{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:08:24Z","timestamp":1788930504386,"version":"build-2803163510"},"reference-count":94,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universidad Autonoma Metropolitana"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Robotic Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The distal end of a robotic surgical instrument is where access, dexterity, tissue interaction and procedural capability converge. In flexible, endoluminal, transoral, percutaneous, vascular and neuroendoscopic surgery, the clinical value of an instrument depends not only on kinematic complexity but also on miniaturisation, usable lumen, transmission reliability, stiffness, sensing and validation maturity. This article presents a structured narrative review of distal mechanisms for robotic surgical instruments, based on a technical-clinical synthesis of studies identified through IEEE Xplore, PubMed and Web of Science. Distal architectures are organised into discrete articulated, continuous and hybrid mechanisms and are interpreted according to surgical access route, dominant task, tissue interaction requirements and procedure-specific performance trade-offs. The review shows that no single distal architecture is universally superior. Discrete mechanisms can support local orientation and load-bearing tasks; continuous mechanisms facilitate navigation through tortuous anatomy but introduce shape-estimation and transmission challenges; and hybrid architectures seek to balance access, stability, dexterity and deployment capability. Across these families, miniaturisation should be understood as functional rather than dimensional: reduced outer diameter is clinically meaningful only when force transmission, usable lumen, stiffness, sensing and workflow compatibility are preserved. The article proposes a minimum reporting core for distal robotic mechanisms, including outer diameter, usable lumen, transmission principle, distal force, stiffness definition and validation level. Future progress will depend on procedure-specific evaluation frameworks linking mechanism design with surgical task, anatomical constraints and translational readiness.<\/jats:p>","DOI":"10.1007\/s11701-026-03929-x","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T04:29:20Z","timestamp":1788928160000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Distal mechanisms in robotic surgical instruments: a structured review of surgical access, miniaturisation constraints and procedure-specific performance trade-offs"],"prefix":"10.1007","volume":"20","author":[{"given":"Carlos E. D\u00edaz","family":"Guti\u00e9rrez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00edctor Eduardo Quiroz","family":"Vel\u00e1zquez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roemi","family":"Fern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"3929_CR1","doi-asserted-by":"publisher","DOI":"10.34133\/cbsystems.0007","volume":"4","author":"X Gu","year":"2023","unstructured":"Gu X, Ren H (2023) A survey of transoral robotic mechanisms: distal dexterity, variable stiffness, and triangulation. Cyborg Bionic Syst 4:0007. https:\/\/doi.org\/10.34133\/cbsystems.0007","journal-title":"Cyborg Bionic Syst"},{"issue":"7","key":"3929_CR2","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1109\/JPROC.2022.3141338","volume":"110","author":"PE Dupont","year":"2022","unstructured":"Dupont PE, Simaan N, Choset H, Rucker C (2022) Continuum robots for medical interventions. Proc IEEE 110(7):847\u2013870. https:\/\/doi.org\/10.1109\/JPROC.2022.3141338","journal-title":"Proc IEEE"},{"issue":"6","key":"3929_CR3","doi-asserted-by":"publisher","DOI":"10.1002\/aisy.202200403","volume":"5","author":"X Luo","year":"2023","unstructured":"Luo X, Song D, Zhang Z, Wang S, Shi C (2023) A novel distal hybrid pneumatic\/cable-driven continuum joint with variable stiffness capacity for flexible gastrointestinal endoscopy. Adv Intell Syst 5(6):2200403. https:\/\/doi.org\/10.1002\/aisy.202200403","journal-title":"Adv Intell Syst"},{"issue":"3","key":"3929_CR4","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1016\/j.gie.2010.04.009","volume":"72","author":"KY Ho","year":"2010","unstructured":"Ho KY et al (2010) Endoscopic submucosal dissection of gastric lesions using a Master and Slave Transluminal Endoscopic Robot (MASTER). Gastrointest Endosc 72(3):593\u2013599. https:\/\/doi.org\/10.1016\/j.gie.2010.04.009","journal-title":"Gastrointest Endosc"},{"issue":"2","key":"3929_CR5","doi-asserted-by":"publisher","first-page":"2993","DOI":"10.1109\/LRA.2021.3062583","volume":"6","author":"K Yan","year":"2021","unstructured":"Yan K et al (2021) Towards a wristed percutaneous robot with variable stiffness for pericardiocentesis. IEEE Robot Autom Lett 6(2):2993\u20133000. https:\/\/doi.org\/10.1109\/LRA.2021.3062583","journal-title":"IEEE Robot Autom Lett"},{"key":"3929_CR6","doi-asserted-by":"publisher","DOI":"10.1002\/rcs.1930","author":"G Tay","year":"2018","unstructured":"Tay G, Tan H-K, Nguyen TK, Phee SJ, Iyer NG (2018) Use of the EndoMaster robot-assisted surgical system in transoral robotic surgery: A cadaveric study. Int J Medical Robotics Computer Assisted Surgery. https:\/\/doi.org\/10.1002\/rcs.1930","journal-title":"Int J Medical Robotics Computer Assisted Surgery"},{"key":"3929_CR7","doi-asserted-by":"publisher","DOI":"10.1109\/TMECH.2025.3563471","author":"Y Song","year":"2025","unstructured":"Song Y et al (2025) Development of a miniature 5-DOF modularised flexible instrument with distal rotation capability for dual-armed upper gastrointestinal endoscopic robots. IEEE ASME Trans Mechatron. https:\/\/doi.org\/10.1109\/TMECH.2025.3563471","journal-title":"IEEE ASME Trans Mechatron"},{"key":"3929_CR8","doi-asserted-by":"publisher","DOI":"10.1109\/TIE.2020.2984427","author":"T Chen","year":"2021","unstructured":"Chen T et al (2021) Novel, flexible, and ultrathin pressure feedback sensor for miniaturized intraventricular neurosurgery robotic tools. IEEE Trans Ind Electron. https:\/\/doi.org\/10.1109\/TIE.2020.2984427","journal-title":"IEEE Trans Ind Electron"},{"issue":"4","key":"3929_CR9","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.1109\/TBME.2020.3024184","volume":"68","author":"I Tamadon","year":"2021","unstructured":"Tamadon I et al (2021) Valvetech: a novel robotic approach for minimally invasive aortic valve replacement. IEEE Trans Biomed Eng 68(4):1238\u20131248. https:\/\/doi.org\/10.1109\/TBME.2020.3024184","journal-title":"IEEE Trans Biomed Eng"},{"issue":"1","key":"3929_CR10","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.tige.2022.10.005","volume":"25","author":"TLN Lam","year":"2023","unstructured":"Lam TLN, Chiu PWY (2023) Current applications of flexible endoluminal robotics for colorectal endoscopic submucosal dissection. Tech Innov Gastrointest Endosc 25(1):88\u201394. https:\/\/doi.org\/10.1016\/j.tige.2022.10.005","journal-title":"Tech Innov Gastrointest Endosc"},{"issue":"6","key":"3929_CR11","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics14060595","volume":"14","author":"N Tada","year":"2024","unstructured":"Tada N, Sumiyama K (2024) Robotic platforms for therapeutic flexible endoscopy: a literature review. Diagnostics (Basel) 14(6):595. https:\/\/doi.org\/10.3390\/diagnostics14060595","journal-title":"Diagnostics (Basel)"},{"key":"3929_CR12","doi-asserted-by":"publisher","DOI":"10.1109\/TIM.2024.3472808","author":"H Wei","year":"2024","unstructured":"Wei H et al (2024) \u201cDexterity assessment for wrist joints of surgical robots: a statics-based evaluation method,.\u201d IEEE Trans Instrum Meas. https:\/\/doi.org\/10.1109\/TIM.2024.3472808","journal-title":"IEEE Trans Instrum Meas"},{"key":"3929_CR13","doi-asserted-by":"publisher","DOI":"10.1109\/LRA.2025.3558452","author":"J Chen","year":"2025","unstructured":"Chen J et al (2025) A novel cable-driven variable-stiffness manipulator with teeth-engagement structure for transoral surgery. IEEE Robot Autom Lett. https:\/\/doi.org\/10.1109\/LRA.2025.3558452","journal-title":"IEEE Robot Autom Lett"},{"key":"3929_CR14","doi-asserted-by":"publisher","DOI":"10.1109\/TMECH.2023.3252279","author":"X Wang","year":"2023","unstructured":"Wang X et al (2023) A novel miniature spring-based continuum manipulator for minimally invasive surgery: design and evaluation. IEEE ASME Trans Mechatron. https:\/\/doi.org\/10.1109\/TMECH.2023.3252279","journal-title":"IEEE ASME Trans Mechatron"},{"issue":"1","key":"3929_CR15","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1109\/TMECH.2023.3279648","volume":"29","author":"J Ahn","year":"2024","unstructured":"Ahn J et al (2024) Asymmetric rolling contact joint for enhanced payload capabilities. IEEE\/ASME Trans Mechatron 29(1):212\u2013223. https:\/\/doi.org\/10.1109\/TMECH.2023.3279648","journal-title":"IEEE\/ASME Trans Mechatron"},{"key":"3929_CR16","doi-asserted-by":"publisher","DOI":"10.1109\/TMECH.2025.3602724","author":"C Wang","year":"2026","unstructured":"Wang C et al (2026) Design and analytical modelling of a double-joint catheter robot with wire-reinforced spring backbones. IEEE\/ASME Trans Mechatron. https:\/\/doi.org\/10.1109\/TMECH.2025.3602724","journal-title":"IEEE\/ASME Trans Mechatron"},{"key":"3929_CR17","doi-asserted-by":"publisher","DOI":"10.1016\/j.birob.2024.100168","volume":"4","author":"B Lin","year":"2024","unstructured":"Lin B, Song S, Wang J (2024) Variable stiffness methods of flexible robots for minimally invasive surgery: a review. Biomim Intell Robot 4:100168. https:\/\/doi.org\/10.1016\/j.birob.2024.100168","journal-title":"Biomim Intell Robot"},{"key":"3929_CR18","doi-asserted-by":"publisher","DOI":"10.1016\/j.sna.2025.116588","author":"K Wang","year":"2025","unstructured":"Wang K, Sun L, Liu Z, Sun N, Zhang J (2025) Actuators and variable stiffness of flexible surgical actuators: A review. Sensors Actuators A Physical. https:\/\/doi.org\/10.1016\/j.sna.2025.116588","journal-title":"Sensors Actuators A Physical"},{"issue":"1","key":"3929_CR19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1109\/TMECH.2019.2945525","volume":"25","author":"Z Li","year":"2020","unstructured":"Li Z et al (2020) Flexible robot with variable stiffness in transoral surgery. IEEE-ASME Trans Mechatron 25(1):1\u201310. https:\/\/doi.org\/10.1109\/TMECH.2019.2945525","journal-title":"IEEE-ASME Trans Mechatron"},{"key":"3929_CR20","doi-asserted-by":"publisher","DOI":"10.1002\/rcs.2081","author":"S Jiang","year":"2020","unstructured":"Jiang S, Chen B, Qi F, Cao Y, Ju F, Bai D, Wang Y (2020) A variable-stiffness continuum manipulator using an SMA-based sheath for minimally invasive surgery. Int J Medical Robotics Computer Assisted Surgery. https:\/\/doi.org\/10.1002\/rcs.2081","journal-title":"Int J Medical Robotics Computer Assisted Surgery"},{"key":"3929_CR21","doi-asserted-by":"publisher","DOI":"10.3389\/frobt.2019.00012","author":"M Brancadoro","year":"2019","unstructured":"Brancadoro M, Manti M, Tognarelli S, Cianchetti M, Menciassi A (2019) Towards a Variable Stiffness Surgical Manipulator Based on Fiber Jamming Transition. Frontiers Robotics AI. https:\/\/doi.org\/10.3389\/frobt.2019.00012","journal-title":"Frontiers Robotics AI"},{"issue":"7","key":"3929_CR22","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1055\/s-0032-1309404","volume":"44","author":"Z Wang","year":"2012","unstructured":"Wang Z et al (2012) Endoscopic submucosal dissection of gastric lesions using a master-slave transluminal endoscopic robot: An animal survival study. Endoscopy 44(7):690\u2013694. https:\/\/doi.org\/10.1055\/s-0032-1309404","journal-title":"Endoscopy"},{"issue":"2","key":"3929_CR23","doi-asserted-by":"publisher","first-page":"150","DOI":"10.5009\/gnl19047","volume":"14","author":"HL Kaan","year":"2020","unstructured":"Kaan HL, Ho KY (2020) Robot-assisted endoscopic resection: current status and future directions. Gut Liver 14(2):150\u2013152. https:\/\/doi.org\/10.5009\/gnl19047","journal-title":"Gut Liver"},{"issue":"9","key":"3929_CR24","doi-asserted-by":"publisher","first-page":"2794","DOI":"10.1109\/TBME.2025.3552551","volume":"72","author":"Y Yang","year":"2025","unstructured":"Yang Y et al (2025) A soft inflatable cable-driven parallel robot with a variable stiffness end-effector for advanced interventional endoscopy. IEEE Trans Biomed Eng 72(9):2794\u20132803. https:\/\/doi.org\/10.1109\/TBME.2025.3552551","journal-title":"IEEE Trans Biomed Eng"},{"key":"3929_CR25","doi-asserted-by":"publisher","DOI":"10.1109\/TMRB.2025.3573412","author":"H Qu","year":"2025","unstructured":"Qu H et al (2025) A novel robotic guiding sheath with variable stiffness capability based on conductive graphene and thermoplastic polymer. IEEE Trans Med Robot Bionics. https:\/\/doi.org\/10.1109\/TMRB.2025.3573412","journal-title":"IEEE Trans Med Robot Bionics"},{"issue":"6","key":"3929_CR26","doi-asserted-by":"publisher","first-page":"6504","DOI":"10.1109\/LRA.2025.3568564","volume":"10","author":"D Song","year":"2025","unstructured":"Song D et al (2025) A phase-change-material-based variable stiffness sheath inspired by a multi-layer wave spring structure for flexible upper gastrointestinal endoscopic robots. IEEE Robot Autom Lett 10(6):6504\u20136511. https:\/\/doi.org\/10.1109\/LRA.2025.3568564","journal-title":"IEEE Robot Autom Lett"},{"issue":"1","key":"3929_CR27","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1109\/TMECH.2025.3592964","volume":"31","author":"G Li","year":"2026","unstructured":"Li G, Liang X, Zhang J, Su T, Hou Z-G (2026) A Stiffness-Enhanced Extensible Continuum Surgical Robot: Design, Modeling, and Evaluation. IEEE\/ASME Trans Mechatron 31(1):413\u2013424. https:\/\/doi.org\/10.1109\/TMECH.2025.3592964","journal-title":"IEEE\/ASME Trans Mechatron"},{"key":"3929_CR28","doi-asserted-by":"publisher","first-page":"26381","DOI":"10.1109\/ACCESS.2026.3661103","volume":"14","author":"C Kim","year":"2026","unstructured":"Kim C et al (2026) Shape-locking mechanism using double pawl\u2013ratchet system for endoscopic surgery. IEEE Access 14:26381\u201326390. https:\/\/doi.org\/10.1109\/ACCESS.2026.3661103","journal-title":"IEEE Access"},{"issue":"12","key":"3929_CR29","doi-asserted-by":"publisher","DOI":"10.3390\/machines9120303","volume":"9","author":"L Gao","year":"2021","unstructured":"Gao L, He Y, Zhu H, Sun G, Zhu L (2021) Stiffness modelling and performance evaluation of a soft cardiac fixator flexible arm with granular jamming. Machines 9(12):303. https:\/\/doi.org\/10.3390\/machines9120303","journal-title":"Machines"},{"issue":"1","key":"3929_CR30","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1007\/s00464-024-11406-5","volume":"39","author":"Y Tu","year":"2025","unstructured":"Tu Y, Jiang J, Huang J, Sui J, Yang S (2025) A review of wrist mechanism design and the application in gastrointestinal minimally invasive surgery of multi-degree-of-freedom surgical laparoscopic instruments. Surg Endosc 39(1):99\u2013121. https:\/\/doi.org\/10.1007\/s00464-024-11406-5","journal-title":"Surg Endosc"},{"key":"3929_CR31","doi-asserted-by":"publisher","DOI":"10.1109\/TMECH.2021.3077706","author":"X Wang","year":"2021","unstructured":"Wang X et al (2021) Design and experimental validation of a miniaturised robotic tendon-driven articulated surgical drill for enhancing distal dexterity in minimally invasive spine fusion. IEEE ASME Trans Mechatron. https:\/\/doi.org\/10.1109\/TMECH.2021.3077706","journal-title":"IEEE ASME Trans Mechatron"},{"key":"3929_CR32","doi-asserted-by":"publisher","DOI":"10.3389\/frobt.2020.630245","author":"P Rao","year":"2021","unstructured":"Rao P, Peyron Q, Lilge S, Burgner-Kahrs J (2021) How to Model Tendon-Driven Continuum Robots and Benchmark Modelling Performance. Frontiers Robotics AI. https:\/\/doi.org\/10.3389\/frobt.2020.630245","journal-title":"Frontiers Robotics AI"},{"key":"3929_CR33","doi-asserted-by":"publisher","first-page":"3700","DOI":"10.1109\/TRO.2025.3577011","volume":"41","author":"H Gao","year":"2025","unstructured":"Gao H et al (2025) Dynamic hysteresis compensation for tendon-sheath mechanism in flexible surgical robots without distal perception. IEEE Trans Robot 41:3700\u20133717. https:\/\/doi.org\/10.1109\/TRO.2025.3577011","journal-title":"IEEE Trans Robot"},{"key":"3929_CR34","doi-asserted-by":"publisher","DOI":"10.1002\/rcs.70147","author":"Z Wang","year":"2026","unstructured":"Wang Z et al (2026) Optimization design and bending hysteresis compensation of a flexible ureteroscopy robot. Int J Med Robot Comput Assist Surg. https:\/\/doi.org\/10.1002\/rcs.70147","journal-title":"Int J Med Robot Comput Assist Surg"},{"issue":"1","key":"3929_CR35","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1109\/LRA.2022.3223022","volume":"8","author":"H Wang","year":"2023","unstructured":"Wang H, Zuo S (2023) A novel variable-diameter-stiffness guiding sheath for endoscopic surgery. IEEE Robot Autom Lett 8(1):89\u201396. https:\/\/doi.org\/10.1109\/LRA.2022.3223022","journal-title":"IEEE Robot Autom Lett"},{"key":"3929_CR36","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmmm.2024.172023","author":"X Liu","year":"2024","unstructured":"Liu X et al (2024) A concentric tube magnetic continuum robot with multiple stiffness levels and high flexibility for potential endovascular intervention. J Magn Magn Mater. https:\/\/doi.org\/10.1016\/j.jmmm.2024.172023","journal-title":"J Magn Magn Mater"},{"key":"3929_CR37","doi-asserted-by":"publisher","DOI":"10.1109\/TRO.2024.3378442","author":"Z Li","year":"2024","unstructured":"Li Z et al (2024) Design and hierarchical control of a homocentric variable-stiffness magnetic catheter for multiarm robotic ultrasound-assisted coronary intervention. IEEE Trans Robot. https:\/\/doi.org\/10.1109\/TRO.2024.3378442","journal-title":"IEEE Trans Robot"},{"key":"3929_CR38","doi-asserted-by":"publisher","DOI":"10.1002\/rcs.2232","author":"L Lei","year":"2021","unstructured":"Lei L et al (2021) Development of a novel deployable arm for natural orifice transluminal endoscopic surgery. Int J Med Robot Comput Assist Surg. https:\/\/doi.org\/10.1002\/rcs.2232","journal-title":"Int J Med Robot Comput Assist Surg"},{"issue":"2","key":"3929_CR39","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1109\/TMRB.2023.3249234","volume":"5","author":"Z Zhang","year":"2023","unstructured":"Zhang Z, Zhang G, Wang S, Shi C (2023) Hysteresis modelling and compensation for tendon-sheath mechanisms in robot-assisted endoscopic surgery based on the modified Bouc-Wen model with decoupled model parameters. IEEE Trans Med Robot Bionics 5(2):218\u2013229. https:\/\/doi.org\/10.1109\/TMRB.2023.3249234","journal-title":"IEEE Trans Med Robot Bionics"},{"issue":"1\u20132","key":"3929_CR40","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/j.ymssp.2013.08.014","volume":"42","author":"TN Do","year":"2014","unstructured":"Do TN, Tjahjowidodo T, Lau MWS, Phee SJ (2014) An investigation of a friction-based tendon sheath model suitable for control purposes. Mech Syst Signal Process 42(1\u20132):97\u2013114. https:\/\/doi.org\/10.1016\/j.ymssp.2013.08.014","journal-title":"Mech Syst Signal Process"},{"issue":"1","key":"3929_CR41","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.mechatronics.2013.11.003","volume":"24","author":"TN Do","year":"2014","unstructured":"Do TN, Tjahjowidodo T, Lau MWS, Yamamoto T, Phee SJ (2014) Hysteresis modelling and position control of tendon-sheath mechanism in flexible endoscopic systems. Mechatronics 24(1):12\u201322. https:\/\/doi.org\/10.1016\/j.mechatronics.2013.11.003","journal-title":"Mechatronics"},{"key":"3929_CR42","doi-asserted-by":"publisher","first-page":"770","DOI":"10.1016\/j.ymssp.2015.01.001","volume":"60\u201361","author":"TN Do","year":"2015","unstructured":"Do TN, Tjahjowidodo T, Lau MWS, Phee SJ (2015) Nonlinear friction modelling and compensation control of hysteresis phenomena for a pair of tendon-sheath actuated surgical robots. Mech Syst Signal Process 60\u201361:770\u2013784. https:\/\/doi.org\/10.1016\/j.ymssp.2015.01.001","journal-title":"Mech Syst Signal Process"},{"issue":"2","key":"3929_CR43","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.cmpb.2015.03.001","volume":"119","author":"Z Sun","year":"2015","unstructured":"Sun Z, Wang Z, Phee SJ (2015) Modelling and motion compensation of a bidirectional tendon-sheath actuated system for robotic endoscopic surgery. Comput Methods Programs Biomed 119(2):77\u201387. https:\/\/doi.org\/10.1016\/j.cmpb.2015.03.001","journal-title":"Comput Methods Programs Biomed"},{"issue":"2","key":"3929_CR44","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1016\/j.cmpb.2013.01.018","volume":"112","author":"Z Wang","year":"2013","unstructured":"Wang Z, Sun Z, Phee SJ (2013) Haptic feedback and control of a flexible surgical endoscopic robot. Comput Methods Programs Biomed 112(2):260\u2013271. https:\/\/doi.org\/10.1016\/j.cmpb.2013.01.018","journal-title":"Comput Methods Programs Biomed"},{"key":"3929_CR45","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1016\/j.mechmachtheory.2018.12.035","volume":"134","author":"X Li","year":"2019","unstructured":"Li X, Cao L, Tiong AMH, Phan PT, Phee SJ (2019) Distal-end force prediction of tendon-sheath mechanisms for flexible endoscopic surgical robots using deep learning. Mech Mach Theory 134:323\u2013337. https:\/\/doi.org\/10.1016\/j.mechmachtheory.2018.12.035","journal-title":"Mech Mach Theory"},{"key":"3929_CR46","doi-asserted-by":"publisher","DOI":"10.1109\/TMECH.2019.2951540","author":"W Lai","year":"2020","unstructured":"Lai W et al (2020) Force sensing with 1 mm fiber bragg gratings for flexible endoscopic surgical robots. IEEE-ASME Trans Mechatron. https:\/\/doi.org\/10.1109\/TMECH.2019.2951540","journal-title":"IEEE-ASME Trans Mechatron"},{"issue":"3","key":"3929_CR47","doi-asserted-by":"publisher","first-page":"4120","DOI":"10.1109\/JSEN.2023.3345028","volume":"24","author":"S Wang","year":"2024","unstructured":"Wang S, Shen H, Liu Z, Xie L (2024) TCN-based distal force feedback strategy of a vascular interventional surgery robot. IEEE Sens J 24(3):4120\u20134130. https:\/\/doi.org\/10.1109\/JSEN.2023.3345028","journal-title":"IEEE Sens J"},{"key":"3929_CR48","doi-asserted-by":"publisher","DOI":"10.1109\/TMECH.2021.3071437","author":"L Lai","year":"2022","unstructured":"Lai L et al (2022) \u201cA three-axial force sensor based on fiber Bragg gratings for surgical robots.\u201d IEEE-ASME Trans Mechatron. https:\/\/doi.org\/10.1109\/TMECH.2021.3071437","journal-title":"IEEE-ASME Trans Mechatron"},{"key":"3929_CR49","doi-asserted-by":"publisher","DOI":"10.1109\/TIM.2024.3457926","author":"Y Pan","year":"2024","unstructured":"Pan Y et al (2024) A modular miniature 6-D force sensor designed for minimally invasive surgery. IEEE Trans Instrum Meas. https:\/\/doi.org\/10.1109\/TIM.2024.3457926","journal-title":"IEEE Trans Instrum Meas"},{"key":"3929_CR50","doi-asserted-by":"publisher","DOI":"10.3390\/biomimetics8020147","author":"M Russo","year":"2023","unstructured":"Russo M, Gautreau E, Bonnet X, Laribi MA (2023) Continuum Robots: From Conventional to Customised Performance Indicators. Biomimetics. https:\/\/doi.org\/10.3390\/biomimetics8020147","journal-title":"Biomimetics"},{"issue":"6","key":"3929_CR51","doi-asserted-by":"publisher","first-page":"434","DOI":"10.4253\/wjge.v15.i6.434","volume":"15","author":"K Kume","year":"2023","unstructured":"Kume K (2023) Flexible robotic endoscopy for treating gastrointestinal neoplasms. World J Gastrointest Endosc 15(6):434\u2013439. https:\/\/doi.org\/10.4253\/wjge.v15.i6.434","journal-title":"World J Gastrointest Endosc"},{"issue":"1","key":"3929_CR52","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.tige.2022.11.006","volume":"25","author":"A Alian","year":"2023","unstructured":"Alian A et al (2023) Current engineering developments for robotic systems in flexible endoscopy. Tech Innov Gastrointest Endosc 25(1):67\u201381. https:\/\/doi.org\/10.1016\/j.tige.2022.11.006","journal-title":"Tech Innov Gastrointest Endosc"},{"issue":"5","key":"3929_CR53","doi-asserted-by":"publisher","first-page":"1811","DOI":"10.3748\/wjg.v22.i5.1811","volume":"22","author":"BPM Yeung","year":"2016","unstructured":"Yeung BPM, Chiu PWY (2016) Application of robotics in gastrointestinal endoscopy: a review. World J Gastroenterol 22(5):1811\u20131825. https:\/\/doi.org\/10.3748\/wjg.v22.i5.1811","journal-title":"World J Gastroenterol"},{"key":"3929_CR54","doi-asserted-by":"publisher","DOI":"10.1016\/j.media.2021.102306","volume":"76","author":"L Maier-Hein","year":"2022","unstructured":"Maier-Hein L et al (2022) Surgical data science - from concepts toward clinical translation. Med Image Anal 76:102306. https:\/\/doi.org\/10.1016\/j.media.2021.102306","journal-title":"Med Image Anal"},{"key":"3929_CR55","unstructured":"Wu J, Xie F, Zhang M, Zhang H, Sun J, Gu Y, Yang GZ (2026) EndoSERV: A Vision-based Endoluminal Robot Navigation System. arXiv preprint arXiv:2603.08324"},{"key":"3929_CR56","doi-asserted-by":"publisher","DOI":"10.1002\/aisy.202400522","author":"A Mesot","year":"2025","unstructured":"Mesot A et al (2025) Teleoperated Magnetic Endoscopy: A Case Study and Perspective. Adv Intell Syst. https:\/\/doi.org\/10.1002\/aisy.202400522","journal-title":"Adv Intell Syst"},{"key":"3929_CR57","doi-asserted-by":"publisher","first-page":"17207","DOI":"10.1109\/ACCESS.2021.3136796","volume":"10","author":"F Bianchi","year":"2022","unstructured":"Bianchi F et al (2022) Hybrid 6-DoF magnetic localization for robotic capsule endoscopes compatible with high-grade magnetic field navigation. IEEE Access 10:17207\u201317222. https:\/\/doi.org\/10.1109\/ACCESS.2021.3136796","journal-title":"IEEE Access"},{"issue":"1\u20133","key":"3929_CR58","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1177\/0278364914558006","volume":"35","author":"AW Mahoney","year":"2016","unstructured":"Mahoney AW, Abbott JJ (2016) Five-degree-of-freedom manipulation of an untethered magnetic device in fluid using a single permanent magnet with application in stomach capsule endoscopy. Int J Robot Res 35(1\u20133):129\u2013147. https:\/\/doi.org\/10.1177\/0278364914558006","journal-title":"Int J Robot Res"},{"key":"3929_CR59","doi-asserted-by":"publisher","DOI":"10.1002\/smb2.70043","volume":"2","author":"BJ Nelson","year":"2026","unstructured":"Nelson BJ (2026) Microrobots: two decades of progress. SmartBot 2:e70043. https:\/\/doi.org\/10.1002\/smb2.70043","journal-title":"SmartBot"},{"issue":"5","key":"3929_CR60","doi-asserted-by":"publisher","first-page":"5317","DOI":"10.1021\/acs.chemrev.1c00481","volume":"122","author":"Y Kim","year":"2022","unstructured":"Kim Y, Zhao X (2022) Magnetic soft materials and robots. Chem Rev 122(5):5317\u20135364. https:\/\/doi.org\/10.1021\/acs.chemrev.1c00481","journal-title":"Chem Rev"},{"key":"3929_CR61","doi-asserted-by":"publisher","DOI":"10.1002\/smb2.12011","volume":"1","author":"Y Ma","year":"2025","unstructured":"Ma Y et al (2025) Magnetic continuum robot for intelligent manipulation in medical applications. SmartBot 1:e12011. https:\/\/doi.org\/10.1002\/smb2.12011","journal-title":"SmartBot"},{"key":"3929_CR62","doi-asserted-by":"publisher","DOI":"10.34133\/research.0681","volume":"8","author":"S Fu","year":"2025","unstructured":"Fu S et al (2025) Multifunctional magnetic catheter robot with triaxial force sensing capability for minimally invasive surgery. Res 8:0681. https:\/\/doi.org\/10.34133\/research.0681","journal-title":"Res"},{"key":"3929_CR63","doi-asserted-by":"publisher","first-page":"7707","DOI":"10.1109\/TASE.2026.3678482","volume":"23","author":"S Wei","year":"2026","unstructured":"Wei S, Wu Z, Gao Y, Zhang J (2026) Structure-aware and energy-minimized actuation design for magnetic continuum robot control in vascular intervention. IEEE Trans Autom Sci Eng 23:7707\u20137719. https:\/\/doi.org\/10.1109\/TASE.2026.3678482","journal-title":"IEEE Trans Autom Sci Eng"},{"issue":"2","key":"3929_CR64","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1109\/TMRB.2026.3680982","volume":"8","author":"S Wei","year":"2026","unstructured":"Wei S, Wu Z, Zhang J (2026) Configuration optimization strategy of magnetic soft robot for robot-assisted intervention. IEEE Trans Med Robot Bionics 8(2):654\u2013666. https:\/\/doi.org\/10.1109\/TMRB.2026.3680982","journal-title":"IEEE Trans Med Robot Bionics"},{"key":"3929_CR65","doi-asserted-by":"publisher","first-page":"3252","DOI":"10.1109\/TRO.2024.3415230","volume":"40","author":"S Lilge","year":"2024","unstructured":"Lilge S, Nuelle K, Childs JA, Wen K, Rucker DC, Burgner-Kahrs J (2024) Parallel-continuum robots: a survey. IEEE Trans Robot 40:3252\u20133270. https:\/\/doi.org\/10.1109\/TRO.2024.3415230","journal-title":"IEEE Trans Robot"},{"key":"3929_CR66","doi-asserted-by":"publisher","DOI":"10.1109\/TMECH.2025.3599951","author":"X Ren","year":"2025","unstructured":"Ren X et al (2025) Robotic origami-based soft endoscope (ROSE) for minimally-invasive colonoscopy. IEEE ASME Trans Mechatron. https:\/\/doi.org\/10.1109\/TMECH.2025.3599951","journal-title":"IEEE ASME Trans Mechatron"},{"issue":"3","key":"3929_CR67","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1109\/TMRB.2024.3408324","volume":"6","author":"G Li","year":"2024","unstructured":"Li G, Li J, Ciuti G, Dario P, Huang Q (2024) Pose-independent interaction distance adjustment for magnetically driven robotic capsules. IEEE Trans Med Robot Bionics 6(3):961\u2013970. https:\/\/doi.org\/10.1109\/TMRB.2024.3408324","journal-title":"IEEE Trans Med Robot Bionics"},{"key":"3929_CR68","doi-asserted-by":"publisher","unstructured":"Lee K, Shentu C, Pogue C, Burgner-Kahrs J (2025) Automating Tension Calibration for Tendon-Driven Continuum Robots: A Low-Cost Approach Towards Consistent Teleoperation. In: IEEE International Conference on Robotics and Automation (ICRA). https:\/\/doi.org\/10.1109\/ICRA55743.2025.11128689","DOI":"10.1109\/ICRA55743.2025.11128689"},{"key":"3929_CR69","unstructured":"Chikhaoui MT, Burgner-Kahrs J, (2018) Control of Continuum Robots for Medical Applications: State of the Art. In: ACTUATOR 2018, 16th International Conference on New Actuators, Bremen, Germany"},{"key":"3929_CR70","unstructured":"Wu Z, Luo J, Wei S, Zhang J (2025) Topology-Inspired Morphological Descriptor for Soft Continuum Robots. arXiv preprint arXiv:2508.00258"},{"key":"3929_CR71","doi-asserted-by":"publisher","first-page":"24174","DOI":"10.1021\/acsnano.5c03911","volume":"19","author":"X Ju","year":"2025","unstructured":"Ju X et al (2025) Technology roadmap of micro\/nanorobots. ACS Nano 19:24174\u201324334. https:\/\/doi.org\/10.1021\/acsnano.5c03911","journal-title":"ACS Nano"},{"key":"3929_CR72","doi-asserted-by":"publisher","DOI":"10.1002\/adhm.202505942","volume":"15","author":"Y Zhang","year":"2026","unstructured":"Zhang Y et al (2026) Magnetically guided microrobots for targeted drug delivery. Adv Healthc Mater 15:e05942. https:\/\/doi.org\/10.1002\/adhm.202505942","journal-title":"Adv Healthc Mater"},{"key":"3929_CR73","doi-asserted-by":"publisher","DOI":"10.1109\/ACCESS.2023.3236821","author":"J Colan","year":"2023","unstructured":"Colan J et al (2023) OpenRST: an open platform for customizable 3D printed cable-driven robotic surgical tools. IEEE Access. https:\/\/doi.org\/10.1109\/ACCESS.2023.3236821","journal-title":"IEEE Access"},{"issue":"2","key":"3929_CR74","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1109\/TRO.2020.3031270","volume":"37","author":"Y Chitalia","year":"2021","unstructured":"Chitalia Y et al (2021) Modeling and control of a 2-DoF meso-scale continuum robotic tool for pediatric neurosurgery. IEEE Trans Robot 37(2):520\u2013531. https:\/\/doi.org\/10.1109\/TRO.2020.3031270","journal-title":"IEEE Trans Robot"},{"issue":"2","key":"3929_CR75","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1109\/TMRB.2021.3127366","volume":"4","author":"W Bai","year":"2022","unstructured":"Bai W et al (2022) Task-based LSTM kinematic modeling for a tendon-driven flexible surgical robot. IEEE Trans Med Robot Bionics 4(2):339\u2013342. https:\/\/doi.org\/10.1109\/TMRB.2021.3127366","journal-title":"IEEE Trans Med Robot Bionics"},{"key":"3929_CR76","doi-asserted-by":"publisher","DOI":"10.1007\/s11701-024-01839-4","volume":"18","author":"Q Jiang","year":"2024","unstructured":"Jiang Q, Wang F, Jiang S (2024) Modeling and experimental analysis of wire-driven continuum surgical robot. J Robot Surg 18:98. https:\/\/doi.org\/10.1007\/s11701-024-01839-4","journal-title":"J Robot Surg"},{"key":"3929_CR77","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.2020.3007581","author":"CM Lim","year":"2021","unstructured":"Lim CM et al (2021) \u201cDesign and comparison of magnetically-actuated dexterous forceps instruments for neuroendoscopy,.\u201d IEEE Trans Biomed Eng. https:\/\/doi.org\/10.1109\/TBME.2020.3007581","journal-title":"IEEE Trans Biomed Eng"},{"key":"3929_CR78","doi-asserted-by":"publisher","unstructured":"Kim BG et al (2013)A novel layer jamming mechanism with tunable stiffness capability for minimally invasive surgery. https:\/\/doi.org\/10.1109\/TRO.2013.2256313","DOI":"10.1109\/TRO.2013.2256313"},{"key":"3929_CR79","doi-asserted-by":"publisher","unstructured":"Mathur N, Mak YX, Naghibi H, Abayazid M (2021) A Novel Asymmetric Pneumatic Soft-Surgical Endoscope Design with Laminar Jamming. In: 2021 43rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Mexico, pp 4636\u20134640. https:\/\/doi.org\/10.1109\/EMBC46164.2021.9629888.","DOI":"10.1109\/EMBC46164.2021.9629888"},{"key":"3929_CR80","doi-asserted-by":"publisher","DOI":"10.1002\/admt.202370028","author":"J Zhang","year":"2023","unstructured":"Zhang J et al (2023) Bioinspired continuum robots with programmable stiffness by harnessing phase change materials. Adv Materials Technol. https:\/\/doi.org\/10.1002\/admt.202370028","journal-title":"Adv Materials Technol"},{"key":"3929_CR81","doi-asserted-by":"publisher","DOI":"10.1109\/LRA.2021.3068115","author":"C Li","year":"2021","unstructured":"Li C et al (2021) A miniature manipulator with variable stiffness towards minimally invasive transluminal endoscopic surgery. IEEE Robot Autom Lett. https:\/\/doi.org\/10.1109\/LRA.2021.3068115","journal-title":"IEEE Robot Autom Lett"},{"issue":"14","key":"3929_CR82","doi-asserted-by":"publisher","first-page":"1620","DOI":"10.1177\/0278364920913929","volume":"39","author":"C Yang","year":"2020","unstructured":"Yang C et al (2020) Geometric constraint-based modelling and analysis of a novel continuum robot with shape memory alloy-induced variable stiffness. Int J Robot Res 39(14):1620\u20131634. https:\/\/doi.org\/10.1177\/0278364920913929","journal-title":"Int J Robot Res"},{"issue":"3","key":"3929_CR83","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1109\/TMRB.2020.3000899","volume":"2","author":"H Alfalahi","year":"2020","unstructured":"Alfalahi H, Renda F, Stefanini C (2020) Concentric tube robots for minimally invasive surgery: current applications and future opportunities. IEEE Trans Med Robot Bionics 2(3):410\u2013424. https:\/\/doi.org\/10.1109\/TMRB.2020.3000899","journal-title":"IEEE Trans Med Robot Bionics"},{"issue":"5","key":"3929_CR84","doi-asserted-by":"publisher","first-page":"E439","DOI":"10.1055\/s-0034-1393178","volume":"3","author":"PWY Chiu","year":"2015","unstructured":"Chiu PWY et al (2015) Enhancing proficiency in performing endoscopic submucosal dissection (ESD) by using a prototype robotic endoscope. Endosc Int Open 3(5):E439\u2013E442. https:\/\/doi.org\/10.1055\/s-0034-1393178","journal-title":"Endosc Int Open"},{"issue":"2","key":"3929_CR85","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1007\/s00464-018-6408-5","volume":"33","author":"Y Okamoto","year":"2019","unstructured":"Okamoto Y et al (2019) Colorectal endoscopic submucosal dissection using novel articulating devices: a comparative study in a live porcine model. Surg Endosc 33(2):651\u2013657. https:\/\/doi.org\/10.1007\/s00464-018-6408-5","journal-title":"Surg Endosc"},{"key":"3929_CR86","doi-asserted-by":"publisher","unstructured":"Phee SJ et al (2009) Master and slave transluminal endoscopic robot (MASTER) for natural orifice transluminal endoscopic surgery (NOTES). In: Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), pp 1192\u20131195. https:\/\/doi.org\/10.1109\/IEMBS.2009.5333413","DOI":"10.1109\/IEMBS.2009.5333413"},{"key":"3929_CR87","doi-asserted-by":"publisher","unstructured":"Seah TET, Do TN, Takeshita N, Ho KY, Phee SJ (2017) Future of flexible robotic endoscopy systems. arXiv preprint arXiv:1703.05569. https:\/\/doi.org\/10.48550\/arXiv.1703.05569","DOI":"10.48550\/arXiv.1703.05569"},{"issue":"2","key":"3929_CR88","doi-asserted-by":"publisher","first-page":"3835","DOI":"10.1109\/LRA.2022.3147454","volume":"7","author":"J Chen","year":"2022","unstructured":"Chen J et al (2022) A variable length, variable stiffness flexible instrument for transoral robotic surgery. IEEE Robot Autom Lett 7(2):3835\u20133842. https:\/\/doi.org\/10.1109\/LRA.2022.3147454","journal-title":"IEEE Robot Autom Lett"},{"key":"3929_CR89","doi-asserted-by":"publisher","DOI":"10.1109\/TIM.2023.3338659","author":"H Wei","year":"2024","unstructured":"Wei H et al (2024) Design and compensation control of modular variable stiffness continuum manipulator for nasal surgery. IEEE Trans Instrum Meas. https:\/\/doi.org\/10.1109\/TIM.2023.3338659","journal-title":"IEEE Trans Instrum Meas"},{"key":"3929_CR90","doi-asserted-by":"publisher","DOI":"10.1109\/LRA.2022.3142920","author":"K Kong","year":"2022","unstructured":"Kong K et al (2022) Design and kinematic modelling of in-situ torsionally-steerable flexible surgical robots. IEEE Robot Autom Lett. https:\/\/doi.org\/10.1109\/LRA.2022.3142920","journal-title":"IEEE Robot Autom Lett"},{"key":"3929_CR91","doi-asserted-by":"publisher","DOI":"10.1109\/TASE.2024.3418092","author":"J Zhang","year":"2025","unstructured":"Zhang J et al (2025) Design and stiffness control of a variable-length continuum robot for endoscopic surgery. IEEE Trans Autom Sci Eng. https:\/\/doi.org\/10.1109\/TASE.2024.3418092","journal-title":"IEEE Trans Autom Sci Eng"},{"key":"3929_CR92","doi-asserted-by":"publisher","DOI":"10.1109\/TMECH.2024.3402445","author":"X Wang","year":"2024","unstructured":"Wang X et al (2024) Design, optimization, and experimental validation of a handheld nonconstant-curvature hybrid-structure robotic instrument for maxillary sinus surgery. IEEE ASME Trans Mechatron. https:\/\/doi.org\/10.1109\/TMECH.2024.3402445","journal-title":"IEEE ASME Trans Mechatron"},{"key":"3929_CR93","doi-asserted-by":"publisher","DOI":"10.1115\/1.4047737","author":"B Padasdao","year":"2021","unstructured":"Padasdao B, Konh B (2021) Shape Memory Alloy Actuators in an Active Needle-Modeling, Precise Assembly, and Performance Evaluation. J Manufacturing Sci Eng. https:\/\/doi.org\/10.1115\/1.4047737","journal-title":"J Manufacturing Sci Eng"},{"issue":"10","key":"3929_CR94","doi-asserted-by":"publisher","first-page":"6555","DOI":"10.1109\/LRA.2023.3307294","volume":"8","author":"M Richter","year":"2023","unstructured":"Richter M, Venkiteswaran VK, Misra S (2023) Concentric tube-inspired magnetic reconfiguration of variable stiffness catheters for needle guidance. IEEE Robot Autom Lett 8(10):6555\u20136562. https:\/\/doi.org\/10.1109\/LRA.2023.3307294","journal-title":"IEEE Robot Autom Lett"}],"container-title":["Journal of Robotic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11701-026-03929-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11701-026-03929-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11701-026-03929-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T04:29:24Z","timestamp":1788928164000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11701-026-03929-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,9]]},"references-count":94,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3929"],"URL":"https:\/\/doi.org\/10.1007\/s11701-026-03929-x","relation":{},"ISSN":["1863-2491"],"issn-type":[{"value":"1863-2491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,9]]},"assertion":[{"value":"23 July 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare that they have no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. This review article does not involve experiments with human participants, animals or clinical data requiring ethics approval.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Artificial intelligence-assisted tools were used to support language editing, structural refinement, consistency checking and preliminary organisation of non-final draft material. These tools were not used as autonomous agents for literature selection, eligibility decisions, data extraction, technical interpretation, reference verification or final scientific judgement. No artificial intelligence tool was considered an author. The authors reviewed, corrected and approved all decisions related to literature selection, technical interpretation, descriptive calculations, table content, figure content, reference verification and final drafting. The authors assume full responsibility for the accuracy, integrity, originality and scientific content of the manuscript.","order":4,"name":"Ethics","label":"Declaration on the use of artificial intelligence-assisted tools","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"972"}}