LoCoMoTE: Low Cost Morphable Teleoperated Endoscope for Gastric Intestinal Tract Screening

Lead Research Organisation: King's College London
Department Name: Informatics

Abstract

Existing technologies are unable to meet China's endoscopic gastrointestinal (GI) screening needs, due to its large, aging population, insufficient infrastructure and high incidence of GI cancers. To address this challenge, we propose a novel and low cost soft endoscope, together with high-speed wireless communications to create a way to perform regular endoscopic screening programs in China.
The soft endoscope will be able propel itself inside torturous, compliant environments, such as the human gastrointestinal tract, and dramatically reduce the pain associated with conventional endoscopes. Because of the self-propelling feature and the inherent safety of using soft material, the new endoscope can be operated by non-specialist staff with minimal training and be supervised or even controlled remotely by specialist clinicians with wireless communication. The endoscope will be operated by clinicians via a custom made haptic interface. The endoscope itself will be made to be low cost and disposable. Therefore, this will enable rural medical clinics to run regular endoscopic screening programs with the system, as it will require no additional sterilisation facilities and will be easy to learn to use.
To facilitate adoption and to provide support for rural clinicians, the endoscope will be connected to a high-speed 5G wireless that will enable haptic tele-operation. Through this, expert clinicians in large hospitals all over the country will be able to monitor and directly control screening procedures from any location. Experts will therefore be able to train rural clinicians in techniques by physically demonstrating them, support rural clinics to ensure accurate diagnosis and allow experts to perform more complex procedures remotely. Aligning well with China's strategy of starting 5G commercial applications in 2020, this approach is timely and takes advantage of the wide-spread availability of wireless internet in China and deals directly with the challenges faced by efforts to create large-scale endoscopic screening programs in the country.

Planned Impact

The global market for flexible endoscopes for performing GI screenings and surgeries is substantial and continues to grow. In 2013, over 10 million diagnostic GI endoscopies were performed with flexible endoscopes worldwide, including gastroscopies and colonoscopies. In the same year, the global endoscopy market produced a total revenue of 26 billion USD, 7 billion of which was from flexible endoscopy alone.
This new soft endoscope offers several key advantages not only over traditional endoscopes, but also over other robotic endoscopy products. The main advantages include effective self-propulsion and safe interaction, and simple design, addressing the unmet challenges in colonoscopy, and dramatically improving the efficiency and comfort of the procedure.
The real beauty of the teleoperation system is in how it creates an internet of skills, connecting large numbers of clinicians together and allowing them to share their skills and knowledge. Even in a large city hospital, there are only so many experts that are on hand to provide assistance when needed. With this teleoperation system, clinicians will have access to experts from potentially thousands of hospitals, instantly. This will dramatically increase the efficiency of endoscopic clinics and simultaneously disseminate skills and knowledge. Thus, it will not only allow patients to have better access to quality endoscopic screenings, but it will create more skilled clinicians to perform those screenings over time. This, therefore, has the potential to solve both the problem of availability of endoscopic screening and the skill shortage.
This proposal has demonstrated the necessity, vision and ambition of this project. The impact of this project has the potential to change the lives of millions of Chinese people for the better, engender development of crucial medical skills and advance the fields of robotic medicine considerably. This will not require unrealistic leaps in technological innovation; this will not require immense resources. This is possible due to a confluence of circumstances in China and technological development that has created an opportunity. This proposal seeks to seize this opportunity and, in so doing, improve the welfare of the Chinese people and push the frontiers of robotic medicine to a new and exciting level.

Publications

10 25 50
 
Description Endoscopic surgery is an increasingly popular alternative to laparoscopic techniques for many conditions, as the operation site can be reached without skin wounds. In many tasks,
sufficient force generation is desired. As endoscopes must be highly flexible and slim, however, the force generation and sensing capabilities associated with these tools is limited due their compliance, significantly hindering the adoption rate of endoscopic surgeries. My group created a technique, termed 'environmental scaffolding', to stabilize an actuated, flexible segment in the intestine such that larger forces can be applied. Through the measurement of actuation forces, a method for intrinsically sensing multiple contact forces when in this configuration is presented. Experimental results show that with the environmental scaffolding technique, the tip force generated can be increased by over 50% on average, and the tip force estimation is accurate to within 2.97%.
Exploitation Route The finding will be generic in terms of how a steerable flexible instrument work within a narrow and confined environment. The direct application is for flexible endoscopy to carry out medical interventions. It is also applicable to any other industries using steerable flexible camera for inspection or conduct on site work, exemplified by pipe inspections or narrow space inspections inside jet engine
Sectors Aerospace, Defence and Marine,Construction,Electronics,Healthcare,Manufacturing, including Industrial Biotechology

 
Description Through this project, Haptic Mechatronics and Medical Robotics (HaMMeR) Lab developed a new endoscopic robot which has the latest robotic touch technology and integrated with the latest 5G communication technology from Ericsson to enable the real-time human-computer interaction of tactile and visual information, allowing doctors to be fully immersed while operating remotely, and providing remote surgical treatment across regions At the Mobile World Congress (MWC) 2019 in Barcelona, February 25-28, King's College London, Tianjin University, China Mobile, and Ericsson jointly demonstrated technology to wide audiences from tech industries. The MWC is the foremost industrial conference worldwide for companies working in AI, data, and telecommunication. In the future, the physical barrier of distance between doctors and patients will be completely eliminated, allowing rural regions to enjoy high-quality medical services without long-distance travel. The hope is that in the future this will allow doctors not only to perform the procedures but also to provide excellent training for people to watch procedures live and eventually for the platform to support AI to enable us to augment or to coach procedures as they happen.
First Year Of Impact 2019
Sector Digital/Communication/Information Technologies (including Software),Healthcare
Impact Types Cultural

 
Description Ericsson 
Organisation Ericsson
Country Sweden 
Sector Private 
PI Contribution The new tactile sensor developed within the ESSENCE project is promising to provide new touch sensing capability for the products of Shadow Robot. Since the new tactile sensing method allow miniaturized tactile gripper to be created for surgical tasks, this new development provide a ideal showcase for the concept of tactile internet for medical applications, being prompted by Ericsson. A prototype of the tactile gripper developed using ESSENCE technology will be demonstrated by Ericsson at the Mobile World Congress 2017. At the Mobile World Congress 2019 in Barcelona, King's College London, Tianjin University, China Mobile, and Ericsson jointly demonstrated technology for providing remote surgical treatment across regions as a part of development in LoCoMoTE project funded by EPSRC Since last year, we have been conducting tests on the use of our breakthrough technology for natural orifice surgical tools with integrated haptic sensing. Thanks to the low latency, large bandwidth, slicing and edge computing of 5G, the first successful lab-based remote surgery trials were completed in December 2018.
Collaborator Contribution Partners financial support for prototyping developments
Impact A prototype of the tactile gripper developed using ESSENCE technology will be demonstrated by Ericsson at the Mobile World Congress 2017. This collaboration is multi-disciplinary, since it combine the expertise from robotics and telecommunication as well as inputs from the clinicians for sensor functionality requirements http://kclhammerlab.com/2019/about/lab-news/hammer-showcases-5g-remote-surgery-at-the-mobile-world-congress-2019/
Start Year 2016
 
Description ICRA 2019 Workshop on Soft Haptic Interaction: Modeling, Design and Application, 24 May 2019 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This workshop aims to consolidate the contributions from a special issue on RA-L on the same topics, organized by the applicants. Evidenced by the large amount of interests and submission numbers, we believe that it is timely to define the emerging soft haptics to be a new science, with specific and distinct features that deserve a comprehensive multi-disciplinary approach. This workshop aims to bring together experts from the diverse range of disciplines to discuss the following topics: 1. Science of functional materials, modeling of soft-sensorized bodies, morphological optimization; 2 novel fabrication methods, integration of sensing and actuating elements, active sensing; and 3. specific applications of soft haptics in soft-bodied robots for interactive tasks such as soft grasping, locomotion, and human-machine interfaces. Such research is not only relevant to academic community, but has immediate and potentially high impact in many practical areas such as telerobotics, medical devices, and advanced human-human and human-robot communication through wearables, among the others
Year(s) Of Engagement Activity 2019
URL http://kclhammerlab.com/2019/about/lab-news/icra-2019-workshop-on-soft-haptic-interaction-modeling-d...