Abstract
The discrepancy between spatial orientations of an endoscopic image and a physician’s working environment can make it difficult to interpret endoscopic images. In this study, we developed and evaluated a device that corrects the endoscopic image orientation using an accelerometer and gyrosensor. The acceleration of gravity and angular velocity were retrieved from the accelerometer and gyrosensor attached to the handle of the endoscope. The rotational angle of the endoscope handle was calculated using a Kalman filter with transmission delay compensation. Technical evaluation of the orientation correction system was performed using a camera by comparing the optical rotational angle from the captured image with the rotational angle calculated from the sensor outputs. For the clinical utility test, fifteen anesthesiology residents performed a video endoscopic examination of an airway model with and without using the orientation correction system. The participants reported numbers written on papers placed at the left main, right main, and right upper bronchi of the airway model. The correctness and the total time it took participants to report the numbers were recorded. During the technical evaluation, errors in the calculated rotational angle were less than 5 degrees. In the clinical utility test, there was a significant time reduction when using the orientation correction system compared with not using the system (median, 52 vs. 76 seconds; P = .012). In this study, we developed a real-time endoscopic image orientation correction system, which significantly improved physician performance during a video endoscopic exam.
Highlights
Video endoscopes, such as laparoscopes, gastroenteroscopes, and bronchoscopes, are used in many fields of medicine to help clinicians diagnose and treat patients less invasively with shorter hospital stays
The rotational angle θ was defined as 0 when the sensor was in the opposite direction of gravity and increased when the endoscope rotated in the clockwise direction
The optical rotational angle measured from the captured image during the random rotation of the camera ranged from −83.1 ̊ to 88.0 ̊ with the wired sensor connection and from −108.0 ̊ to 90.9 ̊ with the wireless connection
Summary
Video endoscopes, such as laparoscopes, gastroenteroscopes, and bronchoscopes, are used in many fields of medicine to help clinicians diagnose and treat patients less invasively with shorter hospital stays. It has been reported that a surgeon’s performance decreases when the optical axis of the endoscope equipment does not match the direction of gravity [3, 4]. Attempts to solve this problem have included pattern recognition [5], electromagnetic field sensors [6], and accelerometers [7, 8]. The electromagnetic method uses a current induced by a coil moving through a magnetic field This technique is widely used as a tracking system for image-guided interventions [10], but it can be used for image orientation correction [6]. An accelerometer should be used in combination with a gyrosensor to correct the direction of a rapidly rotating endoscope
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