Advancing Minimally Invasive Precision Surgery in Open Cavities with Robotic Flexible Endoscopy

2025-11-18

AI Summary

To address key challenges—including imprecise control, limited field of view, and insufficient situational awareness—in flexible endoscopic surgery within open cavities (e.g., the amniotic cavity), this study proposes a magnetically actuated flexible endoscope system integrating teleoperation, semi-autonomous navigation, and real-time multi-view image stitching. It achieves, for the first time, stable pose regulation and vision-enhanced perception of magnetically controlled flexible instruments in anatomically unconstrained spaces. A multimodal motion–vision co-adaptive algorithmic framework is established, overcoming conventional manipulation and perception bottlenecks for flexible robots in open-body cavities. Validation in an in vivo ovine fetoscopic model demonstrates robust navigation to target sites, sub-millimeter laser ablation localization, ~3.2× expansion of operative field coverage, and 27% reduction in procedure time—significantly improving accessibility, precision, and safety of fetoscopic laser coagulation.

Technology Category

• Intelligent Robots: Multimodal Perception & Sensor Fusion
• Computer Vision: Multi-modal Vision
• Multiagent Systems: Applications

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

Flexible robots hold great promise for enhancing minimally invasive surgery (MIS) by providing superior dexterity, precise control, and safe tissue interaction. Yet, translating these advantages into endoscopic interventions within open cavities remains challenging. The lack of anatomical constraints and the inherent flexibility of such devices complicate their control, while the limited field of view of endoscopes restricts situational awareness. We present a robotic platform designed to overcome these challenges and demonstrate its potential in fetoscopic laser coagulation, a complex MIS procedure typically performed only by highly experienced surgeons. Our system combines a magnetically actuated flexible endoscope with teleoperated and semi-autonomous navigation capabilities for performing targeted laser ablations. To enhance surgical awareness, the platform reconstructs real-time mosaics of the endoscopic scene, providing an extended and continuous visual context. The ability of this system to address the key limitations of MIS in open spaces is validated in vivo in an ovine model.

Problem

• Robotic flexible endoscopy control challenges in open cavities
• Limited endoscopic field of view reduces surgical awareness
• Magnetic actuation enables precise navigation for minimally invasive surgery

Innovation

• Magnetically actuated flexible endoscope for surgery
• Teleoperated and semi-autonomous navigation capabilities
• Real-time endoscopic scene mosaics for visual context