Abstract Microlaryngoscopic surgery requires surgeons to maintain elevated arm postures for extended periods, often leading to muscle fatigue, hand tremor, and reduced precision. To address these challenges, this paper presents a tendon-sheath-driven upper-limb exoskeleton (TULE) designed to provide ergonomic support during long-duration procedures. The system provides three degrees of freedom per arm and adopts a simplified dynamic model customized to the characteristic motion patterns of microlaryngoscopic surgery, while employing a hybrid control strategy that integrates admittance control with computed-torque sliding-mode control. Simulations and hardware experiments demonstrate that the proposed controller substantially reduces joint tracking errors compared with PID control, while maintaining smooth torque output. Motion-following experiments further confirm that the exoskeleton achieves compliant human–robot interaction with low interaction torques, and tremor-suppression tests show a reduction of wrist tremor amplitude by approximately 75–80% in lock mode. These results indicate that the exoskeleton can effectively enhance surgeon endurance and stability in microsurgical applications.
Bao et al. (2026) studied this question.