Closed-loop Control of Steerable Balloon Endoscopes for Robot-assisted Transcatheter Intracardiac Procedures

2025-11-02

AI Summary

To address the challenges of inadequate visualization, imprecise instrument delivery, and reliance on open-chest surgery in transcatheter intracardiac interventions, this study proposes a steerable balloon-endoscope system. The system employs a single-input dual-output pneumatic actuation mechanism that decouples balloon inflation pressure to independently control field-of-view adjustment and working-channel deflection angle. Integrated optical imaging with an image-based closed-loop feedback algorithm enables stable, targeted navigation of the deflection angle. When mounted on a robot-assisted catheter platform, the system successfully performed aortic valve leaflet incision in a simulated environment. Key innovations include a deployable balloon architecture, a pressure-deformation decoupling control strategy, and real-time image-guided closed-loop regulation. These advances significantly improve instrument positioning accuracy and procedural safety in minimally invasive cardiac interventions.

Technology Category

• Intelligent Robots: State Estimation
• Machine Learning: Calibration & Uncertainty Quantification
• Computer Vision: Multi-modal Vision

Application Category

• Systems and Infrastructure for Web, Mobile and WoT: Experiences and lessons learnt from Web-based algorithms and system deployments
• Responsible Web: Machine-in-the-loop, human agency and autonomy
• Security and Privacy: Browser and end-point security

Abstract

To move away from open-heart surgery towards safer transcatheter procedures, there is a growing need for improved imaging techniques and robotic solutions to enable simple, accurate tool navigation. Common imaging modalities, such as fluoroscopy and ultrasound, have limitations that can be overcome using cardioscopy, i.e., direct optical visualization inside the beating heart. We present a cardioscope designed as a steerable balloon. As a balloon, it can be collapsed to pass through the vasculature and subsequently inflated inside the heart for visualization and tool delivery through an integrated working channel. Through careful design of balloon wall thickness, a single input, balloon inflation pressure, is used to independently control two outputs, balloon diameter (corresponding to field of view diameter) and balloon bending angle (enabling precise working channel positioning). This balloon technology can be tuned to produce cardioscopes designed for a range of intracardiac tasks. To illustrate this approach, a balloon design is presented for the specific task of aortic leaflet laceration. Image-based closed-loop control of bending angle is also demonstrated as a means of enabling stable orientation control during tool insertion and removal.

Problem

• Developing steerable balloon endoscopes for intracardiac visualization
• Enabling robotic tool navigation through integrated working channels
• Achieving closed-loop control of bending angle for stability

Innovation

• Steerable balloon endoscope for intracardiac visualization
• Single inflation pressure controls diameter and bending
• Image-based closed-loop control enables stable orientation