Real-time flexible endoscope navigation within bladder phantom having sparse non-distinct features is enhanced with robotic control

Endoscopic inspection of the bladder is called cystoscopy, and over 1 million are performed annually in the USA.(1) Robotic assistance of the procedure is being considered to overcome healthcare disparities due to geographic distances. To ensure safety, real-time navigation by simultaneous localization and mapping (SLAM) of the cystoscope in the bladder is desired. However, the near-featureless bladder wall and irregular movement of the monocular cystoscope by manual operation has made SLAM-based navigation a difficult challenge. In this work we develop a robot-assisted approach in a bladder phantom using a commercial flexible cystoscope. With this simple remote-controlled robot, we have succeeded in creating a series of real-time 2.5D reconstructions of the bladder interior wall. In post-processing, we combine those 2.5D results and achieve a 3D reconstruction. We compared SLAM performance using the robot and manual control under different scanning speeds. In comparison to manual control using the same cystoscope at 1x, 2x and 3x speeds, the robotic-assistance provides significantly more robust and accurate reconstructions of the camera trajectories and bladder wall locations in real-time.