Robotics and Minimally Invasive Surgery Group, MIRA Institute for Biomedical Technology and Technical Medicine, Carré 3.623, University of Twente, Drienerlolaan 5, 7500, AE, Enschede, The Netherlands,
Surg Endosc. 2013 Oct;27(10):3539-47. doi: 10.1007/s00464-013-3003-7. Epub 2013 May 14.
The design of flexible endoscopes has not changed significantly in the past 50 years. A trend is observed towards a wider application of flexible endoscopes with an increasing role in complex intraluminal therapeutic procedures. The nonintuitive and nonergonomical steering mechanism now forms a barrier in the extension of flexible endoscope applications. Automating the navigation of endoscopes could be a solution for this problem. This paper summarizes the current state of the art in image-based navigation algorithms. The objectives are to find the most promising navigation system(s) to date and to indicate fields for further research.
A systematic literature search was performed using three general search terms in two medical-technological literature databases. Papers were included according to the inclusion criteria. A total of 135 papers were analyzed. Ultimately, 26 were included.
Navigation often is based on visual information, which means steering the endoscope using the images that the endoscope produces. Two main techniques are described: lumen centralization and visual odometry. Although the research results are promising, no successful, commercially available automated flexible endoscopy system exists to date.
Automated systems that employ conventional flexible endoscopes show the most promising prospects in terms of cost and applicability. To produce such a system, the research focus should lie on finding low-cost mechatronics and technologically robust steering algorithms. Additional functionality and increased efficiency can be obtained through software development. The first priority is to find real-time, robust steering algorithms. These algorithms need to handle bubbles, motion blur, and other image artifacts without disrupting the steering process.
在过去的 50 年中，柔性内窥镜的设计并没有发生重大变化。人们观察到一种趋势，即越来越多地将柔性内窥镜应用于复杂的腔内治疗程序，其作用也越来越大。目前，非直观和非人体工程学的导向机构成为了限制柔性内窥镜应用拓展的瓶颈。而内窥镜的导航自动化可能是解决这一问题的方法。本文总结了基于图像的导航算法的最新技术。目的是找到迄今为止最有前途的导航系统，并指出进一步研究的领域。
使用两个医学技术文献数据库中的三个通用搜索词进行了系统的文献检索。根据纳入标准纳入论文。共分析了 135 篇论文，最终纳入了 26 篇。
导航通常基于视觉信息，这意味着使用内窥镜产生的图像来操纵内窥镜。描述了两种主要技术：管腔中心化和视觉里程计。尽管研究结果很有前景，但迄今为止还没有成功的、商业化的自动柔性内窥镜系统。
使用传统柔性内窥镜的自动化系统在成本和适用性方面具有最有前途的前景。为了开发这样的系统，研究重点应放在寻找低成本的机电一体化和技术上稳健的转向算法上。通过软件开发可以获得额外的功能和更高的效率。当务之急是找到实时、稳健的转向算法。这些算法需要在不中断转向过程的情况下处理气泡、运动模糊和其他图像伪影。
