EYE GAZE-CONTROLLED ROBOTIC FLEXIBLE ENDOSCOPY: A FEASIBILITY STUDY

Introduction A gaze-controlled robotic endoscope is innovative technology with myriad potential applications in the rapidly advancing field of flexible endoscopy. Improvements to the current flexible device to allow examination of the gastrointestinal tract whilst minimising procedural discomfort and complications are desirable. Methods Users are able to control endoscope movements without handling the device. A flexible gastroscope (Karl Storz 13801 PKS) was attached to a UR5 6 axis robotic arm (Universal Robots), mounted onto a rail and placed on top of a surgical table. Two cogwheel shaped dials were 3D printed and placed onto the up/down and left/right wheels on the head of the gastroscope (Figure 1a). Robotization of these controls was achieved by using two motors (DYNAMIXEL RX-24F) to steer the distal tip. This system allows users to operate a robotised flexible endoscope using eye gaze control. Gaze interaction with the screen was based on a 3D gaze framework we developed with the synergy of conventional wearable eye-tracking glasses, a motion capture system and fixed in space RGB-D cameras for 3D reconstruction of the environment. The eye gaze technology was calibrated for each user prior to the task. The distal tip of the gastroscope was controlled using eye gaze technology. The UR5 robot was used to enable shaft rotation. This was initiated by fixed head movements left and right rotating the shaft clockwise/anticlockwise. Linear movements of the gastroscope were triggered using a joystick handle (up for forward movement, down for endoscope withdrawal). Pause and automatic retroflexion of the endoscope are achieved by moving the joystick left and right respectively. Users were asked to navigate an endoscope through an UGIT model (Chamberlain group) simulating a diagnostic gastroscopy using gaze control and targeting ten points scattered through the stomach (Figure 1b). Results Four expert endoscopists and one novice used gaze control to successfully navigate a gastroscope through the simulated UGIT. All were able to independently intubate the oesophagus and accurately locate ten targets placed in the fundus, body, antrum and pylorus of the stomach without touching the endoscope. Conclusions Gaze control endoscopy is a feasible concept. It allows ergonomic, user-friendly and intuitive control whilst maintaining the benefits of a flexible endoscope.