Capsule endoscopy of the future: What's on the horizon?

Capsule endoscopes have evolved from passively moving diagnostic devices to actively moving systems with potential therapeutic capability. In this review, we will discuss the state of the art, define the current shortcomings of capsule endoscopy, and address research areas that aim to overcome said shortcomings. Developments in capsule mobility schemes are emphasized in this text, with magnetic actuation being the most promising endeavor. Research groups are working to integrate sensor data and fuse it with robotic control to outperform today's standard invasive procedures, but in a less intrusive manner. With recent advances in areas such as mobility, drug delivery, and therapeutics, we foresee a translation of interventional capsule technology from the bench-top to the clinical setting within the next 10 years

Nonholonomic Closed-loop Velocity Control of a Soft-tethered Magnetic Capsule Endoscope

In this paper, we demonstrate velocity-level closedloop control of a tethered magnetic capsule endoscope that is actuated via serial manipulator with a permanent magnet at its end-effector. Closed-loop control (2 degrees-of-freedom in position, and 2 in orientation) is made possible with the use of a real-time magnetic localization algorithm that utilizes the actuating magnetic field and thus does not require additional hardware. Velocity control is implemented to create smooth motion that is clinically necessary for colorectal cancer diagnostics. Our control algorithm generates a spline that passes through a set of input points that roughly defines the shape of the desired trajectory. The velocity controller acts in the tangential direction to the path, while a secondary position controller enforces a nonholonomic constraint on capsule motion. A soft nonholonomic constraint is naturally imposed by the lumen while we enforce a strict constraint for both more accurate estimation of tether disturbance and hypothesized intuitiveness for a clinician’s teleoperation. An integrating disturbance force estimation control term is introduced to predict the disturbance of the tether. This paper presents the theoretical formulations and experimental validation of our methodology. Results show the system’s ability to achieve a repeatable velocity step response with low steady-state error as well as ability of the tethered capsule to maneuver around a bend

Doctor of Philosophy

dissertationClosed-loop control of wireless capsule endoscopes is an active area of research because it would drastically improve screening of the gastrointestinal tract. Traditional endoscopic procedures are unable to view the entire gastrointestinal tract and current commercial wireless capsule endoscopes are limited in their effectiveness due to their passive nature. This dissertation advances the field of active capsule endoscopy by developing methods to localize the full six-degree-of-freedom (6-DOF) pose of a screw-type magnetic capsule while it is being propelled through a lumen (such as the small intestines) using an external rotating magnetic dipole. The same external magnetic dipole is utilized for both propulsion and localization. Hardware was designed and constructed to enable testing of the magnetic localization and propulsion methods, including a robotic end-effector used as the external actuator magnet, and a prototype capsule embedded with Hall-effect sensors. Due to the use of a rotating magnetic field for propulsion, at any given time, the capsule can be in one of three regimes: synchronously rotating with the applied field, in "step-out" where it is free to move but the external field is rotating too quickly for the capsule to remain synchronously rotating, or completely stationary. We show that it is only necessary to distinguish whether or not the capsule is synchronously rotating (i.e., a single localization method can be used for a capsule in either the step-out or stationary regimes). Two magnetic localization methods are developed. The first uses nonlinear least squares to estimate the capsule's pose when it has no (or approximately no) net motion (e.g., to find the initial capsule pose or when it is stuck in an intestinal fold). The second method estimates the 6-DOF capsule pose as it synchronously rotates with the applied magnetic field using a square-root variant of the Unscented Kalman filter. A simple process model is adopted that restricts the capsule's movement to translation along and rotation about its principle axis. The capsule is actively propelled forward or backward, but it is not actively steered, rather, steering is provided by the lumen. The propulsion parameters that transform magnetic force and torque to the capsule's spatial velocity and angular velocity are estimated with an additional square-root Unscented Kalman filter to enable the capsule to navigate heterogeneous environments such as the small intestines. An optimized localization-propulsion system is described using the two localization algorithms and prior work in screw-type magnetic capsule propulsion with a single rotating dipole field. The capsule's regime is determined and the corresponding localization method is employed. Based on the capsule's estimated pose and the current estimates of its propulsion parameters, the actuator magnet's pose relative to the capsule is optimized to maximize the capsule's forward propulsion. Using this system, our prototype magnetic capsule successfully completed U-shaped and S-shaped trajectories in fresh bovine intestines with an average forward velocity of 5.5mm/s and 3.5 mm/s, respectively. At this rate it would take approximately 18-30 minutes to traverse the 6 meters of a typical human small intestine

Soft Robot-Assisted Minimally Invasive Surgery and Interventions: Advances and Outlook

Since the emergence of soft robotics around two decades ago, research interest in the field has escalated at a pace. It is fuelled by the industry's appreciation of the wide range of soft materials available that can be used to create highly dexterous robots with adaptability characteristics far beyond that which can be achieved with rigid component devices. The ability, inherent in soft robots, to compliantly adapt to the environment, has significantly sparked interest from the surgical robotics community. This article provides an in-depth overview of recent progress and outlines the remaining challenges in the development of soft robotics for minimally invasive surgery

Explicit Model Predictive Control of a Magnetic Flexible Endoscope

In this letter, explicit model predictive control is applied in conjunction with nonlinear optimization to a magnetically actuated flexible endoscope for the first time. The approach is aimed at computing the motion of the external permanent magnet, given the desired forces and torques. The strategy described here takes advantage of the nonlinear nature of the magnetic actuation and explicitly considers the workspace boundaries, as well as the actuation constraints. Initially, a simplified dynamic model of the tethered capsule, based on the Euler-Lagrange equations is developed. Subsequently, the explicit model predictive control is described and a novel approach for the external magnet positioning, based on a single step, nonlinear optimisation routine, is proposed. Finally, the strategy is implemented on the experimental platform, where bench-top trials are performed on a realistic colon phantom, showing the effectiveness of the technique. The work presented here constitutes an initial exploration for model-based control techniques applied to magnetically manipulated payloads; the techniques described here may be applied to a wide range of devices, including flexible endoscopes and wireless capsules. To our knowledge, this is the first example of advanced closed-loop control of magnetic capsules

A wireless platform for in vivo measurement of resistant properties of the gastrointestinal tract

Abstract Active locomotion of wireless capsule endoscopes has the potential to improve the diagnostic yield of this painless technique for the diagnosis of gastrointestinal tract disease. In order to design effective locomotion mechanisms, a quantitative measure of the propelling force required to effectively move a capsule inside the gastrointestinal tract is necessary. In this study, we introduce a novel wireless platform that is able to measure the force opposing capsule motion, without perturbing the physiologic conditions with physical connections to the outside of the gastrointestinal tract. The platform takes advantage of a wireless capsule that is magnetically coupled with an external permanent magnet. A secondary contribution of this manuscript is to present a real-time method to estimate the axial magnetic force acting on a wireless capsule manipulated by an external magnetic field. In addition to the intermagnetic force, the platform provides real-time measurements of the capsule position, velocity, and acceleration. The platform was assessed with benchtop trials within a workspace that extends 15 cm from each side of the external permanent magnet, showing average error in estimating the force and the position of less than 0.1 N and 10 mm, respectively. The platform was also able to estimate the dynamic behavior of a known resistant force with an error of 5.45%. Finally, an in vivo experiment on a porcine colon model validated th

Characterisation and State Estimation of Magnetic Soft Continuum Robots

Minimally invasive surgery has become more popular as it leads to less bleeding, scarring, pain, and shorter recovery time. However, this has come with counter-intuitive devices and steep surgeon learning curves. Magnetically actuated Soft Continuum Robots (SCR) have the potential to replace these devices, providing high dexterity together with the ability to conform to complex environments and safe human interactions without the cognitive burden for the clinician. Despite considerable progress in the past decade in their development, several challenges still plague SCR hindering their full realisation. This thesis aims at improving magnetically actuated SCR by addressing some of these challenges, such as material characterisation and modelling, and sensing feedback and localisation. Material characterisation for SCR is essential for understanding their behaviour and designing effective modelling and simulation strategies. In this work, the material properties of commonly employed materials in magnetically actuated SCR, such as elastic modulus, hyper-elastic model parameters, and magnetic moment were determined. Additionally, the effect these parameters have on modelling and simulating these devices was investigated. Due to the nature of magnetic actuation, localisation is of utmost importance to ensure accurate control and delivery of functionality. As such, two localisation strategies for magnetically actuated SCR were developed, one capable of estimating the full 6 degrees of freedom (DOFs) pose without any prior pose information, and another capable of accurately tracking the full 6-DOFs in real-time with positional errors lower than 4~mm. These will contribute to the development of autonomous navigation and closed-loop control of magnetically actuated SCR

Challenges of continuum robots in clinical context: a review

With the maturity of surgical robotic systems based on traditional rigid-link principles, the rate of progress slowed as limits of size and controllable degrees of freedom were reached. Continuum robots came with the potential to deliver a step change in the next generation of medical devices, by providing better access, safer interactions and making new procedures possible. Over the last few years, several continuum robotic systems have been launched commercially and have been increasingly adopted in hospitals. Despite the clear progress achieved, continuum robots still suffer from design complexity hindering their dexterity and scalability. Recent advances in actuation methods have looked to address this issue, offering alternatives to commonly employed approaches. Additionally, continuum structures introduce significant complexity in modelling, sensing, control and fabrication; topics which are of particular focus in the robotics community. It is, therefore, the aim of the presented work to highlight the pertinent areas of active research and to discuss the challenges to be addressed before the potential of continuum robots as medical devices may be fully realised