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Towards automated visual flexible endoscope navigation

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Abstract

Background

The design of flexible endoscopes has not changed significantly in the past 50 years. A trend is observed towards a wider application of flexible endoscopes with an increasing role in complex intraluminal therapeutic procedures. The nonintuitive and nonergonomical steering mechanism now forms a barrier in the extension of flexible endoscope applications. Automating the navigation of endoscopes could be a solution for this problem. This paper summarizes the current state of the art in image-based navigation algorithms. The objectives are to find the most promising navigation system(s) to date and to indicate fields for further research.

Methods

A systematic literature search was performed using three general search terms in two medical–technological literature databases. Papers were included according to the inclusion criteria. A total of 135 papers were analyzed. Ultimately, 26 were included.

Results

Navigation often is based on visual information, which means steering the endoscope using the images that the endoscope produces. Two main techniques are described: lumen centralization and visual odometry. Although the research results are promising, no successful, commercially available automated flexible endoscopy system exists to date.

Conclusions

Automated systems that employ conventional flexible endoscopes show the most promising prospects in terms of cost and applicability. To produce such a system, the research focus should lie on finding low-cost mechatronics and technologically robust steering algorithms. Additional functionality and increased efficiency can be obtained through software development. The first priority is to find real-time, robust steering algorithms. These algorithms need to handle bubbles, motion blur, and other image artifacts without disrupting the steering process.

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Disclosures

N. van der Stap and F. van der Heijden have no conflicts of interest or financial ties to disclose. I. Broeders is partner in the Teleflex project, funded by Pieken in de Delta Oost Nederland (PIDON).

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Authors and Affiliations

  1. Robotics and Minimally Invasive Surgery Group, MIRA Institute for Biomedical Technology and Technical Medicine, Carré 3.623, University of Twente, Drienerlolaan 5, 7500, AE, Enschede, The Netherlands

    Nanda van der Stap & Ivo A. M. J. Broeders

  2. Signals and Systems Group of MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands

    Ferdinand van der Heijden

Authors
  1. Nanda van der Stap
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  2. Ferdinand van der Heijden
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  3. Ivo A. M. J. Broeders
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Corresponding author

Correspondence to Nanda van der Stap.

Appendix

Appendix

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Table 1 Content overview of the included papers
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van der Stap, N., van der Heijden, F. & Broeders, I.A.M.J. Towards automated visual flexible endoscope navigation. Surg Endosc 27, 3539–3547 (2013). https://doi.org/10.1007/s00464-013-3003-7

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