A Continuum Robot and Control Interface for Surgical Assist in Fetoscopic Interventions

Area of Science:

• Medical Mechatronics
• Minimally Invasive Surgery
• Fetal Surgery

Background:

• Twin-twin transfusion syndrome (TTTS) necessitates complex fetoscopic laser ablation of placental vessels.
• Current instrumentation offers limited dexterity and visualization, posing challenges during this delicate procedure.
• Enhanced robotic or mechatronic systems are needed to improve surgical precision and outcomes in fetal interventions.

Purpose of the Study:

• To present a novel mechatronic comanipulated instrument for fetoscopic procedures.
• To enhance dexterity, stability, and visualization capabilities for treating TTTS.
• To evaluate the system's potential for intraoperative geometry computation and view enhancement.

Main Methods:

• Design and implementation of a mechatronic system featuring concentric tube actuation and a remote center of motion.
• Integration of a stereoscopic camera at the distal tip for high-fidelity imaging.
• Validation using electromagnetic sensors and comparison with visual odometry for motion tracking and geometric analysis.

Main Results:

• The developed instrument demonstrates significantly enhanced dexterity and stability of the imaging device.
• The system successfully enabled geometry computation and improved visualization of the surgical field.
• Electromagnetic sensor data verified the system's accuracy and performance, showing promising results.

Conclusions:

• The reported mechatronic instrument offers a promising advancement for fetoscopic interventions, particularly in TTTS treatment.
• Enhanced dexterity and imaging capabilities can lead to improved surgical precision and patient outcomes.
• Further development holds potential for broader clinical applications in minimally invasive fetal surgery.