King's College London

Research portal

Design and shared control of a flexible endoscope with autonomous distal tip alignment

Research output: Chapter in Book/Report/Conference proceedingConference paper

Mirza Awais Ahmad, Mouloud Ourak, Caspar Gruijthuijsen, Julie Legrand, Tom Vercauteren, Jan Deprest, Sebastien Ourselin, Emmanuel Vander Poorten

Original languageEnglish
Title of host publication2019 19th International Conference on Advanced Robotics, ICAR 2019
PublisherInstitute of Electrical and Electronics Engineers Inc.
Number of pages7
ISBN (Electronic)9781728124674
Publication statusPublished - Dec 2019
Event19th International Conference on Advanced Robotics, ICAR 2019 - Belo Horizonte, Brazil
Duration: 2 Dec 20196 Dec 2019

Publication series

Name2019 19th International Conference on Advanced Robotics, ICAR 2019


Conference19th International Conference on Advanced Robotics, ICAR 2019
CityBelo Horizonte

King's Authors


Open womb surgery for prenatal therapy is an extreme option which may induce severe side effects on both the fetus and the mother. Minimal invasive surgery (MIS) is, in general, less strenuous than open surgery. Unfortunately, the current tools and techniques are not optimized for the unique environment of the womb. Used in prenatal MIS, the physician visually assesses the in-utero environment, the fetus and the placenta. This work deals with the use of fetoscopic instruments in photocoagulation therapy using lasers for Twin-to-Twin Transfusion Syndrome (TTTS). The TTTS procedure consists of identifying and coagulating the anastomosing vessels. We propose a fetoscopic instrument with a flexible steerable distal tip as opposed to currently used rigid scopes. The enhanced dexterity improves the ability of the surgeon to coagulate otherwise hard to access regions. We anticipate usability issues and a potentially steep learning curve as currently surgeons solely work with non-bendable instruments. To alleviate this problem, a shared control approach is proposed in which the surgeon controls the position of the instrument inside the uterus while an autonomous controller controls the orientation. The system is validated by testing on a novel instrument with 2 actuated degrees of freedom in an in-silico setup featuring a real placenta image, a motion tracking system and a mechanical fulcrum point to mimic the incision port. The autonomous distal tip controller achieved an overall 4.75° RMSE with respect to the desired orientation, which is within the targeted range of orientations.

View graph of relations

© 2018 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454