Endoscopic Module for On-Demand Robotic Assistance (EndoMODRA)

Nascent endoscopic therapeutic procedures, such as endoscopic submucosal dissection, enable unparalleled access to and removal of mid-size cancerous neoplasia from within the gastrointestinal tract. However, the remote locations of these lesions often require substantial dexterity which imparts appreciable cognitive loading on the clinician and opens up the possibility of adverse events such as intestinal perforation due to limited dexterity and a lack of sensory feedback. In this work, we introduce EndoMODRA (Endoscopic Module for On-Demand Robotic Assistance) which interfaces with commercially-available endoscopic tools and provides additional dexterity and feedback sensing using on-board actuators and sensors. Leveraging alternative actuation strategies and monolithic, printed-circuit-inspired manufacturing processes, we develop mm-scale actuation and sensing modalities that are fully contained within the distal module, obviating the need for a continuous mechanical transmission to a proximal actuation source. Closed-loop position-controlled trajectory execution is demonstrated using on-board actuation and sensing, realizing the first instance where fully-distal loop closure is achieved in an endoscope-mounted robotic module with no proximal actuation or sensing component. System efficacy is demonstrated through in vitro, ex vivo, and in vivo tests on appropriate analogs. This research lays the groundwork for a new class of endoscopic robot modalities the bridges the gap between simplistic, low-cost add-on devices and sophisticated, stand-alone robotic systems.