Fl. Nageotte

Robotic Assistance to Flexible Endoscopy by Physiological-Motion Tracking

Flexible endoscopes are used in many diagnostic exams, like gastroscopies or colonoscopies, as well as for small surgical procedures. Recently, they have also been used for endoscopic surgical procedures through natural orifices [natural orifice transluminal endoscopic surgery (NOTES)] and for single-port-access abdominal surgery (SPA). Indeed, flexible endoscopes allow access of operating areas that are not easily reachable with only one small external or internal incision. However, their manipulation is complex, especially for surgical interventions. This study proposes to motorize the flexible endoscope and to partly robotize its movements in order to help the physicians during such interventions. The paper explains how the robotized endoscope can be used to automatically track an area of interest despite breathing motion. The system uses visual servoing and repetitive control strategies and allows stabilization of the endoscopic view. All required parameters are automatically estimated. In vivo experiments show the validity of the proposed solution for the improvement of the manipulation of flexible endoscopes.

Physiological motion rejection in flexible endoscopy using visual servoing

Flexible endoscopes are used in many surgical procedures and diagnostic exams, like in gastroscopy or coloscopy. They have also been used recently for new surgical procedures using natural orifices called NOTES. While these procedures are very promising for the patients, they are quite awkward for the surgeons. The flexible endoscope allows the access to operating areas which are not easily reachable, with small or no incisions; but the manipulation of the system is complex. In order to help the practicians during NOTES or classical interventions with flexible endoscopes, we propose to motorize the system so as to partially robotize the movements. This paper presents the problems in the use of the flexible endoscope and explains how the system can be used to stabilize the endoscope on an area of interest despite physiological motions and therefore to improve the manipulation of the system.

Detection of grey regions in color images : application to the segmentation of a surgical instrument in robotized laparoscopy

In this paper, the detection and localization of grey regions in color images is addressed. This work has been developed in the scope of the robotized laparoscopic surgery, specifically for surgical procedures occurring inside the abdominal cavity. Since very few works have been already published about that purpose, some existing algorithms have been selected and brought together to achieve a robust color segmentation, as fast as possible. The foreseen application is a good training ground to evaluate these algorithms since main difficulties came from the complexity of the scene, the moving background due to breathing motion, the high surface reflectance, the non-uniform and time-varying lighting conditions. Nevertheless, to achieve the image segmentation suitable for robot control, we propose a new approach, without markers, based on a recursive thresholding of the histogram of a new purity color attribute and region growing. The main contribution of this work is threefold and consists in: the definition of a new color purity component, a selection of reliable, fast and robust existing video processings for the above-mentioned application areas, improving some existing video processings to enhance color properties either to homogenize regions and to emphasize the saturation feature of chromatic pixels. The usefulness of the proposed set of sequential processings has been successfully validated with image sequences of an endoscope to efficiently extracting boundaries of a cylindrical needle-holder with a sampling rate of 5 Hz.

Comparison of visual tracking algorithms on in vivo sequences for robot-assisted flexible endoscopic surgery

Flexible endoscopes are used in many diagnostic and interventional procedures. Physiological motions may render the physicians task very difficult to perform. Assistance could be achieved by using motorized endoscopes and real-time visual tracking algorithm to automatically follow a selected target. In order to control the motors, one needs to have an accurate estimation of the motion of the target in the endoscopic view, which requires an efficient tracking algorithm. In this paper, we compare tracking algorithms on various in vivo targets in order to assess their behavior under different conditions. The study shows that among the difficulties which arise when tracking an in vivo target, the change of illumination is paramount. Nevertheless, some algorithms, with minor modifications and without a priori knowledge about the target, achieve very good results.

Physiological motion rejection in flexible endoscopy using visual servoing and repetitive control : Improvements on non-periodic reference tracking and non-periodic disturbance rejection

Flexible endoscopes are used in many surgical procedures and diagnostic exams, like in gastroscopy or coloscopy. They have also been used recently for new surgical procedures using natural orifices called NOTES. While these procedures are very promising for the patients, they are quite awkward for the surgeons. The flexible endoscope allows the access to operating areas which are not easily reachable, with small or no incisions; but the manipulation of the system is complex. In order to help the practicians during NOTES or classical interventions with flexible endoscopes, we propose to motorize the system so as to partially robotize the movements. This paper presents the problems in the use of the flexible endoscope and explains how the system can be used to stabilize the endoscope on an area of interest despite physiological motions and therefore to improve the manipulation of the system.

In vivo comparison of real-time tracking algorithms for interventional flexible endoscopy

Flexible endoscopes are used in many diagnostic and interventional procedures. Physiological motions may render the physicians task very difficult to perform. Assistance could be achieved by using motorized endoscopes and real-time visual tracking algorithm to automatically follow a selected target. In order to control the motors, one needs to have an accurate estimation of the motion of the target in the endoscopic view, which requires an efficient tracking algorithm. In this paper, we compare existing tracking algorithms on various in vivo targets in order to assess their behavior under different conditions. The study shows that several issues have to be overcome by tracking algorithms in in vivo environment like illumination change and forward/backward motions of the target.

Simultaneous Physiological Motion Cancellation and Depth Adaptation in Flexible Endoscopy

Flexible endoscopes are used in many surgical procedures and diagnostic exams. They have also been used recently for new surgical procedures using natural orifices called NOTES. While these procedures are really promising for the patients, they are really awkward for the surgeons. In order to assist the surgeon, physiological motion cancellation has been successfully applied on a robotized endoscope in [8]. However, the stability and performance of the involved controller were ensured only on a small working area, thus preventing the surgeon to manually move the endoscope during motion rejection. We propose in this paper to improve the physiological motion rejection despite depth changes due to the manual manipulation of the system. For this purpose, the complete model of the system is developed and an adaptive predictive controller based on depth estimation is proposed. The validity of the approach is demonstrated in in vitro experiments.