Intraoperative Robotic-Assisted Large-Area High-Speed Microscopic Imaging and Intervention.

OBJECTIVE: Probe-based confocal endomicroscopy is an emerging high-magnification optical imaging technique that provides in vivo and in situ cellular-level imaging for real-time assessment of tissue pathology. Endomicroscopy could potentially be used for intraoperative surgical guidance, but it is challenging to assess a surgical site using individual microscopic images due to the limited field-of-view and difficulties associated with manually manipulating the probe. METHODS: In this paper, a novel robotic device for large-area endomicroscopy imaging is proposed, demonstrating a rapid, but highly accurate, scanning mechanism with image-based motion control, which is able to generate histology-like endomicroscopy mosaics. The device also includes, for the first time in robotic-assisted endomicroscopy, the capability to ablate tissue without the need for an additional tool. RESULTS: The device achieves preprogrammed trajectories with positioning accuracy of less than 30 [Formula: see text], while the image-based approach demonstrated that it can suppress random motion disturbances up to [Formula: see text]. Mosaics are presented from a range of ex vivo human and animal tissues, over areas of more than [Formula: see text], scanned in approximate [Formula: see text]. CONCLUSION: This paper demonstrates the potential of the proposed instrument to generate large-area, high-resolution microscopic images for intraoperative tissue identification and margin assessment. SIGNIFICANCE: This approach presents an important alternative to current histology techniques, significantly reducing the tissue assessment time, while simultaneously providing the capability to mark and ablate suspicious areas intraoperatively.

The i2Snake Robotic Platform for Endoscopic Surgery.

Endoscopic procedures have transformed minimally invasive surgery as they allow the examination and intervention on a patient's anatomy through natural orifices, without the need for external incisions. However, the complexity of anatomical pathways and the limited dexterity of existing instruments, limit such procedures mainly to diagnosis and biopsies. This paper proposes a new robotic platform: the Intuitive imaging sensing navigated and kinematically enhanced ([Formula: see text]) robot that aims to improve the field of endoscopic surgery. The proposed robotic platform includes a snake-like robotic endoscope equipped with a camera, a light-source and two robotic instruments, supported with a robotic arm for global positioning and for insertion of the [Formula: see text] and a master interface for master-slave teleoperation. The proposed robotic platform design focuses on ergonomics and intuitive control. The control workflow was first validated in simulation and then implemented on the robotic platform. The results are consistent with the simulation and show the clear clinical potential of the system. Limitations such as tendon backlash and elongation over time will be further investigated by means of combined hardware and software solutions. In conclusion, the proposed system contributes to the field of endoscopic surgical robots and could allow to perform more complex endoscopic surgical procedures while reducing patient trauma and recovery time.