Endoscopic Tactile Capsule for Non-Polypoid Colorectal Tumour Detection

An endoscopic tactile robotic capsule, embedding miniaturized MEMS force sensors, is presented. The capsule is conceived to provide automatic palpation of non-polypoid colorectal tumours during colonoscopy, since it is characterized by high degree of dysplasia, higher invasiveness and lower detection rates with respect to polyps. A first test was performed employing a silicone phantom that embedded inclusions with variable hardness and curvature. A hardness-based classification was implemented, demonstrating detection robustness to curvature variation. By comparing a set of supervised classification algorithms, a weighted 3-nearest neighbor classifier was selected. A bias force normalization model was introduced in order to make different acquisition sets consistent. Parameters of this model were chosen through a particle swarm optimization method. Additionally, an ex-vivo test was performed to assess the capsule detection performance when magnetically-driven along a colonic tissue. Lumps were identified as voltage peaks with a prominence depending on the total magnetic force applied to the capsule. Accuracy of 94 % in hardness classification was achieved, while a 100 % accuracy is obtained for the lump detection within a tolerance of 5 mm from the central path described by the capsule. In real application scenario, we foresee our device aiding physicians to detect tumorous tissues

Prevalence of haptic feedback in robot-mediated surgery : a systematic review of literature

© 2017 Springer-Verlag. This is a post-peer-review, pre-copyedit version of an article published in Journal of Robotic Surgery. The final authenticated version is available online at: https://doi.org/10.1007/s11701-017-0763-4With the successful uptake and inclusion of robotic systems in minimally invasive surgery and with the increasing application of robotic surgery (RS) in numerous surgical specialities worldwide, there is now a need to develop and enhance the technology further. One such improvement is the implementation and amalgamation of haptic feedback technology into RS which will permit the operating surgeon on the console to receive haptic information on the type of tissue being operated on. The main advantage of using this is to allow the operating surgeon to feel and control the amount of force applied to different tissues during surgery thus minimising the risk of tissue damage due to both the direct and indirect effects of excessive tissue force or tension being applied during RS. We performed a two-rater systematic review to identify the latest developments and potential avenues of improving technology in the application and implementation of haptic feedback technology to the operating surgeon on the console during RS. This review provides a summary of technological enhancements in RS, considering different stages of work, from proof of concept to cadaver tissue testing, surgery in animals, and finally real implementation in surgical practice. We identify that at the time of this review, while there is a unanimous agreement regarding need for haptic and tactile feedback, there are no solutions or products available that address this need. There is a scope and need for new developments in haptic augmentation for robot-mediated surgery with the aim of improving patient care and robotic surgical technology further.Peer reviewe

Toward Bio-Inspired Tactile Sensing Capsule Endoscopy for Detection of Submucosal Tumors

© 2016 IEEE. Here, we present a method for lump characterization using a bio-inspired remote tactile sensing capsule endoscopy system. While current capsule endoscopy utilizes cameras to diagnose lesions on the surface of the gastrointestinal tract lumen, this proposal uses remote palpation to stimulate a bio-inspired tactile sensing surface that deforms under the impression of both hard and soft raised objects. Current capsule endoscopy utilizes cameras to visually diagnose lesions on the surface of the gastrointestinal tract. Our approach introduces remote palpation by deploying a bio-inspired tactile sensor that deforms when pressed against soft or hard lumps. This can enhance visual inspection of lesions and provide more information about the structure of the lesions. Using classifier systems, we have shown that lumps of different sizes, shapes, and hardnesses can be distinguished in a synthetic test environment. This is a promising early start toward achieving a remote palpation system used inside the GI tract that will utilize the clinician's sense of touch

Towards tactile sensing active capsule endoscopy

Examination of the gastrointestinal(GI) tract has traditionally been performed using tethered endoscopy tools with limited reach and more recently with passive untethered capsule endoscopy with limited capability. Inspection of small intestines is only possible using the latter capsule endoscopy with on board camera system. Limited to visual means it cannot detect features beneath the lumen wall if they have not affected the lumen structure or colour. This work presents an improved capsule endoscopy system with locomotion for active exploration of the small intestines and tactile sensing to detect deformation of the capsule outer surface when it follows the intestinal wall. In laboratory conditions this system is capable of identifying sub-lumen features such as submucosal tumours.Through an extensive literary review the current state of GI tract inspection in particular using remote operated miniature robotics, was investigated, concluding no solution currently exists that utilises tactile sensing with a capsule endoscopy. In order to achieve such a platform, further investigation was made in to tactile sensing technologies, methods of locomotion through the gut, and methods to support an increased power requirement for additional electronics and actuation. A set of detailed criteria were compiled for a soft formed sensor and flexible bodied locomotion system. The sensing system is built on the biomimetic tactile sensing device, Tactip, \cite{Chorley2008, Chorley2010, Winstone2012, Winstone2013} which has been redesigned to fit the form of a capsule endoscopy. These modifications have required a $360^{o}$ cylindrical sensing surface with $360^{o}$ panoramic optical system. Multi-material 3D printing has been used to build an almost complete sensor assembly with a combination of hard and soft materials, presenting a soft compliant tactile sensing system that mimics the tactile sensing methods of the human finger. The cylindrical Tactip has been validated using artificial submucosal tumours in laboratory conditions. The first experiment has explored the new form factor and measured the device's ability to detect surface deformation when travelling through a pipe like structure with varying lump obstructions. Sensor data was analysed and used to reconstruct the test environment as a 3D rendered structure. A second tactile sensing experiment has explored the use of classifier algorithms to successfully discriminate between three tumour characteristics; shape, size and material hardness. Locomotion of the capsule endoscopy has explored further bio-inspiration from earthworm's peristaltic locomotion, which share operating environment similarities. A soft bodied peristaltic worm robot has been developed that uses a tuned planetary gearbox mechanism to displace tendons that contract each worm segment. Methods have been identified to optimise the gearbox parameter to a pipe like structure of a given diameter. The locomotion system has been tested within a laboratory constructed pipe environment, showing that using only one actuator, three independent worm segments can be controlled. This configuration achieves comparable locomotion capabilities to that of an identical robot with an actuator dedicated to each individual worm segment. This system can be miniaturised more easily due to reduced parts and number of actuators, and so is more suitable for capsule endoscopy. Finally, these two developments have been integrated to demonstrate successful simultaneous locomotion and sensing to detect an artificial submucosal tumour embedded within the test environment. The addition of both tactile sensing and locomotion have created a need for additional power beyond what is available from current battery technology. Early stage work has reviewed wireless power transfer (WPT) as a potential solution to this problem. Methods for optimisation and miniaturisation to implement WPT on a capsule endoscopy have been identified with a laboratory built system that validates the methods found. Future work would see this combined with a miniaturised development of the robot presented. This thesis has developed a novel method for sub-lumen examination. With further efforts to miniaturise the robot it could provide a comfortable and non-invasive procedure to GI tract inspection reducing the need for surgical procedures and accessibility for earlier stage of examination. Furthermore, these developments have applicability in other domains such as veterinary medicine, industrial pipe inspection and exploration of hazardous environments

An experimental investigation of sensory feedback methods within teleoperation robotic systems

This project serves as an experimental investigation into sensory feedback methods within teleoperation applications, focusing on vibration feedback and visual cues. A bilateral teleoperation system is developed on a semi humanoid industrial inspired robot using HTC Vive tracking technology as a control method. The design and implementation of a dual touch and proximity sensing system is documented along with the development of novel visual and vibration feedback systems. A study scenario with defined assessment criteria is outlined to evaluate the impact of the multiple feedback methods in relation to overall completion time, error rate, perceived workload (using NASA-TLX) and frustration. A 24 participant study is presented, with results demonstrating no significant findings in relation to the reduction of task completion time and error rate with the additional feedback systems. However, there are significant findings showing a consistent reduction of perceived workload across all tasks, due to the integration of vibration feedback

Imaging skins: stretchable and conformable on-organ beta particle detectors for radioguided surgery

While radioguided surgery (RGS) traditionally relied on detecting gamma rays, direct detection of beta particles could facilitate the detection of tumour margins intraoperatively by reducing radiation noise emanating from distant organs, thereby improving the signal-to-noise ratio of the imaging technique. In addition, most existing beta detectors do not offer surface sensing or imaging capabilities. Therefore, we explore the concept of a stretchable scintillator to detect beta-particles emitting radiotracers that would be directly deployed on the targeted organ. Such detectors, which we refer to as imaging skins, would work as indirect radiation detectors made of light-emitting agents and biocompatible stretchable material. Our vision is to detect scintillation using standard endoscopes routinely employed in minimally invasive surgery. Moreover, surgical robotic systems would ideally be used to apply the imaging skins, allowing for precise control of each component, thereby improving positioning and task repeatability. While still in the exploratory stages, this innovative approach has the potential to improve the detection of tumour margins during RGS by enabling real-time imaging, ultimately improving surgical outcomes

Distributed Sensing and Stimulation Systems Towards Sense of Touch Restoration in Prosthetics

Modern prostheses aim at restoring the functional and aesthetic characteristics of the lost limb. To foster prosthesis embodiment and functionality, it is necessary to restitute both volitional control and sensory feedback. Contemporary feedback interfaces presented in research use few sensors and stimulation units to feedback at most two discrete feedback variables (e.g. grasping force and aperture), whereas the human sense of touch relies on a distributed network of mechanoreceptors providing high-fidelity spatial information. To provide this type of feedback in prosthetics, it is necessary to sense tactile information from artificial skin placed on the prosthesis and transmit tactile feedback above the amputation in order to map the interaction between the prosthesis and the environment. This thesis proposes the integration of distributed sensing systems (e-skin) to acquire tactile sensation, and non-invasive multichannel electrotactile feedback and virtual reality to deliver high-bandwidth information to the user. Its core focus addresses the development and testing of close-loop sensory feedback human-machine interface, based on the latest distributed sensing and stimulation techniques for restoring the sense of touch in prosthetics. To this end, the thesis is comprised of two introductory chapters that describe the state of art in the field, the objectives and the used methodology and contributions; as well as three studies distributed over stimulation system level and sensing system level. The first study presents the development of close-loop compensatory tracking system to evaluate the usability and effectiveness of electrotactile sensory feedback in enabling real-time close-loop control in prosthetics. It examines and compares the subject\u2019s adaptive performance and tolerance to random latencies while performing the dynamic control task (i.e. position control) and simultaneously receiving either visual feedback or electrotactile feedback for communicating the momentary tracking error. Moreover, it reported the minimum time delay needed for an abrupt impairment of users\u2019 performance. The experimental results have shown that electrotactile feedback performance is less prone to changes with longer delays. However, visual feedback drops faster than electrotactile with increased time delays. This is a good indication for the effectiveness of electrotactile feedback in enabling close- loop control in prosthetics, since some delays are inevitable. The second study describes the development of a novel non-invasive compact multichannel interface for electrotactile feedback, containing 24 pads electrode matrix, with fully programmable stimulation unit, that investigates the ability of able-bodied human subjects to localize the electrotactile stimulus delivered through the electrode matrix. Furthermore, it designed a novel dual parameter -modulation (interleaved frequency and intensity) and compared it to conventional stimulation (same frequency for all pads). In addition and for the first time, it compared the electrotactile stimulation to mechanical stimulation. More, it exposes the integration of virtual prosthesis with the developed system in order to achieve better user experience and object manipulation through mapping the acquired real-time collected tactile data and feedback it simultaneously to the user. The experimental results demonstrated that the proposed interleaved coding substantially improved the spatial localization compared to same-frequency stimulation. Furthermore, it showed that same-frequency stimulation was equivalent to mechanical stimulation, whereas the performance with dual-parameter modulation was significantly better. The third study presents the realization of a novel, flexible, screen- printed e-skin based on P(VDF-TrFE) piezoelectric polymers, that would cover the fingertips and the palm of the prosthetic hand (particularly the Michelangelo hand by Ottobock) and an assistive sensorized glove for stroke patients. Moreover, it developed a new validation methodology to examine the sensors behavior while being solicited. The characterization results showed compatibility between the expected (modeled) behavior of the electrical response of each sensor to measured mechanical (normal) force at the skin surface, which in turn proved the combination of both fabrication and assembly processes was successful. This paves the way to define a practical, simplified and reproducible characterization protocol for e-skin patches In conclusion, by adopting innovative methodologies in sensing and stimulation systems, this thesis advances the overall development of close-loop sensory feedback human-machine interface used for restoration of sense of touch in prosthetics. Moreover, this research could lead to high-bandwidth high-fidelity transmission of tactile information for modern dexterous prostheses that could ameliorate the end user experience and facilitate it acceptance in the daily life