Michael Hughes

Petros Giataganas, Michael Hughes, Christopher J. Payne et al.

Objective: Probe-based confocal endomicroscopy is an emerging high-magnification optical imaging technique that provides in vivo and in situ cellular-level imaging for real-time assessment of tissue pathology. Endomicroscopy could potentially be used for intraoperative surgical guidance, but it is challenging to assess a surgical site using individual microscopic images due to the limited field-of-view and difficulties associated with manually manipulating the probe. Methods: In this paper, a novel robotic device for large-area endomicroscopy imaging is proposed, demonstrating a rapid, but highly accurate, scanning mechanism with image-based motion control which is able to generate histology-like endomicroscopy mosaics. The device also includes, for the first time in robotic-assisted endomicroscopy, the capability to ablate tissue without the need for an additional tool. Results: The device achieves pre-programmed trajectories with positioning accuracy of less than 30 um, while the image-based approach demonstrated that it can suppress random motion disturbances up to 1.25 mm/s. Mosaics are presented from a range of ex vivo human and animal tissues, over areas of more than 3 mm^2, scanned in approximate 10 seconds. Conclusion: This work demonstrates the potential of the proposed instrument to generate large-area, high-resolution microscopic images for intraoperative tissue identification and margin assessment. Significance: This approach presents an important alternative to current histology techniques, significantly reducing the tissue assessment time, while simultaneously providing the capability to mark and ablate suspicious areas intraoperatively.

Lin Zhang, Menglong Ye, Petros Giataganas et al.

Robotic-assisted Minimally Invasive Surgery (RMIS) can benefit from the automation of common, repetitive or well-defined but ergonomically difficult tasks. One such task is the scanning of a pick-up endomicroscopy probe over a complex, undulating tissue surface in order to enhance the effective field-of-view through video mosaicing. In this paper, the da Vinci surgical robot, through the dVRK framework, is used for autonomous scanning and 2D mosaicing over a user-defined region of interest. To achieve the level of precision required for high quality large-area mosaic generation, which relies on sufficient overlap between consecutive image frames, visual servoing is performed using a tracking marker attached to the probe. The resulting sub-millimetre accuracy of the probe motion allows for the generation of large endomicroscopy mo- saics with minimal intervention from the surgeon. It also allows the probe to be maintained in an orientation perpendicular to the local tissue surface, providing optimal imaging results. Images are streamed from the endomicroscope and overlaid live onto the surgeons view, while 2D mosaics are generated in real-time, and fused into a 3D stereo reconstruction of the surgical scene, thus providing intuitive visualisation and fusion of the multi-scale images. The system therefore offers significant potential to enhance surgical procedures, by providing the operator with cellular-scale information over a larger area than could typically be achieved by manual scanning.