type smooth impact drive mechanism (SIDM) actuator using a bolt-clamped Langevin transducer. Ultrasonics 52, 75–80 (2012).

    Article  Google Scholar 

  31. 31.

    Park, J., Keller, S., Carman, G. P. & Hahn, H. T. Development of a compact displacement accumulation actuator device for both large force and large displacement. Sens. Actuat. A 90, 191–202 (2001).

    Article  Google Scholar 

  32. 32.

    Zhou, M. et al. Design and experimental research of a novel stick-slip type piezoelectric actuator. Micromachines 8, 150 (2017).

    Article  Google Scholar 

  33. 33.

    Gijbels, A., Poorten, E. B. V., Stalmans, P., Brussel, H. V. & Reynaerts, D. Design of a teleoperated robotic system for retinal surgery. In Int. Conf. Robot. Autom. 2357–2363 (IEEE, 2014).

  34. 34.

    Lum, M. J. H., Rosen, J., Sinanan, M. N. & Hannaford, B. Optimization of a spherical mechanism for a minimally invasive surgical robot: theoretical and experimental approaches. IEEE Trans. Biomed. Eng. 53, 1440–1445 (2006).

    Article  Google Scholar 

  35. 35.

    Hannaford, B. et al. Raven-II: an open platform for surgical robotics research. IEEE Trans. Biomed. Eng. 60, 954–959 (2013).

    Article  Google Scholar 

  36. 36.

    Ramrath, L., Hofmann, U. G. & Schweikard, A. Spherical assistant for stereotactic surgery. In Int. Conf. Intell. Robot. Syst. 859–864 (IEEE/RSJ, 2007).

  37. 37.

    Sakai, T. et al. Design and development of miniature parallel robot for eye surgery. In 2014 36th Ann. Int. Conf. IEEE Engineering in Medicine and Biology Society 371–374 (IEEE, 2014).

  38. 38.

    Wong, T. Y., Klein, R., Klein, B. E. K., Meuer, S. M. & Hubbard, L. D. Retinal vessel diameters and their associations with age and blood pressure. Invest. Ophthalm. Vis. Sci. 44, 4644–4650 (2003).

    Article  Google Scholar 

  39. 39.

    Goldenberg, D., Shahar, J., Loewenstein, A. & Goldstein, M. Diameters of retinal blood vessels in a healthy cohort as measured by spectral domain optical coherence tomography. Retina 33, 1888–1894 (2013).

  40. 40.

    Bado, P., Clark, W. & Said, A. Ultrafast Laser Micromachining Handbook (Clark-MXR, 1999).

  41. 41.

    Baba, S. et al. Development of an advanced micro-neurosurgical robotic system for the deep surgical field. In First IEEE/RAS-EMBS Int. Conf. on Biomedical Robotics and Biomechatronics (BioRob 2006) 437–442 (IEEE, 2006).

  42. 42.

    Masamune, K. et al. Development of an MRI-compatible needle insertion manipulator for stereotactic neurosurgery. J. Image Guid. Surg. 14, 242–248 (1995).

    Article  Google Scholar 

  43. 43.

    Jun, C. et al. MR safe robot assisted needle access of the brain: preclinical study. J. Med. Robot. Res. 03, 1–11 (2018).

    Article  Google Scholar 

  44. 44.

    Li, G. et al. Robotic system for MRI-guided stereotactic neurosurgery. IEEE Trans. Biomed. Eng. 62, 1077–1088 (2015).

    Article  Google Scholar 

  45. 45.

    Monfaredi, R., Cleary, K. & Sharma, K. MRI robots for needle-based interventions: systems and technology. Ann. Biomed. Eng. 46, 1479–1497 (2018).

    Article  Google Scholar 

  46. 46.

    Uneri, A. et al. New steady-hand eye robot with micro-force sensing for vitreoretinal surgery. Proc. IEEE/RAS-EMBS Int. Conf. on Biomedical Robotics and Biomechatronics 2010, 814–819 (2010).

    Article  Google Scholar 

  47. 47.

    Wilson, J. et al. Intraocular robotic interventional surgical system (IRISS): mechanical design, evaluation, and master-slave manipulation. Int. J. Med. Robot. 14, e1842 (2017).

    Article  Google Scholar 

  48. 48.

    Gijbels, A. et al. Experimental validation of a robotic comanipulation and telemanipulation system for retinal surgery. In 5th IEEE RAS/EMBS Int. Conf. on Biomedical Robotics and Biomechatronics 144–150 (IEEE, 2014).

  49. 49.

    Meenink, H. C. M. et al. Robot-assisted vitreoretinal surgery. In Medical Robotics: Minimally Invasive Surgery (ed. Gomes, P.) 185–209 (Woodhead Publishing, 2012).

  50. 50.

    Nasseri, M. A. et al. The introduction of a new robot for assistance in ophthalmic surgery. In 35th Ann. Int. Conf. IEEE Engineering in Medicine and Biology Society (EMBC) 5682–5685 (IEEE, 2013).

Download references


We acknowledge the advice and discussions about fabrication techniques from G. Freeburn, P. York, D. Lee and all members of the Harvard Microrobotics Laboratory for their help and assistance.

Author information




H.S. and R.J.W. developed the concept. H.S. fabricated the experimental samples of the manipulator. H.S. developed the electrical circuit board and the motion control software for the manipulator. H.S. and R.J.W. designed the experiments. H.S. and R.J.W. wrote the manuscript.

Corresponding authors

Correspondence to Hiroyuki Suzuki or Robert J. Wood.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Extended data

Extended Data Fig. 1 The fabrication process of the mini-LA using the pop-up book MEMS.

a, The rail-unit. b, The runner-unit.

Extended Data Fig. 2 The control system and experimental setup of the mini-LA.

The signal from the function generator can be modified through the multiplier IC according to the output signal from the D/A. We can adjust the speed and motion direction of the runner-unit using the output signal of the D/A. The signal, generated by a proportional controller, is amplified and transmitted to the mini-LA. The displacement is measured and sampled by the mini-LA and a reference laser displacement sensor simultaneously.

Extended Data Fig. 3

Experimental determination of the mini-RCM’s motion range.

Supplementary information

Supplementary Information

Supplementary Tables 1–5

Supplementary Video 1


Supplementary Video 2

Pop-up book assembly

Supplementary Video 3

Mini-LA test

Supplementary Video 4

mini-RCM test

Supplementary Video 5

Task1 Tracing

Supplementary Video 6

Task2 Cannulation

Supplementary Video 7

Fail-safe Power outage

Supplementary Data

Source files of the collected data (.m .csv files).

Source data

Source Data Fig. 4

The result of the mini-LA’s characterization.

Source Data Fig. 5

Characterization of the mini-RCM.

Source Data Fig. 6

The trajectories from a micro-square tracing experiment.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Suzuki, H., Wood, R.J. Origami-inspired miniature manipulator for teleoperated microsurgery. Nat Mach Intell 2, 437–446 (2020).

Download citation

Further reading


Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing