A MagsL-HUD Endoscopic System for Magnetic Compression Anastomosis Surgery in Unstructured Endoluminal Environment

Abstract

Magnetic compression anastomosis (MCA) offers a promising solution for minimally invasive anastomosis surgery. However, current MCA schemes lack safe, real-time localization, and guidance for compression magnets, hindering surgeons’ ability to control the compression magnets effectively in complex, unstructured endoluminal environments. To address these limitations, this article introduces the MagsL-HUD endoscopic system, a novel solution that enables multimagnetic six-degree-of-freedom (six-DoF) localization and head-up display (HUD) guidance within the endoscopic view (EV). Specifically, the system integrates a developed Endo-MagCap device with an orthogonal magnet configuration, along with a magnetic sensor array, to achieve real-time full-pose localization. An endoscopic camera model is incorporated for HUD visualization, enhancing intuitive interaction for surgeons’ better informed decisions. Eventually, the effectiveness of the Mags-LHUD endoscopic system is validated through laboratory experiments and ex vivo animal trials. The system demonstrates six-DoF tracking accuracy with average errors of 0.0070 m and 0.1437 rad, and 0.0071 m and 0.1721 rad in the designed trajectory cases for two compression magnets, respectively. Additionally, ex vivo porcine tests confirm the system’s feasibility and applicability, successfully performing a stomach-colon MCA surgery with a final compression gap of approximately 0.00247 m. Further comparative studies demonstrate that the MagsL-HUD method has a compression success rate of 71.4% versus 42.9% of the non-HUD approaches in the designed tests. This work represents a significant step toward the clinical adoption of magnetic-assisted endoscopy for minimally invasive anastomosis surgeries, holding substantial practical significance for improving the safety and efficacy of MCA procedures in complex, unstructured endoluminal environments.