From a Disposable Ureteroscope to an Active Lightweight Fetoscope-Characterization and Usability Evaluation

Julie Legrand, Mouloud Ourak, Allan Javaux, Caspar Gruijthuijsen, Mirza Awais Ahmad, Ben Van Cleynenbreugel, Tom Vercauteren, Jan Deprest, Sebastien Ourselin, Emmanuel Vander Poorten

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)
302 Downloads (Pure)

Abstract

The twin-to-twin transfusion syndrome is a severe fetal anomaly appearing in up to 15% of identical twin pregnancies. This anomaly occurs when twins share blood vessels from a common placenta. The complication leads to an unbalanced blood transfusion between both fetuses. A current surgical treatment consists in coagulating the shared vessels using a fetoscope with an embedded laser. Such treatment is very delicate and constraining due to limited vision and size of the insertion area. The rigidity and lack of controllability of the current used instruments add an additional difficulty and limit the choice in insertion site. This letter proposes an improved flexible fetoscope, offering an enhanced laser controllability and higher versatility regarding the location of the insertion site. A better approach angle can therefore be realized. Also, tissue damage may be further reduced. This single-handed controllable active fetoscope is obtained after adaptation of a LithoVue (Boston Scientific, Natick, MA, USA), a commercially available passive flexible ureteroscope. The LithoVue is fitted with a unique lightweight add-on actuation module foreseen of an artificial muscle and a dedicated control system. Experiments in a mixed reality trainer suggested that the proposed fetoscope is compact, ergonomic, and intuitive in use, allowing an adequate control of the flexible end.
Original languageEnglish
Pages (from-to)4359-4366
JournalIEEE Robotics and Automation Letters
Volume3
Issue number4
Early online date20 Aug 2018
DOIs
Publication statusPublished - Oct 2018

Keywords

  • Medical robots and systems
  • flexible robots
  • mechanism design

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