Image-guided steering of a motorized hand-held flexible rhino endoscope in ENT diagnoses

Chen, Fang; Weiwei, Sang; Gumprecht, Jan D. J.; Strauß, Gero; Lueth, Tim C.

doi:10.1109/robio.2012.6491114

Cited by 6 publications

(2 citation statements)

References 11 publications

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“…Ruiter et al presented a robotic drive system for colonoscopy using a joystick and a touch controller [5]. Fang et al presented a prototype hand held manipulator to motorize a flexible rhinoscope during ENT procedures [6]. Another robotic system is the Hansen catheter system (Sensei) that drives a passive catheter element and relies on visual feedback for navigation.…”

Section: Introductionmentioning

confidence: 99%

Robotically assisted ureteroscopy for kidney exploration

et al. 2017

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Ureteroscopy is a minimally invasive procedure for diagnosis and treatment of a wide range of urinary tract pathologies. It is most commonly performed in the diagnostic work-up of hematuria and the diagnosis and treatment of upper urinary tract malignancies and calculi. Ergonomic and visualization challenges as well as radiation exposure are limitations to conventional ureteroscopy. For example, for diagnostic tumor inspection, the urologist has to maneuver the ureteroscope through each of the 6 to 12 calyces in the kidney under fluoroscopy to ensure complete surveillance. Therefore, we have been developing a robotic system to “power drive” a flexible fiber-optic ureteroscope with 3D tip tracking and pre-operative image overlay. Our goal is to provide the urologist precise control of the ureteroscope tip with less radiation exposure. Our prototype system allows control of the three degrees of freedom of the ureteroscope via brushless motors and a joystick interface. The robot provides a steady platform for controlling the ureteroscope. Furthermore, the robot design facilitates a quick “snap-in” of the ureteroscope, thus allowing the ureteroscope to be mounted midway through the procedure. We have completed the mechanical system and the controlling software and begun evaluation using a kidney phantom. We put MRI-compatible fiducials on the phantom and obtained MR images. We registered these images with the robot using an electromagnetic tracking system and paired-point registration. The system is described and initial evaluation results are given in this paper.

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Section: Introductionmentioning

confidence: 99%

Robotically assisted ureteroscopy for kidney exploration

et al. 2017

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“…Previous studies showed that remote actuation platforms could not yet compete with the efficiency of conventional endoscope control [38,62,71]. The setup of these platforms prevented adequate scope manipulation [62,72,73]. This study shows that our setup and interface enable at least as efficient manipulation of the endoscope and effective visualization of the bowel wall.…”

Section: Discussionmentioning

confidence: 81%

Robotic steering of flexible endoscopes

Rozeboom¹

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SummaryFlexible endoscopes were originally designed for non-invasive inspection of body cavities and hollow organs. Today, they are also used for complex minimal invasive interventions. Control of the endoscope is difficult and complexity rises with interventional procedures. Endoscopists suffer from long learning curves, ergonomic complaints and multi-person control is needed to steer endoscope and instrument(s).Robotics have the potential to overcome these problems. The combined forces of a technical university, mechatronic company and physicians from multiple hospitals led to the design of an add-on robotic platform. The platform aims to improve usability of conventional flexible endoscopes for complex interventions. These interventions require accurate and precise tip steering.This thesis describes the design and clinical evaluation of the platform's tip steering module. An optimal user interface and control algorithm was sought to improve usability of the endoscope in clinical practise.First, critical user aspects of conventional gastro-and colonoscopes were identified and copied to the robotic platform. The control module includes a remote interface that was evaluated by novices in a simulated colonoscopy environment. This study indicated that robotic steering, using a position-controlled touchpad or a ratecontrolled joystick increases efficiency and satisfaction. However, breaking the mechanical linkage between operator and endoscope tip led to a lack of force feedback on tip bending.The first results did not show a clear preference between two regular user interfaces and their control algorithms. A position-controlled touchpad has benefits for precise targeting (instrument placement), whereas a rate-controlled joystick is better suited for quick tip steering (lumen navigation). Endoscopy requires both quick and precise tip motions. The second study describes the design of a non-linear rate iii control algorithm. This study showed that between regular intuitive interfaces, the joystick with non-linear rate control showed highest efficiency and users' preference.A single-handed controller was introduced to further reduce the experienced workload of flexible endoscopy. The controller was compared to a bimanual interface and conventional control in a simulated colonoscopy procedure. Both the single-handed and a bimanual controller reduced the workload of colonoscopy without reducing efficiency or effectiveness. Despite the single-handed approach, novices appeared to steer the endoscope tip and shaft consecutively, not simultaneously. Making bimanual control the logical route to pursue.The first three studies indicated that the platform changed the current routine of handling an endoscope. A fourth study was designed to determine if expert endoscopists and endoscopists in training were able to perform the complex manoeuvres required in colonoscopy. Experts and PhD students without previous hands-on experience trained on a computer simulator to perform colonoscope intubation. Experts needed a relatively short ...

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Feasibility of joystick guided colonoscopy

2015

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The flexible endoscope is increasingly used to perform minimal invasive interventions. A novel add-on platform allows single-person control of both endoscope and instrument at the site of intervention. The setup changes the current routine of handling the endoscope. This study aims to determine if the platform allows effective and efficient manipulation to position the endoscope at potential intervention sites throughout the bowel. Five experts in flexible endoscopy first performed three colonoscopies on a computer simulator using the conventional angulation wheels. Next they trained with the joystick interface to achieve their personal level of intubation time with low pain score. 14 PhD students (novices) without hands-on experience performed the same colonoscopy case using either the conventional angulation wheels or joystick interface. Both novice groups trained to gain the average expert level. The cecal intubation time, pain score and visualization performance (% of bowel wall) were recorded. All experts reached their personal intubation time in 6 ± 6 sessions. Three experts completed their learning curve with low pain score in 8 ± 6 sessions. The novices required 11 ± 6 sessions using conventional angulation wheels, and 12 ± 6 sessions using the joystick interface. There was no difference in the visualization performance between the novice and between the expert groups. This study shows that the add-on platform enables endoscope manipulation required to perform colonoscopy. Experts need only a relatively short training period. Novices are as effective and as efficient in endoscope manipulation when comparing the add-on platform with conventional endoscope control.

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Image-guided steering of a motorized hand-held flexible rhino endoscope in ENT diagnoses

Cited by 6 publications

References 11 publications

Robotically assisted ureteroscopy for kidney exploration

Robotically assisted ureteroscopy for kidney exploration

Robotic steering of flexible endoscopes

Feasibility of joystick guided colonoscopy

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