Innovations in surgical scopes—wireless steerable endoscopes and magnetic cameras

Conventional rod lens endoscope has for decades facilitated minimally invasive surgery (MIS) procedures. Video-assisted thoracic surgery (VATS) has continued to evolve in pursuit of minimizing surgical access trauma leading to the development of uniportal VATS. However, operating through a single small incision using the rod lens endoscope proves to be challenging. The view and maneuverability of the endoscope is limited by the unidirectional approach, and in addition a crowded port site increases risk of interference and fencing between instruments. These challenges have inspired innovation in endoscopic systems to allow wider range of viewing directions and angles with minimum scope movement. In particular, flexible endoscopes and magnetic endoscopes have unique advantages and potential over conventional rigid equipment. Flexible endoscopes with articulating tips offer distal dexterity, and provide wide range of viewing angles despite limited motion of endoscope shaft. Whereas magnetic anchored and actuated endoscopes go beyond tip dexterity, abandoning the rod body completely, and exploit magnetic linkage to navigate along intrathoracic surface, overcoming limit of unidirectional approach. Through wireless actuation, magnetic endoscopes also provide many views without occupying the access port, reducing incision size and risk of instrument interference. To apply the devices clinically, current prototypes still require lens cleaning strategy and sensors to match image quality of commercial systems. With these issues addressed, these novel systems may allow safer and more efficient performance of uniportal VATS, benefiting both surgeons and patients.