Robotic assistance to flexible endoscopy by physiological motion tracking
Epublication WebSurg.com, Sep 2014;14(09). URL: http://websurg.com/doi/lt03endemathelin001
New techniques are currently under development for minimally invasive surgery with the objective to perform surgery without visible scars. Single port access surgery is one of the approaches, natural orifice endoluminal or transluminal surgery is the other one. The latter is based on the use of flexible endoscopes and instruments which are introduced inside the patient through natural orifices such as the mouth or the anus. This type of surgery is quite complex. It relies on the use of flexible instruments which allow the surgeon or the endoscopist to control the orientation of the endoscope's head as well as the instruments inside the channels. Two surgeons are often required to work simultaneously. The ICube laboratory and the IRCAD institute have developed a robotic platform for endoluminal and transluminal surgery with a flexible endoscope and two flexible instruments that can be efficiently telemanipulated by one surgeon. Physiological motions of organs are difficult to compensate in manual procedures while controlling flexible instruments. By using automatic visual tracking of the anatomical target, the robotized flexible endoscope can follow the moving organ at a constant distance. This feature provides the surgeons the perception of a non-mobile surgical environment while the organ is moving. This feature has been tested and validated in vivo using porcine models.