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

Closed Loop Control of a Tethered Magnetic Capsule Endoscope

Magnetic field gradients have repeatedly been shown to be the most feasible mechanism for gastrointestinal capsule endoscope actuation. An inverse quartic magnetic force variation with distance results in large force gradients induced by small movements of a driving magnet; this necessitates robotic actuation of magnets to implement stable control of the device. A typical system consists of a serial robot with a permanent magnet at its end effector that actuates a capsule with an embedded permanent magnet. We present a tethered capsule system where a capsule with an embedded magnet is closed loop controlled in 2 degree-of-freedom in position and 2 degree-offreedom in orientation. Capitalizing on the magnetic field of the external driving permanent magnet, the capsule is localized in 6- D allowing for both position and orientation feedback to be used in a control scheme. We developed a relationship between the serial robot’s joint parameters and the magnetic force and torque that is exerted onto the capsule. Our methodology was validated both in a dynamic simulation environment where a custom plug-in for magnetic interaction was written, as well as on an experimental platform. The tethered capsule was demonstrated to follow desired trajectories in both position and orientation with accuracy that is acceptable for colonoscopy

Jacobian-Based Iterative Method for Magnetic Localization in Robotic Capsule Endoscopy

The purpose of this study is to validate a Jacobian-based iterative method for real-time localization of magnetically controlled endoscopic capsules. The proposed approach applies finite-element solutions to the magnetic field problem and least-squares interpolations to obtain closed-form and fast estimates of the magnetic field. By defining a closed-form expression for the Jacobian of the magnetic field relative to changes in the capsule pose, we are able to obtain an iterative localization at a faster computational time when compared with prior works, without suffering from the inaccuracies stemming from dipole assumptions. This new algorithm can be used in conjunction with an absolute localization technique that provides initialization values at a slower refresh rate. The proposed approach was assessed via simulation and experimental trials, adopting a wireless capsule equipped with a permanent magnet, six magnetic field sensors, and an inertial measurement unit. The overall refresh rate, including sensor data acquisition and wireless communication was 7 ms, thus enabling closed-loop control strategies for magnetic manipulation running faster than 100 Hz. The average localization error, expressed in cylindrical coordinates was below 7 mm in both the radial and axial components and 5° in the azimuthal component. The average error for the capsule orientation angles, obtained by fusing gyroscope and inclinometer measurements, was below 5°

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

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

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 the feasibility of measuring the resistant force in opposition to magnetic propulsion of a wireless capsule

Six DOF Motion Estimation for Teleoperated Flexible Endoscopes Using Optical Flow: A Comparative Study

Colorectal cancer is one of the leading causes of cancer-related deaths worldwide, although it can be effectively treated if detected early. Teleoperated flexible endoscopes are an emerging technology to promote participation in these preventive screenings. Real-time pose estimation is therefore essential to enable feedback to the robotic endoscope's control system. Vision-based endoscope localization approaches are a promising avenue, since they do not require extra sensors on board the endoscopes. In this work, we compare several state-of-the-art algorithms for computing the image motion (optical flow), which is then used with a supervised learning strategy to provide an accurate estimate of the 6 degree of freedom endoscope motion. The method is validated using a robotically actuated endoscope in a human colon simulator, and represents a preliminary effort towards testing with clinical video data

Design, Fabrication, and Testing of a Capsule With Hybrid Locomotion for Gastrointestinal Tract Exploration

Abstract—This paper describes a novel solution for the active lo-comotion of a miniaturized endoscopic capsule in the gastrointesti-nal (GI) tract. The authors present the design, development, and testing of a wireless endocapsule with hybrid locomotion, where hybrid locomotion is defined as the combination between internal actuation mechanisms and external magnetic dragging. The cap-sule incorporates an internal actuating legged mechanism, which modifies the capsule profile, and small permanent magnets, which interact with an external magnetic field, thus imparting a dragging motion to the device. The legged mechanism is actuated whenever the capsule gets lodged in collapsed areas of the GI tract. This allows modification of the capsule profile and enables magnetic dragging to become feasible and effective once again. A key com-ponent of the endoscopic pill is the internal mechanism, endowed with a miniaturized brushless motor and featuring compact design, and adequate mechanical performance. The internal mechanism is able to generate a substantial force, which allows the legs to open against the intestinal tissue that has collapsed around the capsule body. An accurate simulation of the performance of the minia-turized motor under magnetic fields was carried out in order to define the best configuration of the internal permanent magnets (which are located very close to the motor) and the best tradeoff operating distance for the external magnet, which is responsible for magnetically dragging the capsule. Finally, a hybrid capsule was developed generating 3.8 N at the tip of the legged mechanism and a magnetic link force up to 135 mN. The hybrid capsule and its wireless control were extensively tested in vitro, ex vivo, and in vivo, thus confirming fulfilment of the design specifications and demon-strating a good ability to manage collapsed areas of the intestinal tract. Index Terms—Capsule endoscopy, endoscopic capsule, magnetic locomotion, robotic surgery. I

SMAC — A Modular Open Source Architecture for Medical Capsule Robots

The field of Medical Capsule Robots (MCRs) is gaining momentum in the robotics community, with applications spanning from abdominal surgery to gastrointestinal (GI) endoscopy. MCRs are miniature multifunctional devices usually constrained in both size and on-board power supply. The design process for MCRs is time consuming and resource intensive, as it involves the development of custom hardware and software components. In this work, we present the STORM Lab Modular Architecture for Capsules (SMAC), a modular open source architecture for MCRs aiming to provide the MCRs research community with a tool for shortening the design and development time for capsule robots. The SMAC platform consists of both hardware modules and firmware libraries that can be used for developing MCRs. In particular, the SMAC modules are miniature boards of uniform diameter (i.e., 9.8 mm) that are able to fulfill five different functions: signal coordination combined with wireless data transmission, sensing, actuation, powering and vision/illumination. They are small in size, low power, and have reconfigurable software libraries for the Hardware Abstraction Layer (HAL), which has been proven to work reliably for different types of MCRs. A design template for a generic SMAC application implementing a robust communication protocol is presented in this work, together with its finite state machine abstraction, capturing all the architectural components involved. The reliability of the wireless link is assessed for different levels of data transmission power and separation distances. The current consumption for each SMAC module is quantified and the timing of a SMAC radio message transmission is characterized. Finally, the applicability of SMAC in the field of MCRs is discussed by analysing examples from the literature

Laparoscopic Camera Based on an Orthogonal Magnet Arrangement

In this letter, we present for the first time a magnetic anchoring-actuation link with an auto-flip feature. This orthogonal magnetic arrangement relies on the placement of two permanent magnets such that their magnetic moments are respectfully orthogonal. Though the arrangement may have many applications, in this study we integrate it in a small factor magnetic camera for minimally invasive procedures. Upon insertion through a trocar incision, the 5.5 mm diameter and 35 mm length magnetic camera is coupled with an external robotic controller and displaced from the port thus preventing clutter of the surgical workspace. The device allows for manual lateral translation as well as robotically controlled tilt and pan, resulting in four degrees of freedom. The auto-flip feature prevents the need for image adjustment in software as the camera tilts through its hemispherical workspace. A static model that relates an input external control tilt and output camera tilt has been developed and validated. Favorable results during bench and canine cadaver evaluation suggest promise for the proposed magnetic camera to improve the state of art in minimally invasive surgical procedures

Computational Design of Magnetic Soft Shape-Forming Catheters using the Material Point Method

Magnetic Soft Catheters (MSCs) are capable of miniaturization due to the use of an external magnetic field for actuation. Through careful design of the magnetic elements within the MSC and the external magnetic field, the shape along the full length of the catheter can be precisely controlled. However, modeling of the magnetic-soft material is challenging due to the complex relationship between magnetic and elastic stresses within the material. Approaches based on traditional Finite Element Methods (FEM) lead to high computation time and rely on proprietary implementations. In this work, we showcase the use of our recently presented open-source simulation framework based on the Material Point Method (MPM) for the computational design of magnetic soft catheters to realize arbitrary shapes in 3D, and to facilitate follow-the-leader shape-forming insertion.Comment: 3 pages, 2 figure