Endoluminal Procedures and Devices for Esophageal Tract Investigation: A Critical Review.

Diseases of the esophageal tract represent a heterogeneous class of pathological conditions for which diagnostic paradigms continue to emerge. In the last few decades, innovative diagnostic devices have been developed, and several attempts have been made to advance and standardize diagnostic algorithms to be compliant with medical procedures. To the best of our knowledge, a comprehensive review of the procedures and available technologies to investigate the esophageal tract was missing in the literature. Therefore, the proposed review aims to provide a comprehensive analysis of available endoluminal technologies and procedures to investigate esophagus health conditions. The proposed systematic review was performed using PubMed, Scopus, and Web of Science databases. Studies have been divided into categories based on the type of evaluation and measurement that the investigated technology provides. In detail, three main categories have been identified, i.e., endoluminal technologies for the (i) morphological, (ii) bio-mechanical, and (iii) electro-chemical evaluation of the esophagus.

Spherical Wrist Manipulator Local Planner for Redundant Tasks in Collaborative Environments.

Standard industrial robotic manipulators use well-established high performing technologies. However, such manipulators do not guarantee a safe Human-Robot Interaction (HRI), limiting their usage in industrial and medical applications. This paper proposes a novel local path planner for spherical wrist manipulators to control the execution of tasks where the manipulator number of joints is redundant. Such redundancy is used to optimize robot motion and dexterity. We present an intuitive parametrization of the end-effector (EE) angular motion, which decouples the rotation of the third joint of the wrist from the rest of the angular motions. Manipulator EE motion is controlled through a decentralized linear system with closed-loop architecture. The local planner integrates a novel collision avoidance strategy based on a potential repulsive vector applied to the EE. Contrary to classic potential field approaches, the collision avoidance algorithm considers the entire manipulator surface, enhancing human safety. The local path planner is simulated in three generic scenarios: (i) following a periodic reference, (ii) a random sequence of step signal references, and (iii) avoiding instantly introduced obstacles. Time and frequency domain analysis demonstrated that the developed planner, aside from better parametrizing redundant tasks, is capable of successfully executing the simulated paths (max error = 0.25°) and avoiding obstacles.

Small bowel to closest human body surface distance calculation through a custom-made software using CT-based datasets.

Screening of the gastrointestinal tract is imperative for the detection and treatment of physiological and pathological disorders in humans. Ingestible devices (e.g., magnetic capsule endoscopes) represent an alternative to conventional flexible endoscopy for reducing the invasiveness of the procedure and the related patient's discomforts. However, to properly design localization and navigation strategies for capsule endoscopes, the knowledge of anatomical features is paramount. Therefore, authors developed a semi-automatic software for measuring the distance between the small bowel and the closest human external body surface, using CT colonography images. In this study, volumetric datasets of 30 patients were processed by gastrointestinal endoscopists with the dedicated custom-made software and results showed an average distance of 79.29 ± 23.85 mm.

A Novel Capacitive Measurement Device for Longitudinal Monitoring of Bone Fracture Healing.

The healing process of surgically-stabilised long bone fractures depends on two main factors: (a) the assessment of implant stability, and (b) the knowledge of bone callus stiffness. Currently, X-rays are the main diagnostic tool used for the assessment of bone fractures. However, they are considered unsafe, and the interpretation of the clinical results is highly subjective, depending on the clinician's experience. Hence, there is the need for objective, non-invasive and repeatable methods to allow a longitudinal assessment of implant stability and bone callus stiffness. In this work, we propose a compact and scalable system, based on capacitive sensor technology, able to measure, quantitatively, the relative pins displacements in bone fractures treated with external fixators. The measurement device proved to be easily integrable with the external fixator pins. Smart arrangements of the sensor units were exploited to discriminate relative movements of the external pins in the 3D space with a resolution of 0.5 mm and 0.5°. The proposed capacitive technology was able to detect all of the expected movements of the external pins in the 3D space, providing information on implant stability and bone callus stiffness.

Robotic-Assisted Colonoscopy Platform with a Magnetically-Actuated Soft-Tethered Capsule.

Background and Aims: Colorectal cancer (CRC) is a major cause of morbidity and mortality worldwide. Despite offering a prime paradigm for screening, CRC screening is often hampered by invasiveness. Endoo is a potentially painless colonoscopy method with an active locomotion tethered capsule offering diagnostic and therapeutic capabilities. Materials and Methods: The Endoo system comprises a soft-tethered capsule, which embeds a permanent magnet controlled by an external robot equipped with a second permanent magnet. Capsule navigation is achieved via closed-loop interaction between the two magnets. Ex-vivo tests were conducted by endoscopy experts and trainees to evaluate the basic key features, usability, and compliance in comparison with conventional colonoscopy (CC) in feasibility and pilot studies. Results: Endoo showed a 100% success rate in operating channel and target approach tests. Progression of the capsule was feasible and repeatable. The magnetic link was lost an average of 1.28 times per complete procedure but was restored in 100% of cases. The peak value of interaction forces was higher in the CC group than the Endoo group (4.12N vs. 1.17N). The cumulative interaction forces over time were higher in the CC group than the Endoo group between the splenic flexure and mid-transverse colon (16.53Ns vs. 1.67Ns, p < 0.001), as well as between the hepatic flexure and cecum (28.77Ns vs. 2.47Ns, p = 0.005). The polyp detection rates were comparable between groups (9.1 ± 0.9% vs. 8.7 ± 0.9%, CC and Endoo respectively, per procedure). Robotic colonoscopies were completed in 67% of the procedures performed with Endoo (53% experts and 100% trainees). Conclusions: Endoo allows smoother navigation than CC and possesses comparable features. Although further research is needed, magnetic capsule colonoscopy demonstrated promising results compared to CC.

Frontiers of Robotic Colonoscopy: A Comprehensive Review of Robotic Colonoscopes and Technologies.

Flexible colonoscopy remains the prime mean of screening for colorectal cancer (CRC) and the gold standard of all population-based screening pathways around the world. Almost 60% of CRC deaths could be prevented with screening. However, colonoscopy attendance rates are affected by discomfort, fear of pain and embarrassment or loss of control during the procedure. Moreover, the emergence and global thread of new communicable diseases might seriously affect the functioning of contemporary centres performing gastrointestinal endoscopy. Innovative solutions are needed: artificial intelligence (AI) and physical robotics will drastically contribute for the future of the healthcare services. The translation of robotic technologies from traditional surgery to minimally invasive endoscopic interventions is an emerging field, mainly challenged by the tough requirements for miniaturization. Pioneering approaches for robotic colonoscopy have been reported in the nineties, with the appearance of inchworm-like devices. Since then, robotic colonoscopes with assistive functionalities have become commercially available. Research prototypes promise enhanced accessibility and flexibility for future therapeutic interventions, even via autonomous or robotic-assisted agents, such as robotic capsules. Furthermore, the pairing of such endoscopic systems with AI-enabled image analysis and recognition methods promises enhanced diagnostic yield. By assembling a multidisciplinary team of engineers and endoscopists, the paper aims to provide a contemporary and highly-pictorial critical review for robotic colonoscopes, hence providing clinicians and researchers with a glimpse of the major changes and challenges that lie ahead.

Visual-Based Defect Detection and Classification Approaches for Industrial Applications-A SURVEY.

This paper reviews automated visual-based defect detection approaches applicable to various materials, such as metals, ceramics and textiles. In the first part of the paper, we present a general taxonomy of the different defects that fall in two classes: visible (e.g., scratches, shape error, etc.) and palpable (e.g., crack, bump, etc.) defects. Then, we describe artificial visual processing techniques that are aimed at understanding of the captured scenery in a mathematical/logical way. We continue with a survey of textural defect detection based on statistical, structural and other approaches. Finally, we report the state of the art for approaching the detection and classification of defects through supervised and non-supervised classifiers and deep learning.

Tactile Decoding of Edge Orientation With Artificial Cuneate Neurons in Dynamic Conditions.

Generalization ability in tactile sensing for robotic manipulation is a prerequisite to effectively perform tasks in ever-changing environments. In particular, performing dynamic tactile perception is currently beyond the ability of robotic devices. A biomimetic approach to achieve this dexterity is to develop machines combining compliant robotic manipulators with neuroinspired architectures displaying computational adaptation. Here we demonstrate the feasibility of this approach for dynamic touch tasks experimented by integrating our sensing apparatus in a 6 degrees of freedom robotic arm via a soft wrist. We embodied in the system a model of spike-based neuromorphic encoding of tactile stimuli, emulating the discrimination properties of cuneate nucleus neurons based on pathways with differential delay lines. These strategies allowed the system to correctly perform a dynamic touch protocol of edge orientation recognition (ridges from 0 to 40°, with a step of 5°). Crucially, the task was robust to contact noise and was performed with high performance irrespectively of sensing conditions (sensing forces and velocities). These results are a step forward toward the development of robotic arms able to physically interact in real-world environments with tactile sensing.