This work shows that intuitive user interfaces can improve the efficiency of endoscope tip steering.

In current flexible endoscopy the physician faces problems in manipulating the endoscope. A lot of experience is required to master the procedure. This paper describes the design of an add-on robotic module that improves the user interface of traditional endoscopes and allows a single physician to operate it easily. We identified critical user aspects of traditional endoscopes that need to be copied in a robotic setup. In our design the physician uses a remote control that is connected to a light drive system. It allows manipulation of the robotic endoscope in space. We conducted an experiment to judge the usability of our system. Results indicate that robotic steering, using a position-controlled touchpad or a ratecontrolled joystick increases efficiency and satisfaction.

In therapeutic flexible endoscopy a team of physician and assistant(s) is required to control all independent translations and rotations of the flexible endoscope and its instruments. As a consequence the physician lacks valuable force feedback information on tissue interaction, communication errors easily occur, and procedures are not cost-effective. Current tools are not suitable for performing therapeutic procedures in an intuitive and user-friendly way by one person. A shift from more invasive surgical procedures that require external incisions to endoluminal procedures that use the natural body openings could be expected if enabling techniques were available. This paper describes the design and evaluation of a robotic system which interacts with traditional flexible endoscopes to perform therapeutic procedures that require advanced maneuverability. The physician uses one multi-degree-of-freedom input device to control camera steering as well as shaft manipulation of the motorized flexible endoscope, while the other hand is able to manipulate instruments. We identified critical use aspects that need to be addressed in the robotic setup. A proof-of-principle setup was built and evaluated to judge the usability of our system. Results show that robotic endoscope control increases efficiency and satisfaction. Participants valued its intuitiveness, its accuracy, the feeling of being in control, and its single-person setup. Future work will concentrate on the design of a system that is fully functional and takes safety, cleanability, and easy positioning close to the patient into account.

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The control of the conventional flexible endoscope is non-ergonomic and non-intuitive. A novel singlehanded interface could reduce the experienced workload, without reducing current efficiency or effectiveness of endoscope manipulation. The aim of this study is to evaluate the workload, efficiency and effectiveness of a singlehanded controller in colonoscopy, in comparison to a bimanual controller and the conventional angulation wheels. Twenty-one inexperienced students performed colonoscopies on a computer simulator using either the single-handed controller with a joystick interface, a bimanual controller with a joystick interface or the conventional angulation wheels. Participants performed three sessions of colonoscopies. After each session, the experienced workload was evaluated using a seven-component absolute scoring scale. Efficiency of the procedure was evaluated by the cecal intubation time and total-used scope length. Effectiveness was evaluated by the percentage of bowel wall visualization. The total workload of the singlehanded controller was lower compared to the conventional angulation wheels for all three sessions. The total workload of the bimanual controller was lower compared to the conventional angulation wheels in the second and third session and also lower compared to the single-handed controller in the third session. There was no significant difference between the three control interfaces in time efficiency, used scope length or visualization performance. Single-handed and bimanual controllers with a joystick interface are a feasible approach to reduce the workload of colonoscopy without reducing efficiency or effectiveness of endoscope manipulation.