Tian-Ao Ren

Guankun Wang, Tian-Ao Ren, Jiewen Lai et al.

Video-assisted transoral tracheal intubation (TI) necessitates using an endoscope that helps the physician insert a tracheal tube into the glottis instead of the esophagus. The growing trend of robotic-assisted TI would require a medical robot to distinguish anatomical features like an experienced physician which can be imitated by utilizing supervised deep-learning techniques. However, the real datasets of oropharyngeal organs are often inaccessible due to limited open-source data and patient privacy. In this work, we propose a domain adaptive Sim-to-Real framework called IoU-Ranking Blend-ArtFlow (IRB-AF) for image segmentation of oropharyngeal organs. The framework includes an image blending strategy called IoU-Ranking Blend (IRB) and style-transfer method ArtFlow. Here, IRB alleviates the problem of poor segmentation performance caused by significant datasets domain differences; while ArtFlow is introduced to reduce the discrepancies between datasets further. A virtual oropharynx image dataset generated by the SOFA framework is used as the learning subject for semantic segmentation to deal with the limited availability of actual endoscopic images. We adapted IRB-AF with the state-of-the-art domain adaptive segmentation models. The results demonstrate the superior performance of our approach in further improving the segmentation accuracy and training stability.

Chi Kit Ng, Huxin Gao, Tian-Ao Ren et al.

Navigating a flexible robotic endoscope (FRE) through the gastrointestinal tract is critical for surgical diagnosis and treatment. However, navigation in the dynamic stomach is particularly challenging because the FRE must learn to effectively use contact with the deformable stomach walls to reach target locations. To address this, we introduce a deep reinforcement learning (DRL) based Contact-Aided Navigation (CAN) strategy for FREs, leveraging contact force feedback to enhance motion stability and navigation precision. The training environment is established using a physics-based finite element method (FEM) simulation of a deformable stomach. Trained with the Proximal Policy Optimization (PPO) algorithm, our approach achieves high navigation success rates (within 3 mm error between the FRE's end-effector and target) and significantly outperforms baseline policies. In both static and dynamic stomach environments, the CAN agent achieved a 100% success rate with 1.6 mm average error, and it maintained an 85% success rate in challenging unseen scenarios with stronger external disturbances. These results validate that the DRL-based CAN strategy substantially enhances FRE navigation performance over prior methods.

Guankun Wang, Tian-Ao Ren, Jiewen Lai et al.

Robotic-assisted tracheal intubation requires the robot to distinguish anatomical features like an experienced physician using deep-learning techniques. However, real datasets of oropharyngeal organs are limited due to patient privacy issues, making it challenging to train deep-learning models for accurate image segmentation. We hereby consider generating a new data modality through a virtual environment to assist the training process. Specifically, this work introduces a virtual dataset generated by the Simulation Open Framework Architecture (SOFA) framework to overcome the limited availability of actual endoscopic images. We also propose a domain adaptive Sim-to-Real method for oropharyngeal organ image segmentation, which employs an image blending strategy called IoU-Ranking Blend (IRB) and style-transfer techniques to address discrepancies between datasets. Experimental results demonstrate the superior performance of the proposed approach with domain adaptive models, improving segmentation accuracy and training stability. In the practical application, the trained segmentation model holds great promise for robot-assisted intubation surgery and intelligent surgical navigation.