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Updated: Nov 19, 2025

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Handheld Active Add-On Control Unit for a Cable-Driven Flexible Endoscope.

Julie Legrand1, Allan Javaux1, Mouloud Ourak1

  • 1Laboratory of Robot-Assisted Surgery, Department of Mechanical Engineering, KU Leuven, Leuven, Belgium.

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Summary
This summary is machine-generated.

Surgeons can now use a novel flexible endoscope add-on system for in utero treatment of twin-to-twin transfusion syndrome (TTTS). This system enhances control and reduces force, improving safety for this complex fetal surgery.

Keywords:
TTTSadd-on systemflexible robotsmechanism designmedical robots

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Area of Science:

  • Medical Devices
  • Minimally Invasive Surgery
  • Fetal Surgery

Background:

  • Current instruments for in utero twin-to-twin transfusion syndrome (TTTS) treatment are rigid, limiting dexterity and increasing surgical risk.
  • The complexity of TTTS surgery necessitates more controlled and flexible instrumentation.

Purpose of the Study:

  • To design, assemble, and evaluate an add-on system for commercial flexible endoscopes to improve in utero surgical interventions.
  • To enhance the dexterity and control of instruments used for treating twin-to-twin transfusion syndrome (TTTS).

Main Methods:

  • Development of a lightweight, exchangeable add-on system utilizing McKibben muscle actuators.
  • Integration of the add-on system with a commercial cable-driven flexible endoscope.
  • Quantitative evaluation of the modified endoscope's precision and force application.

Main Results:

  • The enhanced flexible endoscope demonstrated a precision of 7.4% across its bending range.
  • The system reduced the maximum planar force on the body wall by 6.15% compared to the original endoscope.
  • The add-on control system provided more stable and precise actuation of the endoscope's flexible tip.

Conclusions:

  • The proposed add-on system significantly improves the controllability and safety of flexible endoscopes for in utero fetal surgery.
  • This innovation holds great potential for treating twin-to-twin transfusion syndrome (TTTS), particularly in challenging anatomical regions.
  • The developed system offers a promising advancement for minimally invasive fetal interventions.