Feasibility of automated target centralization in colonoscopy

Abstract

PurposeEarly detection of colorectal cancer is key to full recovery. This urged governments to start population screening programs for colorectal cancer, often using flexible endoscopes. Flexible endoscopy is difficult to learn and time-consuming. Automation of flexible endoscopes may increase the capacity for the screening programs. The goal of this pilot study is to investigate the clinical and technical feasibility of an assisting automated navigation algorithm for a colonoscopy procedure.MethodsAutomated navigation (lumen centralization) was implemented in a robotized system designed for conventional flexible endoscopes. Ten novice and eight expert users were asked to perform a diagnostic colonoscopy on a colon model twice: once using the conventional and once using the robotic system. Feasibility was evaluated using time and location data as measures of the system’s added value.ResultsAutomated target centralization (ATC) was turned on by the novices for a median of 4.2 % of the time during insertion and 0.3 % during retraction. Experts turned ATC on for 4.0 % of the time during insertion and 11.6 % during retraction. Novices and experts showed comparable times to reach the cecum with the conventional or the robotic setup with ATC.ConclusionThe ATC algorithm combined with the robotized endoscope setup works in an experimental setup that closely resembles the clinical environment and is considered feasible, although ATC use was lower than expected. For novices, it was unclear whether the low usage was due to unfamiliarity with the system or because they did not need ATC. Experts used ATC also during the retraction phase of the procedure. This was an unexpected finding and may indicate an added value of the system.Electronic supplementary materialThe online version of this article (doi:10.1007/s11548-015-1301-3) contains supplementary material, which is available to authorized users.

Deep learning driven colorectal lesion detection in gastrointestinal endoscopic and pathological imaging

“…According to the bronchoscope navigation system researched by Luo and others, an operation navigation system of the digestive tract can be developed to realize the localization and treatment of lesions[ 57 ]. At present, an image-based navigation strategy is proposed in Van Der Stap[ 58 ] to realize the automation of the flexible endoscope, and a framework composed of robot steering and cavity concentration is proposed to realize the automation of the colonoscope[ 59 ]. Perhaps in the future, endoscopic surgery will present operations similar to that of a surgical Da Vinci robot.…”

Robotics for Advanced Therapeutic Colonoscopy

“…The robotic steering and automated lumen centralization system (University of Twente, Enschede, Netherlands) is a prototype robotic platform using a new algorithm based on dark region centralization for colonoscopy steering [29]. The system allows a conventional endoscope to be docked to its drive to take advantage of the system’s capability.…”