Eighty percent of medical robotics papers have been published in the past decade—What has been accomplished?

SUMMARY: This paper describes a novel approach to capsular endoscopy that takes advantage of active magnetic locomotion in the gastrointestinal tract guided by an anthropomorphic robotic arm. Simulations were performed to select the design parameters allowing an effective and reliable magnetic link between the robot end-effector (endowed with a permanent magnet) and the capsular device (endowed with small permanent magnets). In order to actively monitor the robotic endoluminal system and to efficiently perform diagnostic and surgical medical procedures, a feedback control based on inertial sensing was also implemented. The proposed platform demonstrated to be a reliable solution to move and steer a capsular device in a slightly insufflated gastrointestinal lumen.

We present design and experimental performance results for a novel mechanism for robotic legged locomotion at the mesoscale (from hundreds of microns to tens of centimeters). The new mechanism is compact and strikes a balance between conflicting design objectives, exhibiting high foot forces and low power consumption. It enables a small robot to traverse a compliant, slippery, tubular environment, even while climbing against gravity. This mechanism is useful for many mesoscale locomotion tasks, including endoscopic capsule robot locomotion in the gastrointestinal tract. It has enabled fabrication of the first legged endoscopic capsule robot whose mechanical components match the dimensions of commercial pill cameras (11 mm diameter by 25 mm long). A novel slot-follower mechanism driven via lead screw enables the mechanical components of the capsule robot to be as small while simultaneously generating 0.63 N average propulsive force at each leg tip. In this paper, we describe kinematic and static analyses of the lead screw and slot-follower mechanisms, optimization of design parameters, and experimental design and tuning of a gait suitable for locomotion. A series of ex vivo experiments demonstrate capsule performance and ability to traverse the intestine in a manner suitable for inspection of the colon in a time period equivalent to standard colonoscopy.

The gastrointestinal tract is home to some of the most deadly human diseases. Exacerbating the problem is the difficulty of accessing it for diagnosis or intervention and the concomitant patient discomfort. Flexible endoscopy has established itself as the method of choice and its diagnostic accuracy is high, but there remain technical limitations in modern scopes, and the procedure is poorly tolerated by patients, leading to low rates of compliance with screening guidelines. Although advancement in clinical endoscope design has been slow in recent years, a critical mass of enabling technologies is now paving the way for the next generation of gastrointestinal endoscopes. This review describes current endoscopes and provides an overview of innovative flexible scopes and wireless capsules that can enable painless endoscopy and/or enhanced diagnostic and therapeutic capabilities. We provide a perspective on the potential of these new technologies to address the limitations of current endoscopes in mass cancer screening and other contexts and thus to save many lives.