Search Results (35)

Inspired by the musculoskeletal structure of snakes, this study proposes a cable-driven continuum robotic system, comprising a dual-segment continuum arm and a linear feeding module. The continuum arm provides four joint degrees of freedom through coordinated cable actuation for snake-like bending, while the feeding module enables linear translation along the Z-axis, resulting in a total of five degrees of freedom. A constant-curvature kinematic model is developed, and a real-time inverse kinematics solution based on fifth-order Taylor expansion is proposed. To enhance postural stability, a master–slave teleoperation control framework is implemented that decouples translational motion from orientation control. Leveraging the geometric symmetry of its dual-segment design, the system achieves consistent end-effector orientation by coordinating bending angles and rotation directions between segments. Simulation and experimental results validate the accuracy of the kinematic model and demonstrate the robot’s capability for dexterous, stable movements in confined environments. The proposed continuum robot offers high positioning accuracy, structural adaptability, and strong potential for bioinspired applications in endoscopy and minimally invasive surgical procedures. Full article

Capsule endoscopy (CE) has revolutionized gastrointestinal (GI) diagnostics by providing a non-invasive, patient-centered approach to observing the digestive tract. Conceived in 2000 by Gavriel Iddan, CE employs a diminutive, ingestible capsule containing a high-resolution camera, LED lighting, and a power supply. It specializes in visualizing the small intestine, a region frequently unreachable by conventional endoscopy. CE helps detect and monitor disorders, such as unexplained gastrointestinal bleeding, Crohn’s disease, and cancer, while presenting a lower procedural risk than conventional endoscopy. Contrary to conventional techniques that necessitate anesthesia, CE reduces patient discomfort and complications. Nonetheless, its constraints, specifically the incapacity to conduct biopsies or therapeutic procedures, have spurred technical advancements. Five primary types of capsule endoscopes have emerged: steerable, magnetic, robotic, tethered, and hybrid. Their performance varies substantially. For example, the image sizes vary from 256 × 256 to 640 × 480 pixels, the fields of view (FOV) range from 140° to 360°, the battery life is between 8 and 15 h, and the frame rates fluctuate from 2 to 35 frames per second, contingent upon motion-adaptive capture. This study addresses a significant gap by methodically evaluating CE platforms, outlining their clinical preparedness, and examining the underexploited potential of artificial intelligence in improving diagnostic precision. Through the examination of technical requirements and clinical integration, we highlight the progress made in overcoming existing CE constraints and outline prospective developments for next-generation GI diagnostics. Full article

The fifth annual REFLECT (The futuRE oF MinimalLy InvasivE GI and Capsule diagnosTics) symposium, held in October 2024 in Nyborg, Denmark, focused on advancements in minimally invasive gastrointestinal (GI) diagnostics, particularly capsule endoscopy (CE) technologies. Key discussions included clinical updates, innovations in hardware and software, and the growing role of colon CE (CCE) in colorectal cancer screening. The event provided a platform for clinicians, engineers, industry representatives, and scientists to exchange knowledge and present the latest advancements in the field. Discussions covered clinical studies, future research protocols, and technological innovations, with also a notable focus on commercial solutions and expansion of the implementation of capsule endoscopy. The symposium also highlighted the significance of predictive models for patient selection and developments in panenteric CE. Innovative technologies presented included robotics for drug delivery and magnetic endoscopic guidance systems. AI advancements were discussed for their potential to reduce diagnostic fatigue and standardize image interpretation, but ethical concerns and the need for transparent algorithms remain. The importance of multidisciplinary collaboration was emphasized to bridge innovation and clinical practice. Home-based CCE delivery emerged as a promising model, despite mixed results from environmental impact assessments. Overall, REFLECT 2024 reinforced the clinical utility and challenges of capsule-based diagnostics, advocating for ongoing interdisciplinary research to support safe and effective integration into healthcare systems. Full article

Current wireless capsule endoscopy (WCE) is limited in the long examination time and low flexibility since the capsule is passively moved by the natural peristalsis. Efforts have been made to facilitate the active locomotion of WCE using magnetic actuation and localization technologies. This work focuses on the motion control of the robotic capsule under magnetic actuation in a complex gastrointestinal (GI) tract environment in order to improve the efficiency and accuracy of its motion in dynamic, complex environments. Specifically, a magnetic actuation system based on a four-electromagnetic coil module is designed, and a control strategy for the system is proposed. In particular, the proportional–integral–derivative (PID) control parameters and current values are optimized online and in real time using the adaptive particle swarm optimization (APSO) algorithm. In this paper, both simulations and real-world experiments were conducted using acrylic plates with irregular shapes to simulate the GI tract environment for evaluation. The results demonstrate the potential of the proposed control methods to realize the accurate and efficient inspection of the intestine using active WCE. The methods presented in this paper can be integrated with current WCE to improve the diagnostic accuracy and efficiency of the GI tract. Full article

This paper presents a minimally invasive surgical robot system for endoluminal gastrointestinal endoscopy through natural orifices. In minimally invasive gastrointestinal endoscopic surgery (MIGES), surgical instruments need to pass through narrow endoscopic channels to perform highly flexible tasks, imposing strict constraints on the size of the surgical robot while requiring it to possess a certain gripping force and flexibility. Therefore, we propose a novel minimally invasive robot system with advantages such as compact size and high precision. The system consists of an endoscope, two compact flexible continuum mechanical arms with diameters of 3.4 mm and 2.4 mm, respectively, and their driving systems, totaling nine degrees of freedom. The robot’s driving system employs bidirectional ball-screw-driven motion of two ropes simultaneously, converting the choice of opening and closing of the instrument’s end into linear motion, facilitating easier and more precise control of displacement when in position closed-loop control. By means of coordinated operation of the terminal surgical tools, tasks such as grasping and peeling can be accomplished. This paper provides a detailed analysis and introduction of the system. Experimental results validate the robot’s ability to grasp objects of 3 N and test the system’s accuracy and payload by completing basic operations, such as grasping and peeling, thereby preliminarily verifying the flexibility and coordination of the robot’s operation in a master–slave configuration. Full article

This contribution is intended to provide researchers with a comprehensive overview of the current state-of-the-art concerning real-time 3D reconstruction methods suitable for medical endoscopy. Over the past decade, there have been various technological advancements in computational power and an increased research effort in many computer vision fields such as autonomous driving, robotics, and unmanned aerial vehicles. Some of these advancements can also be adapted to the field of medical endoscopy while coping with challenges such as featureless surfaces, varying lighting conditions, and deformable structures. To provide a comprehensive overview, a logical division of monocular, binocular, trinocular, and multiocular methods is performed and also active and passive methods are distinguished. Within these categories, we consider both flexible and non-flexible endoscopes to cover the state-of-the-art as fully as possible. The relevant error metrics to compare the publications presented here are discussed, and the choice of when to choose a GPU rather than an FPGA for camera-based 3D reconstruction is debated. We elaborate on the good practice of using datasets and provide a direct comparison of the presented work. It is important to note that in addition to medical publications, publications evaluated on the KITTI and Middlebury datasets are also considered to include related methods that may be suited for medical 3D reconstruction. Full article

Endoscopy has made a significant and noteworthy contribution to the field of medical science and technology. Nevertheless, its potential remains constrained due to the limited availability of rigid or flexible endoscopes. This paper introduces a novel hydraulic actuator based on electrorheological fluid (ERF) as a pivotal advancement in bridging the existing gap within the realm of endoscopy. Following a comprehensive introduction that briefly outlines the electrorheological effect, the subsequent section is dedicated to the elucidation of the actuator’s development process. Challenges arise, particularly in terms of miniaturization and the realization of a hydraulically sealed system with integrated valve electrodes. An internal electrorheological valve system consisting of four valves that are controlled using a pulse-width modulated high voltage was suitable for position control of the antagonistic hydraulic actuators. High-precision stereolithography (SLA) printing has proven practical for manufacturing actuator components. For functional testing, a test bench was set up in which the actuator follows a setpoint through a PI control loop. The control deviation ranged from 0.6 to 1 degree, with a response time between 6 and 8 s. The experiments have demonstrated that through the use of ERF and integrated valve electrodes, a miniaturized functional actuator can be constructed. Full article

Flexible endoscopy, initially developed for diagnosis and tissue sampling, has been adapted for therapeutic interventions, leading to the emergence of natural orifice transluminal endoscopic surgery (NOTES) in the 2000s. The need for a triangulation function to enhance the intuitiveness and safety of NOTES has prompted the development of dual-arm, flexible endoscopic robotic platforms. Although the global interest in NOTES has decreased in the last decade, no-scar surgery concepts are still being applied to other complex endoluminal interventions, such as endoscopic submucosal dissection (ESD) and endoscopic full-thickness resection (EFTR), with ongoing research and development. The application of robotics in flexible endoscopy may facilitate the standardization of these procedures and expedite their global spread. Various robotic platforms have been developed and tested in the preclinical and clinical settings to demonstrate their efficacy and safety. In this article, we review the publications on technology and elucidate their advantages and existing challenges. Full article

In the early 2000s, the introduction of single-camera wireless capsule endoscopy (CE) redefined small bowel study. Progress continued with the development of double-camera devices, first for the colon and rectum, and then, for panenteric assessment. Advancements continued with magnetic capsule endoscopy (MCE), particularly when assisted by a robotic arm, designed to enhance gastric evaluation. Indeed, as CE provides full visualization of the entire gastrointestinal (GI) tract, a minimally invasive capsule panendoscopy (CPE) could be a feasible alternative, despite its time-consuming nature and learning curve, assuming appropriate bowel cleansing has been carried out. Recent progress in artificial intelligence (AI), particularly in the development of convolutional neural networks (CNN) for CE auxiliary reading (detecting and diagnosing), may provide the missing link in fulfilling the goal of establishing the use of panendoscopy, although prospective studies are still needed to validate these models in actual clinical scenarios. Recent CE advancements will be discussed, focusing on the current evidence on CNN developments, and their real-life implementation potential and associated ethical challenges. Full article

Three-dimensional reconstruction technology based on binocular stereo vision is a key research area with potential clinical applications. Mainstream research has focused on sparse point reconstruction within the soft tissue domain, limiting the comprehensive 3D data acquisition required for effective surgical robot navigation. This study introduces a new paradigm to address existing challenges. An innovative stereoscopic endoscopic image correction algorithm is proposed, exploiting intrinsic insights into stereoscopic calibration parameters. The synergy between the stereoscopic endoscope parameters and the disparity map derived from the cardiac soft tissue images ultimately leads to the acquisition of precise 3D points. Guided by deliberate filtering and optimization methods, the triangulation process subsequently facilitates the reconstruction of the complex surface of the cardiac soft tissue. The experimental results strongly emphasize the accuracy of the calibration algorithm, confirming its utility in stereoscopic endoscopy. Furthermore, the image rectification algorithm exhibits a significant reduction in vertical parallax, which effectively enhances the stereo matching process. The resulting 3D reconstruction technique enables the targeted surface reconstruction of different regions of interest in the cardiac soft tissue landscape. This study demonstrates the potential of binocular stereo vision-based 3D reconstruction techniques for integration into clinical settings. The combination of joint calibration algorithms, image correction innovations, and precise tissue reconstruction enhances the promise of improved surgical precision and outcomes in the field of cardiac interventions. Full article

GI endoscopy forms an important part in the daily practice of a gastroenterologist. Musculoskeletal injuries related to GI endoscopy are on the rise. Observational studies and surveys depict the importance of a proper ergonomic environment when performing GI endoscopy. Our aim is to describe the pathophysiology, risk factors and possible preventive measures to reduce the risk of musculoskeletal injuries during gastrointestinal (GI) endoscopy. We review the most relevant studies that outline the gravity of the problem. A detailed analysis of proposed ergonomic recommendations is performed, outlining crucial steps in injury prevention. Proper ergonomic education is a key step in preventing occupational injury. Robotics and other mechanical solutions offer a variety of approaches to tackling the ergonomic challenge. Implementing proper ergonomic education and mechanical solutions lowers the possibility of occupational injury. The strategies and appliances presented are beneficial to all GI endoscopy practitioners. Full article

Lower gastrointestinal endoscopy is considered the gold standard for the diagnosis and removal of colonic polyps. Delays in colonoscopy following a positive fecal immunochemical test increase the likelihood of advanced adenomas and colorectal cancer (CRC) occurrence. However, patients may refuse to undergo conventional colonoscopy (CC) due to fear of possible risks and pain or discomfort. In this regard, patients undergoing CC frequently require sedation to better tolerate the procedure, increasing the risk of deep sedation or other complications related to sedation. Accordingly, the use of CC as a first-line screening strategy for CRC is hampered by patients’ reluctance due to its invasiveness and anxiety about possible discomfort. To overcome the limitations of CC and improve patients’ compliance, several studies have investigated the use of robotic colonoscopy (RC) both in experimental models and in vivo. Self-propelling robotic colonoscopes have proven to be promising thanks to their peculiar dexterity and adaptability to the shape of the lower gastrointestinal tract, allowing a virtually painless examination of the colon. In some instances, when alternatives to CC and RC are required, barium enema (BE), computed tomographic colonography (CTC), and colon capsule endoscopy (CCE) may be options. However, BE and CTC are limited by the need for subsequent investigations whenever suspicious lesions are found. In this narrative review, we discussed the current clinical applications of RC, CTC, and CCE, as well as the advantages and disadvantages of different endoscopic procedures, with a particular focus on RC. Full article

Small living organisms such as lizards possess naturally built functional surface textures that enable them to walk or climb on versatile surface topographies. Bio-mimicking the surface characteristics of these geckos has enormous potential to improve the accessibility of modern robotics. Therefore, gecko-inspired adhesives have significant industrial applications, including robotic endoscopy, bio-medical cleaning, medical bandage tapes, rock climbing adhesives, tissue adhesives, etc. As a result, synthetic adhesives have been developed by researchers, in addition to dry fibrillary adhesives, elastomeric adhesives, electrostatic adhesives, and thermoplastic adhesives. All these adhesives represent significant contributions towards robotic grippers and gloves, depending on the nature of the application. However, these adhesives often exhibit limitations in the form of fouling, wear, and tear, which restrict their functionalities and load-carrying capabilities in the natural environment. Therefore, it is essential to summarize the state of the art attributes of contemporary studies to extend the ongoing work in this field. This review summarizes different adhesion mechanisms involving gecko-inspired adhesives and attempts to explain the parameters and limitations which have impacts on adhesion. Additionally, different novel adhesive fabrication techniques such as replica molding, 3D direct laser writing, dip transfer processing, fused deposition modeling, and digital light processing are encapsulated. Full article

Background: Esophagectomy for cancer is one of the most complex procedures in visceral surgery. Postoperative complications negatively affect the patient’s overall survival. They are not influenced by the histology type (adenocarcinoma (AC)/squamous cell carcinoma (SCC)), or the surgical approach (open, laparoscopic, or robotic-assisted). Among those dreadful complications are anastomotic leak (AL), esophago-respiratory fistula (ERF), and chylothorax (CT). Methods: In this review, we summarize the methods to avoid these complications, the diagnostic approach, and new therapeutic strategies. Results: In the last 20 years, both centralization of the medical care, and the development of endoscopy and radiology have positively influenced the management of postoperative complications. For the purpose of their prevention, perioperative measures have been applied. The treatment includes conservative, endoscopic, and surgical approaches. Conclusions: Post-esophagectomy complications are common. Prevention measures should be known. Early recognition and adequate treatment of these complications save lives and lead to better outcomes. Full article

An endoscopy is a tool that is used to examine the interior of a hollow organ or cavity of the body by inserting directly into the organ. However, intestinal endoscopy is not friendly to patients due to discomfort, and it can easily cause intestinal damage or even perforation due to the use of the rigid materials of the endoscopy. Here, we provide an earthworm-based intestinal soft robot equipped with a gripper for application on intestinal exams or surgery. The intestinal soft robot is composed of a frontal radial actuator, a central axial actuator, a rear radial actuator and a gripper. The first three actuators drive the robot to move freely in some specific pipes by altering its own deformation, and the gripper, fixed at the end of the frontal radial actuator, is used to pick up “foreign bodies” into and out of the pipes for the purpose of intestinal applications. The different experiments validated that the intestinal soft robot could move forward and backward autonomously in a rigid pipe, a flexible pipe, and a mucus-containing pipe and could extract objects from these pipes. The ultimate weight that the intestinal soft robot extracts is up to 220 g, and the maximum moving speed is 12.0 cm/min in the rigid pipe. This intestinal soft robot is non-destructive to the operating environment, providing a friendly and novel method for the application of intestinal diseases. Full article