Active Stabilization of Interventional Tasks Utilizing a Magnetically Manipulated Endoscope

Abstract

Magnetically actuated robots have become increasingly popular in medical endoscopy over the past decade. Despite the significant improvements in autonomy and control methods, progress within the field of medical magnetic endoscopes has mainly been in the domain of enhanced navigation. Interventional tasks such as biopsy, polyp removal, and clip placement are a major procedural component of endoscopy. Little advancement has been done in this area due to the problem of adequately controlling and stabilizing magnetically actuated endoscopes for interventional tasks. In the present paper we discuss a novel model-based Linear Parameter Varying (LPV) control approach to provide stability during interventional maneuvers. This method linearizes the non-linear dynamic interaction between the external actuation system and the endoscope in a set of equilibria, associated to different distances between the magnetic source and the endoscope, and computes different controllers for each equilibrium. This approach provides the global stability of the overall system and robustness against external disturbances. The performance of the LPV approach is compared to an intelligent teleoperation control method (based on a Proportional Integral Derivative (PID) controller), on the Magnetic Flexible Endoscope (MFE) platform. Four biopsies in different regions of the colon and at two different system equilibria are performed. Both controllers are asked to stabilize the endoscope in the presence of external disturbances (i.e. the introduction of the biopsy forceps through the working channel of the endoscope). The experiments, performed in a benchtop colon simulator, show a maximum reduction of the mean orientation error of the endoscope of 45.8% with the LPV control compared to the PID controller.

Scoping review: autonomous endoscopic navigation

“…The magnetic flexible endoscope (MFE) has been developed for painless colonoscopy, which could provide a major improvement and disruption in the early detection and treatment of colorectal diseases and relies on passive navigation as visual images from the tip of the endoscope are used to enable a robotic arm and magnet to passively drag the scope through the colon [16] . This method is relevant to a variety of additional endoscopic applications where the environment is unstructured and provides major navigational issues [32] .…”

“…Advanced control techniques capable of helping and providing a simple user interface with shortened process durations would enable magnetic colonoscopy to be clinically translated, broadening and enhancing patient care. Although navigation with magnetic endoscopes has been shown for stomach screening, catheter guiding, and bronchoscopy, navigation in mobile and complicated settings such as the colon requires more advanced control [32] . MFEs show progress in navigation, but interventional tasks such as biopsies face control challenges, which some authors have proposed overcoming with Endorobots [33] .…”