A robotic flexible endoscope with shared autonomy: a study of mockup cholecystectomy
- 58 Downloads
Endoscope is the eye of surgeon in minimally invasive surgery (MIS). Prevailing handheld endoscopes are manually steered, which can cause endoscope-instrument fencing. Robotic endoscopes can reduce the fatigue but could not reduce collisions. Handheld endoscopes with a flexible bending tip can reduce the shaft pivoting and collisions. However, its steering is challenging. In this paper, we present a robotic flexible endoscope with auto-tracking function and compare it with the conventional rigid endoscopes.
A robotic flexible endoscope (RFE) with shared autonomy is developed. The RFE could either track the instruments automatically or be controlled by a foot pedal. A mockup cholecystectomy was designed to evaluate the performance. Five surgeons were invited to perform the mockup cholecystectomy in an abdominal cavity phantom with a manual rigid endoscope (MRE), a robotic rigid endoscope (RRE), and the RFE. Space occupation, time consumption, and questionnaires based on the NASA task load index were adopted to evaluate the performances and compare the three endoscope systems. An ex vivo experiment was conducted to demonstrate the feasibility of using the RFE in a biological tissue environment.
All surgeons completed the mockup cholecystectomy with the RFE independently. Failure occurred in the cases involving the RRE and the MRE. Inside the body cavity, the space occupied when using the RFE is 17.28% and 23.95% (p < 0.05) of that when using the MRE and the RRE, respectively. Outside the body cavity, the space occupied when using the RFE is 14.60% and 15.53% (p < 0.05) of that by using MRE and RRE. Time consumed in the operations with MRE, RRE, and RFE are 28.3 s, 93.2 s and 34.8 s, respectively. Questionnaires reveal that the performance of the RFE is the best among the three endoscope systems.
The RFE provides a wider field of view (FOV) and occupies less space than rigid endoscopes.
KeywordsMinimally invasive surgery Cholecystectomy Robotic flexible endoscope Shared autonomy
This work is supported by the Hong Kong Research Grants Council (RGC) with Project Numbers (14212316, 14207017 and 24204818) and CUHK-SJTU Joint Research Collaboration Fund.
Compliance with ethical standards
Philip Waiyan Chiu serves as the scientific advisory board member of Aptorum Co Ltd and scientific advisory board member of EndoMASTER Pte Ltd. Chengzhi SONG, Xin MA, Xianfeng XIA, Charing CN CHONG, and Zheng LI have no conflict of interest or financial ties to disclose.
- 8.Voros S, Haber GP, Menudet JF, Long JA, Cinquin P (2010) ViKY robotic scope holder: initial clinical experience and preliminary results using instrument tracking. IEEE-ASME T MECH 15(6):879–886Google Scholar
- 17.Ronald C, Rami L, Marc S, Brett C, Marcos M, Todd W (2014) Improving precision and accuracy in laparoscopy using the ENDOEYE FLEX 3D articulating videoscope. https://www.generalsurgerynews.com/Monographs-Whitepapers/Article/04-14/Improving-Precision-and-Accuracy-in-Laparoscopy-Using-the-ENDOEYE-FLEX-3D-Articulating-Videoscope/27350. Accessed 22 Mar 2014
- 20.Luo RC, Wang J, Chang CK, Perng YW (2014, August) Surgeon’s third hand: an assistive robot endoscopic system with intuitive maneuverability for laparoscopic surgery. In: 5th Proceedings of the IEEE RAS EMBS International Conference Biomedical Robotics and Biomechatronics, pp 138–143Google Scholar
- 21.Kazanzides P, Chen Z, Deguet A, Fischer GS, Taylor RH, DiMaio SP (2014, May) An open-source research kit for the da Vinci® Surgical System. In: 2014 IEEE International Conference on Robotics and Automation, pp 6434–6439Google Scholar
- 22.Li Z, Du R (2013) Design and analysis of a bio-inspired wire-driven multi-section flexible robot. IJARS 10(4):209Google Scholar
- 23.Li Z, Ren H, Chiu PWY, Du R, Yu H (2016) A novel constrained wire-driven flexible mechanism and its kinematic analysis. MMT 95:59–75Google Scholar
- 26.O'Donnell CRD, Thomas Eggemeier F (1986) Workload assessment methodology. In: Boff KR, Kaufman L, Thomas JP (eds) Handbook of perception and human performance. Cognitive processes and performance, vol II. Wiley-interscience, New York, p 42-1–42-43Google Scholar