Assisted teleoperation control of robotic endoscope with visual feedback for nasotracheal intubation

Abstract

Endoscopic operation is one of the most difficult parts of nasotracheal intubation (NTI), a surgical procedure used to secure the airway of a patient. Due to the requirement of eye–hand coordination, manual operation of a flexible endoscope is challenging, even for an experienced surgeon. To enhance intubation efficiency, this paper developed a master–slave robotic nasotracheal intubation system (RNIS) for endoscopic operation. Movements in three degrees of freedom of the endoscope are controlled by the RNIS. An assisted teleoperation control strategy is designed to assist the operator in remotely controlling the pose, i.e., position and orientation, of the endoscope tip via a joystick. To ensure the efficiency of intubation, visual feedback assistance is hereby proposed, which fine-tunes the orientation of the endoscope tip as needed. The proposed system and methods are experimentally validated on a motion simulator and a phantom. The results demonstrated that the master–slave RNIS can successfully insert the flexible endoscope into the trachea of a phantom through the nasal cavity.