title: Evaluation of robotically controlled advanced endoscopic instruments.
abstract: BACKGROUND
  Advanced flexible endoscopes and instruments with multiple degrees of freedom enable physicians to perform challenging procedures such as the removal of large sections of mucosal tissue. However, these advanced endoscopes are difficult to control and require several physicians to cooperate.
  
  
  METHODS
  In this article, we present a robotic system that allows the physician to control an instrument in an intuitive way, using a haptic device. Performance with the robotic and conventional control methods were compared in a human subjects experiment. Subjects used both methods to tap a series of targets. They performed four trials while looking at the endoscopic monitor, and two trials while looking at the instrument directly.
  
  
  RESULTS
  Subjects were significantly faster using the robotic method, 54 s vs 164 s. Their performance in the second trial was significantly improved with respect to the first trial.
  
  
  CONCLUSIONS
  This study provides evidence that the robotic control method can be implemented to improve the performance of physicians using advanced flexible endoscopes.
authors.affiliation: Institute for Biomedical Technology and Technical Medicine (MIRA), University of Twente, The Netherlands. r.reilink@utwente.nl
authors.forename: Rob
authors.initials: R
authors.lastname: Reilink
authors.forename: Astrid M L
authors.initials: AM
authors.lastname: Kappers
authors.forename: Stefano
authors.initials: S
authors.lastname: Stramigioli
authors.forename: Sarthak
authors.initials: S
authors.lastname: Misra
mesh_terms: D019723:Endoscopes; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006801:Humans; D008328:Man-Machine Systems; D012371:Robotics / Q000295:instrumentation*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D013647:Task Performance and Analysis; D014110:Touch; D014584:User-Computer Interface