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

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.