PDF(Pubmed)
Abstract：
Endoscopes navigate within the human body to observe anatomical structures with minimal invasiveness. A major shortcoming of their use is their narrow field-of-view during navigation in large, hollow anatomical regions. Mosaics of endoscopic images can provide surgeons with a map of the tool\'s environment. This would facilitate procedures, improve their efficiency, and potentially generate better patient outcomes. The emergence of magnetically steered endoscopes opens the way to safer procedures and creates an opportunity to provide robotic assistance both in the generation of the mosaic map and in navigation within this map. This paper proposes methods to autonomously navigate magnetic endoscopes to 1) generate endoscopic image mosaics and 2) use these mosaics as user interfaces to navigate throughout the explored area. These are the first strategies, which allow autonomous magnetic navigation in large, hollow organs during minimally invasive surgeries. The feasibility of these methods is demonstrated experimentally both in vitro and ex vivo in the context of the treatment of twin-to-twin transfusion syndrome. This minimally invasive procedure is performed in utero and necessitates coagulating shared vessels of twin fetuses on the placenta. A mosaic of the vasculature in combination with autonomous navigation has the potential to significantly facilitate this challenging surgery.
摘要：
内窥镜在人体内导航以观察具有最小侵入性的解剖结构。它们使用的一个主要缺点是它们在大导航过程中的视野窄，中空解剖区域。内窥镜图像的马赛克可以为外科医生提供工具环境的地图。这将有助于程序，提高他们的效率，并可能产生更好的患者结果。磁操纵内窥镜的出现为更安全的程序开辟了道路，并创造了在马赛克地图的生成和该地图内的导航中提供机器人辅助的机会。本文提出了自主导航磁内窥镜的方法，以1）生成内窥镜图像马赛克和2）使用这些马赛克作为用户界面来导航整个探索区域。这些是第一个策略，它允许大型的自主磁导航，微创手术中的中空器官。在双胞胎对双胞胎输血综合征的治疗中，在体外和离体实验中都证明了这些方法的可行性。这种微创手术在子宫内进行，需要在胎盘上凝结双胎的共享血管。脉管系统的马赛克结合自主导航具有显著促进这种挑战性手术的潜力。
