Advancing Minimally Invasive Precision Surgery in Open Cavities with Robotic Flexible Endoscopy

Abstract

Flexible robots hold great promise for enhancing minimally invasive surgery (MIS) by providing superior dexterity, precise control, and safe tissue interaction. Yet, translating these advantages into endoscopic interventions within open cavities remains challenging. The lack of anatomical constraints and the inherent flexibility of such devices complicate their control, while the limited field of view of endoscopes restricts situational awareness. We present a robotic platform designed to overcome these challenges and demonstrate its potential in fetoscopic laser coagulation, a complex MIS procedure typically performed only by highly experienced surgeons. Our system combines a magnetically actuated flexible endoscope with teleoperated and semi-autonomous navigation capabilities for performing targeted laser ablations. To enhance surgical awareness, the platform reconstructs real-time mosaics of the endoscopic scene, providing an extended and continuous visual context. The ability of this system to address the key limitations of MIS in open spaces is validated in vivo in an ovine model.