3D Slicer is a customizable, open-source platform widely used for advanced medical image analysis tasks. While existing surveys cover specific applications (e.g., 3D printing, surgical navigation), none have comprehensively addressed the growing number of extensions that integrate AI, cloud computing, and interventional technologies. This gap hinders clinical researchers from fully utilizing the potential of 3D Slicer in their research pipelines. Therefore, this study aims to provide readers with insights into recent advances in 3D Slicer in relevant fields. A narrative review approach was followed in the preparation of the paper. Peer-reviewed articles and preprints published at open-access archives, such as arXiv and medRxiv, were collected. We surveyed approximately 100 studies that proposed 3D Slicer-based applications and covered novel 3D Slicer extensions. The extensions included tools for interactive/fully automatic image segmentation, data annotation, and interfacing with publicly available image repositories and cloud-based computational resources. The developing community of the platform is pushing forward to accelerate the user’s learning process, whereas computational bottlenecks and interface improvements are increasingly needed for a seamless user experience. In conclusion, this paper summarizes the recent advances in 3D Slicer, which integrate AI, cloud computing, and interventional technologies. It has been demonstrated that 3D Slicer is rapidly evolving as a highly adaptable platform in the field of medical image analysis. This study is intended to serve as a reference for clinical researchers seeking to integrate 3D Slicer’s advanced computational capabilities into their research workflows, while understanding both the platform’s expanding potential and current considerations for optimal adoption.

Total hip arthroplasty (THA) is widely performed to treat hip disorders and is effective for pain relief. Among various existing surgical approaches, the direct anterior approach (DAA) has gained attention because it is minimally invasive and preserves soft tissue. A lower leg traction operating device previously developed for the anterior approach cannot measure the traction forces and moments. Excessive extension of the patient's leg by the surgeon may result in complications such as bone fractures and nerve paralysis. In this study, a system that can measure the traction force and moment applied to the patient's leg was developed using a 6-axis force sensor. Additionally, rotational angles during operation were measured using inertial measurement units (IMUs). An initial IMU (TAG289N1000) was mounted on the traction stand, and accuracy was tested against a motion analysis system. To address discrepancies between foot displacement and table displacement, two auxiliary IMUs (IMU2 and IMU3: MPU6886) were added to separately capture traction-relaxation and extension-flexion displacements of the traction table. Although quantitative accuracy of these IMUs has not yet been validated, a preliminary demonstration indicated their ability to capture combined movements. Experiments using a skeletal model simulating the human body were conducted to measure the traction force, moment, and rotational angle. For individual movements, when the traction distance was 40 mm, the maximum force was Fz, with an average peak of 86.2 N. When the total rotation was 20° around the Y-axis, the maximum extension force was Fz, with an average peak of 66.7 N. The minimum moment was My, with an average negative peak of −2.97 Nm. When the boot was rotated at 135° around the Z-axis, the average negative peaks of My and Mz were −13.0 and −10.8 Nm, respectively. Combined movements of external rotation, extension, and adduction were also performed to simulate femoral stem insertion. Excluding rotational movement, the force was mainly applied along the longitudinal and gravity axes. The moment was mainly applied around the longitudinal and horizontal axes. All measured forces and moments were within the rated capacity of the force sensor. Rotational angles measured using the initial IMU had average errors less than 1°, while combined movements measured using the IMU2 and IMU3 had errors less than 2°. The developed lower-limb traction table possessing force and moment measuring functions has been registered in Japan as a class I medical device named “LECURE Traction Force Measurement Boot” and is now available for use in surgery.

The demand for surgical robots has increased in recent years, accompanying the growing attention to minimally invasive surgery. To support the development of compact and cost-effective forceps for surgical robots, this paper proposes a novel forceps mechanism inspired by the pincers of crabs. The mechanism aims to reduce the number of components compared to conventional forceps, enabling a simpler, smaller, lighter, and compliant structure. Among organisms on Earth, crustaceans exhibit a high force-to-body-weight ratio, which led to our inspiration from crab chelae. The proposed mechanism, termed “Clawceps”, applies the crab’s scissor-like mechanism and incorporates the principle of leverage to stabilize force transmission. While the structure is compliant when no force is applied, the mechanism changes mode when the forceps are closed, engaging the joint to act as a fulcrum, thereby increasing the gripping force. The novel mechanism was evaluated using finite element analysis (FEA) with a PLA 3D-printed physical prototype. Models with and without a fulcrum were prepared to observe the gripping force. According to the FEA results, when the displacement was 1.5 mm, the gripping force of the model with a fulcrum was 7.8 N, while that without a fulcrum was 0.2 N. Experimental measurements with the actual prototype also showed significantly higher gripping force of the model with a fulcrum compared with that without a fulcrum, demonstrating the effectiveness of the mechanism. By implementing a mechanism that switches operation modes and transmits force using the principle of leverage, the Clawceps achieve both compliance and strong gripping force. This study successfully proved the concept of the proposed method to overcome a current limitation of compliant mechanism by incorporating principles derived from exoskeletal structures.

Colonoscopy is the most effective procedure for cancer screening. However, insertion of a colonoscope into the large intestine remains challenging because of the complex and highly variable anatomy of the colon, particularly variations in its inner diameter. Various self-propelled colonoscopy robots have been proposed to overcome these difficulties. Nevertheless, several existing systems require complex mechanisms for adaptation to changes in the inner diameter of the colon, which increases structural complexity and limits practicality. Therefore, simpler and more adaptive propulsion mechanisms are required. In this paper, we propose a self-propelled colonoscopy robot with an elastic wall-fitting mechanism. This mechanism utilizes the elastic force of shape memory alloy (SMA) wires to adaptively conform to variations in the inner diameter of the colon, ensuring continuous contact with the intestinal wall. A prototype robot was fabricated using a 3D printer. Evaluation experiments were conducted using simulated intestinal tract models with inner diameters ranging from 30 to 60 mm to assess propulsion performance and thrust generation. The experimental results demonstrated that the proposed robot successfully self-propelled in all the simulated intestinal models. The robot achieved a maximum propulsive speed of 11 mm/s and generated sufficient thrust across the diameter range tested, indicating stable propulsion performance despite changes in the inner diameter. These results confirm that the proposed elastic wall-fitting mechanism effectively adapts to variations in the inner diameter of the colon without requiring complex mechanical structures. By leveraging the elastic properties of the SMA wires, the robot maintained consistent wall contact and stable propulsion, suggesting its potential applicability in safe and efficient colonoscopy procedures.