Application of Robot in Colonoscopy

Author(s): Yongde Zhang*, Peiwang Qin, Jingang Jiang, Xinghua Wu, Qi Zhao, Zhiyuan Huang

Journal Name: Recent Patents on Mechanical Engineering

Volume 13 , Issue 3 , 2020

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Background: Currently, there are about twenty percent of the subjects who feel pain and become uncomfortable while they are in the middle of the process of bowel disease examination by colonoscopy. Within the examination, the attending physician needs the assistance of nurses to complete the operation, which is extremely inconvenient. And there is still the chance of being hurt or infected by corrosive intestinal juice. Therefore, how to improve the efficiency of diagnosis, ensure the safety of operation, and reduce the pain of patients are the current research hotspots in the field of colonoscopy.

Objective: The study aimed to provide an overview of the existing colonoscopy robots and introduce their classification and characteristics.

Methods: This paper reviews various productions and patents related to the colonoscopy robot. The structural characteristics, differences and applications of the typical colonoscopy robot are also introduced.

Results: The auxiliary colonoscopy robot and the active flexible colonoscopy robot were compared and analyzed, and the typical characteristics were concluded. The main problems in colonoscopy robot’s development were analyzed, and the development trend is foreseen. The current and future research works on the productions and patents on colonoscopy robots are discussed.

Conclusion: Colonoscopy robot is helpful for reducing the doctor’s efforts while performing labor operation. It gives a more clear vision and offers an excellent interactive interface to make man-machine conversation easy. With the continuous improvement of technology, especially in the field of artificial intelligence and imaging processing technology, colonoscopy robot has been found to be more stable, comfortable, humanized, intelligent and secure.

Keywords: Colonoscopy, colorectal disease, master-slave operation, propulsion device, remote control section, robot technology, sensor device.

Haggar FA, Boushey RP. Colorectal cancer epidemiology: Incidence, mortality, survival, and risk factors. Clin Colon Rectal Surg 2009; 22(4): 191-7.
Kim B, Lee S, Park JH, Park JO. Design and fabrication of a locomotive mechanism for capsule-type endoscopes using shape memory alloys. IEEE-ASME T Mech 2005; 10(1): 77-86.
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68(6): 394-424.
Torre LA, Bray F, Siegel RL. Global cancer statistics 2012. CA Cancer J Clin 2015; 65(2): 87-108.
Milroy MJ. Quality Cancer Care Cancer statistics: Global and National. Vermillion USA 2018.
Lee AW, Lin FX, Wei PL, Jian-Wei G, Chen JK. Binary-blend fibber-based capture assay of circulating tumor cells for clinical diagnosis of colorectal cancer. J Nanobiotechnology 2018; 16(1): 4.
Chen K, Xu GT, Ma XY, Zhen X. Cohort study on association between colorectal cancer and colorectal polypi. Chin J Publ Health 2004; 20(2): 168-70.
Xie ZY, Qin SH. Incidence of colorectal cancer and anatomical changes. Word Chin J Digestol 2003; 11(7): 1050-3.
Feng X, Hu HY, Zhang HM, Li C, Cai X, Sun L. Research on force sensing system for a colonoscopy robot. Proceedings of 2015 IEEE International Conference on Mechatronics and Automation (ICMA). Beijing, China. August, 2015..
Kekelidze M. Colorectal cancer: Current imaging methods and future perspectives for the diagnosis, staging and therapeutic response evaluation. World J Gastroenterol 2013; 46(19): 8502-14.
Li QL. Application of capsule endoscopy in the diagnosis of digestive tract diseases. Intern Med Chin 2012; 7(6): 172-6.
Chen YD. Progress in diagnosis and treatment of small bowel diseases. Chin Fore Med Res 2011; 09(9): 114-7.
Tan W, Ge ZZ. Advances in study on enteroscopy for treatment of small bowel disorders. Chin J Gastroenterol 2011; 16(12): 751-4.
Wang CL, Zhu XX, Huang YP, Wu M. Principles and applications of new imaging technology of endoscope. Chin Med Eq 2018; 15(4): 125-9.
Wei ZM, Gao Feng, Yang X, Hu YX, Fan L, Bai Y, et al. The feasibility of painless colonoscopy in elderly patients. Mod Digest Interv 2010; 15(1): 20-3.
Snyder CW, Vandromme MJ, Tyra SL, Hawn MT. Retention of colonoscopy skills after virtual reality simulator training by independent and proctored methods. Am Surg 2010; 76(7): 743-6.
Peters BS, Armijo PR, Krause C, Choudhury SA, Oleynikov D. Review of emerging surgical robotic technology. Surg Endosc 2018; 32: 1636-55.
Kurniawan N, Keuchel M. Flexible gastro-intestinal endoscopy-clinical challenges and technical achievements. Comput Struct Biotechnol J 2017; 15: 168-79.
Yan YK, Zou YB. Current status and prospects of robot-assisted natural endoscopic surgery. Chin J Min Inv Surg 2014; 14(6): 563-7.
Wang DX, Zhang YR, Wang YG, Ma XF, Zhong CH. Design and development of robot-assisted endoscope surgery system. Robot 2002; 24(4): 335-41.
Naito K, Ueki R. Endoscope adapter and endoscope. WO2013021710 (2013).
Dehghani H, Welch CR, Pourghodrat A, Nelson CA, Oleynikov D, Dasgupta P, et al. Design and preliminary evaluation of a self-steering, pneumatically driven colonoscopy robot. J Med Eng Technol 2017; 41(3): 223-36.
Shadpey F, Talebi HA, Jayender J. A Robust position and force control strategy for 7-DOF redundant manipulators IEEE-ASME T Mech 2009; 14(5): 575-89.
Pickhardt PJ, Kim DH. Colorectal cancer screening with CT colonography: Key concepts regarding polyp prevalence, size, histology, morphology, and natural history. AJR Am J Roentgenol 2009; 193(1): 40-6.
Sliker LJ, Ciuti G, Rentschler ME, Menciassi A. Frictional resistance model for tissue-capsule endoscope sliding contact in the gastrointestinal tract. Tribol Int 2016; 102: 472-84.
Axel E, Perry JP, Dirk H, Jürgen FR. Colon anatomy based on CT colonography and fluoroscopy: Impact on looping, straightening and ancillary manoeuvres in colonoscopy. Dig Liver Dis 2010; 42(4): 291-6.
Alazmani A, Hood A, Jayne D, Neville A, Culmer P. Quantitative assessment of colorectal morphology: Implications for robotic colonoscopy. Med Eng Phys 2016; 38(2): 148-54.
Li JJ, Yan ZG, Wang KD, Ye DD. On micro-robot driver used on enteric endoscope. Beijing Biomed Eng 2009; 28(2): 179-83.
Hoff G, Moritz V, Bretthauer M. Colonoscope with a sub-distal hyper-flaccid segment for improved insertion at colonoscopy: A randomized study. Scand J Gastroenterol 2011; 46(1): 104-8.
Liu K, Zhang JL. Application of colonoscopy for laparoscopic intraoperative location of colorectal tumors. J Laparosc Surg 2011; 16(4): 278-80.
Sars VD, Haliyo S, Szewczyk J. A practical approach to the design and control of active endoscopes. Mechatronics 2010; 20(2): 251-64.
Feng XX, Hu HY, Li LW, Li WD, Sun LN. A compliant control of a colonoscopy robot based on force sensing. Robot 2016; 38(2): 217-24.
Hu HY, Li CG, Feng X, Li DW, Li J. Endoscope robot control method and device based on pressure sensor information. CN105796043 (2016).
Takeshita N, Phee SJ, Chiu WY. Global Evaluative Assessment of Robotic Skills in Endoscopy (GEARS-E): Objective assessment tool for master and slave transluminal endoscopic robot. Endosc Int Open 2018; 30(4): 1065-9.
Baldwin Y, Philip WYC. Application of robotics in gastrointestinal endoscopy: A review. World J Gastroenterol 2016; 22(5): 1811-25.
Wong JYY, Ho KY. Robotics for advanced therapeutic colonoscopy. Clin Endosc 2018; 51(6): 552-7.
Li Z, Chiu PWY. Robotic endoscopy. Visc Med 2018; 34(1): 45-51.
Zhu WY. Patent Analysis on medical electrical curved endoscopy. Chin Med Dev 2018; 33(12): 122-7.
De Rosa M, Pace U, Rega D, Costabile V, Duraturo F, Izzo P, et al. Genetics, diagnosis and management of colorectal cancer. (Review) Oncol Rep 2015; 34(3): 1087-96.
Cao LL. Comparative analysis of one-man and two-men colonoscopy in 1112 patients. J Hebei Med 2009; 15(4): 504.
Thomann G, Chen G, Redarce T. Design and control of an autonomous bendable tip for colonoscopy. J Micro - Nano Mech 2008; 4(3): 103-4.
Chen G, Pham M, Redarce T. Development and kinematic analysis of a silicone-rubber bending tip for colonoscopy. IEEE/RSJ International Conference on Intelligent Robots & Systems. Beijing, China. October, 2006..
Allen JE, Sharma P. Polyp characterization at colonoscopy: Clinical implications. Best Pract Res Cl Ga 2017; 31(4): 435-40.
Cheng W, Luo W, Qian Z. A novel single hand control unit of colonoscope. IEEE/ASME International Conference on Advanced Intelligent Mechatronics. Wollongong, NSW, Australia. July, 2013..
Woo JH, Seo JT, Yi BJ. A robotic approach for colonoscopy. International Conference on Ubiquitous Robots & Ambient Intelligence IEEE. Kuala Lumpur, Malaysia. November, 2014.
Pourghodrat A, Dehghani H, Nelson CA, Oleynikov D, Dasgupta P, Terry BS. Disposable fluidic self-propelling robot for colonoscopy. ASME J Med Devices 2014; 8(3): 1-2.
Gumbs AA, Milone L. Remote endoscope handle manipulation. US9706907 (2017).
Gumbs AA, Milone L. Remote endoscope handle manipulation US8409080 (2013).
Ueno H, Ikeda Y. Power driven bending endoscope with detachableinsertion portion US7828723 (2010).
Moll FH, Wallace DT. Methods using a robotic catheter system US7850642 2010.
Ruiter JG, Rozeboom ED, Voort VDMC. Design and evaluation of robotic steering of a flexible endoscope. IEEE Ras & Embs International Conference on Biomedical Robotics & Biomechatronics Rome, Italy. August, 2012..
Ruiter JG, Bonnema GM, Voort VDMC. Robotic control of a traditional flexible endoscope for therapy. J Robot Surg 2013; 7(3): 227-34.
Rozeboom ED, Bastiaansen BA, De Vries ES. Robotic-assisted flexible colonoscopy: Preliminary safety and efficiency in humans. Gastrointest Endosc 2016; 83(6): 1267-71.
Rozeboom ED, Broeders IAMJ, Fockens P. Feasibility of joystick guided colonoscopy. J Robot Surg 2015; 9(3): 173-8.
Ruiter JG, Van DV, Bonnema GM. User-centred system design approach applied on a robotic flexible endoscope. Procedia Comput Sci 2013; 16: 581-90.
Selgrad C, Christ J, Weber F. Colonoscopy with robotic steering and automated lumen centralization: A feasibility study in a colon model. Endoscopy 2016; 48(3): 286-90.
Woo J, Choi JH, Seo JT. Development of a robotic colonoscopic manipulation system, using haptic feedback algorithm. Yonsei Med J 2017; 58(1): 139-43.
Kume K, Kuroki T, Sugihara T, Shinnga M. Development of a novel endoscopic manipulation system: The endoscopic operation robot. World J Gastrointest Endosc 2011; 3(7): 145-50.
Kume K, Sakai N, Goto T. Haptic feedback is useful in remote manipulation of flexible endoscopes. Endosc Int Open 2018; 27(3): 1134-9.
Kume K, Kuroki T, Shingai M, Harada M. Endoscopic submucosal dissection using the endoscopic operation robot. Endoscopy 2012; 44(2): 399-400.
Kume K. Ongoing development and directions in flexible robotic endoscopy. J Uoeh 2015; 37(2): 149-56.
Tsutomu I, Ryu N, Shinya O, Yasuharu O, Jumpei A, Susumu O. A new robotic-assisted 〉exible endoscope with single-hand control: Endoscopic submucosal dissection in the ex vivo porcine stomach. Surg Endosc 2018; 32(7): 3386-92.
Yang YS, Li HY, Liu H, et al. Digestion endoscope robot CN103767659 (2014).
Li YM, Liu H, Wang HZ, Yang ZD, Li HY, Yang YS. A novel gastroscope intervention mechanism with circumferentially pneumatic-driven clamping function. In: International Conference of the IEEE Engineering in Medicine & Biology Society; Milan, Italy,. August 2015.
Li GX, Yan J, Liu H, Yang YS, Li HY. Position and posture adjusting passive manipulator for digestive endoscopy conveying robot. CN104758052 (2014).
Li YM, Hao SW, Yang ZD, Li HY, Yang YS, Liu H. Robot-assisted master-slave system for gastroscope intervention. Robot 2016; 38(1): 107-14.
Wang B. Design and research of an endoscope assistant operation system. MS Dissertation. Northeastern University, Shenyang, China, June 2013..
Hu HY, Wang PF, Li WD, Li MT, Sun LN. Continuous body type semi-autonomous endoscope robot. CN101653353 (2010).
Hu HY. Research on Semi-Autonomous colonoscopic robot system. MS Dissertation. Harbin Institute of Technology, Harbin, China, November 2011..
Feng XX, Fu BJ, Hu HY, Hong G. Mechanical analysis of snake-like robot for colonoscopy. Adv Mat Res 2013; 706-708(1): 849-54.
He YY, He C, Wang CC, Li T. S-shaped joint used for surgical robot, surgical instrument and endoscope. CN106963494 (2017).
Yu JP, Gu J, Li L, Liu Y. Active snakelike endoscope robot system CN103479320 (2014).
Belson A. Steerable endoscope and improved method of insertion. US9138132 (2015).
Belson A. Steerable segmented endoscope and method of insertion. US20150005576 (2015).
Ohline RM. Tendon-driven endoscope and methods of use. US20110306836 (2011).
Couvillon JR, Lucien A. Robotic endoscope. US8328714 (2012).
Nobuharu T, Motohiko M, Takuro I. Endoscope system. US20160227982 (2016).
Hirotoshi O, Koji Y. Remote controller for balloon controlling device and endoscope system. US20160220097 2016.
Tadashi S. Balloon controller for endoscopic apparatus US8439825 (2013).
Yeung CK, Chu S, Lam WF. Endoscopic systems, devices, and methods. US10136799 (2018).
Yoshida T. Double-balloon endoscope system. US7935047 (2011).
Yoshida T. Endoscope balloon control device. US20070038025 (2007).
Luria G. Balloon endoscope reprocessing system and method. US20180140175 (2018).
Voelkel JP, Di Palma JA. Deep enteroscopy. South Med J (2010); 103(10): 1045-8.
Garcia P, Low T, Chavez B, Prahlad H, Isaza N, Dutta S. Controllable dexterous endoscopic device. US8388519 (2013).
Garcia P, Low T, Chavez B, Prahlad H. Selectively rigidizable and actively steerable articulatable device US8488295 (2012).
Uchiyama A, Ito M, Ito S, Tanii Y. Rotary self-propelled endoscope system. US9078616 (2015).
Omot K, Kura Y, Kishi T, Tanii Y. Rotating self-propelled endoscope device. US20090156897 (2009).
Tanaka S, Takizawa H, Aoki I, Kawano H. Endoscope insertion aiding device. US20050272976 (2005).
Nagase J, Fukunaga F, Ogawa K. Development of a funicular flexible crawler for colonoscopy. IEEE International Conference on Biomedical Robotics and Biomechatronics. Netherlands. October 2018..
Nagase J. Crawler type robot and traveling robot connected body connecting the same. JP6109643 (2017).
Nagase JY, Suzumori K, Saga N. Development of worm-rack driven cylindrical crawler unit. J Adv Mech Des Syst 2013; 7(3): 422-31.
Groth S, Rex DK, Rösch T, Hoepffner N. High cecal intubation rates with a new computer-assisted colonoscope: A feasibility study. Am J Gastroenterol 2011; 106(6): 1075-80.
Rösch T, Adler A, Pohl H. A motor-driven single-use colonoscope controlled with a hand-held device: A feasibility study in volunteers. Gastrointest Endosc 2008; 67(7): 1139-46.
Gorini S, Arena A, Pemorio G, Menciassi A, Dario P. Selfpropelled endoscopic device. US20070179339 (2007).
Gorini S, Pernorio G, Arena A. Endoscopic device. US8663159 (2014).
Cosentino F, Tumino E, Passoni GR. Functional evaluation of the endotics system, a new disposable self-propelled robotic colonoscope: In vitro tests and clinical trial. Int J Artif Organs 2009; 32(8): 517-27.
Gluck N, Melhem A, Halpern Z, Mergener K, Santo E. A novel self-propelled disposable colonoscope is effective for colonoscopy in humans. Gastrointest Endosc 2016; 83(5): 998-1004.e1.
Pfeffer J, Grinshpon R, Rex D, Levin B, Rösch T, Arber N, et al. The Aer-O-Scope: Proof of the concept of a pneumatic, skill-independent, self-propelling, self-navigating colonoscope in a pig model. Endoscopy 2006; 38(2): 144-8.
Arber N, Grinshpon R, Pfeffer J, Maor L, Bareir S, Rex D. Proof-of-concept study of the Aer-O-Scope™ omnidirectional colonoscopic viewing system in ex vivo and in vivo porcine models. Endoscopy 2007; 39(5): 412-7.
Kumar A, Yadav N, Singh S, Chauhan N. Minimally invasive (endoscopic-computer assisted) surgery: Technique and review. Ann Maxillofac Surg 2016; 6(2): 159-4.
Baek SK, Carmichael JC, Pigazzi A. Robotic surgery: Colon and rectum. Cancer J 2013; 19(2): 140-6.
Weitman E, Saleh M, Marescaux J, Martin TR. Robotic colorectal surgery: Evolution and future. Semin Colon & Rectal Surg 2016; 27(3): 121-9.
Pucci M, Beekley A. Use of robotics in colon and rectal surgery. Clin in Colon & Rectal Surg 2013; 26(1): 039-46.
Zhang L, Qian J, Shen L, Zhang Y. FBG sensor devices for spatial shape detection of intelligent colonoscope. IEEE International Conference on Robotics and Automation. New Orleans, LA, USA. July, 2004..
Walker AS, Steele SR. The future of robotic instruments in colon and rectal surgery. Semin Colon Rectal Surg 2016; 27(3): 1-20.
Nagel H, Baehring T, Scherbaum WA. Virtual reality colonoscopy simulation: A compulsory practice for the future colonoscopist. Endoscopy 2005; 37(12): 1198-204.
Heena B, Sharmila A, Richa S. Use of augmented reality and virtual reality technologies in endoscopic training. Clin Gastroenterol H 2018; 16(11): 1688-91.
Bosio R, Pigazzi A. Emerging and evolving technology in colon and rectal surgery. Clin Colon Rectal Surg 2015; 28(03): 152-7.
Pai A, Melich G, Marecik SJ, Park JJ. Robotic surgery for colon and rectal cancer: Current status, recent advances, and future directions. Curr Colo Cancer Rep 2017; 13(1): 37-44.

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Year: 2020
Published on: 26 August, 2020
Page: [205 - 218]
Pages: 14
DOI: 10.2174/2212797613666200211115802
Price: $25

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