1718 IEEE ROBOTICS AND AUTOMATION LETTERS, VOL. 2, NO.

3, JULY 2017

A Novel Robotic Meshworm With Segment-Bending

Anchoring for Colonoscopy
Julius E. Bernth, Student Member, IEEE, Alberto Arezzo, and Hongbin Liu, Member, IEEE

Abstract—This letter introduces the design and evaluation of a [3]. Bladder structures based on artificial muscles were inflated
novel worm-inspired, multisegment robotic endoscope with mul- to cause an expansion and contraction in a particular segment.
tiple degrees of freedom segments. The novelty of this design is Doing this in proper sequence, peristaltic motion was achieved.
that the robot is able to drive forwards and backwards, anchor
itself, steer while inside a tubular structure and control the orien- The device was tested in a rigid plastic pipe to approximate a
tation of an end-mounted camera all by bending its flexible seg- human intestine and achieved speeds of 5 mm/s. Menciassi et al.
ments. The mechanical design is shown and a sensing system based produced a device in [4] and [5] that relied on shape memory al-
on Hall Effect sensors is incorporated. In a simulated colon, a loy (SMA) actuators to produce worm-like crawling motion. To
top speed of 1.21 mm/s was achieved, equivalent to roughly 38% ensure that the device would move forward, small hooks were
of the theoretical maximum. These results are discussed and fur-
ther improvements are suggested, followed by general concluding embedded on the outer skin of the robot to increase friction in
remarks. one direction. While effective during forward movement, this
feature does, however, prevent the device from moving back-
Index Terms—Biologically-inspired robots, medical robots and
systems, soft material robotics.
wards. Designs presented in [6] and [7] rely on geared DC
motors to actuate linkages between segments, thus producing
peristaltic motion. Additionally, an anchoring mechanism was
I. INTRODUCTION incorporated in the system presented in [6] which allows ei-
OLORECTAL cancer accounts for approximately 10% ther the front-most or rear-most segment to increase friction on
C of all known cancer cases worldwide and is therefore a
serious cost to health services [1]. There is evidence to suggest
its surrounding environment. This anchoring mechanism was
controllable and the device was able to move both forward and
that fear of discomfort is a significant reason for patients not backward. The design presented in [8] consists of a spring-like,
attending regular bowel screenings [1]. As regular screenings soft mesh which is then deformed by a series of SMA actuators.
are one of the best and most effective methods of preventing The arrangement of the actuators is inspired by how circular and
bowel cancer [2], the fact that only a little over half of the longitudinal muscle fibres function in common earth worms.
patients eligible for screening refuse to undergo colonoscopy Motion is achieved through peristalsis. Additionally, a sensing
impairs the effort of screening programs [2]. Finding a more system was employed to achieve position feedback control of
comfortable alternative to traditional push endoscopes could each segment.
significantly increase participation in regular pre-screenings. A number of commercial alternatives to the traditional en-
Worm-like robots present exactly such an alternative to push doscope exist. These include the Aeroscope [9], Invendoscope
endoscopes and research towards improving worm-like robotic [10], [11], NeoGuide [12], [13] and Endotics Systems [14]. With
endoscope design could have significant impact on people’s regard to propulsion method, only Endotics uses an on-board,
health and wellbeing. This letter will present a novel design for worm-inspired locomotion system. The Endotics system relies
a soft, multi-segment worm robot. on a technique involving suction and clamping of local colon
Recently, a number of worm-like robots have been proposed. tissue to anchor either of its two end points. First, the front
An early mesh-based robot consisted of three pneumatically ac- segment is anchored using suction and clamping. The central
tuated segments specifically intended for use in colonoscopy segment is then contracted to bring the rear segment forward,
where after the rear segment is anchored. The middle segment
Manuscript received September 9, 2016; accepted February 13, 2017. Date is then extended and the sequence repeated, driving the device
of publication March 6, 2017; date of current version May 16, 2017. This forward, similar to how an inchworm moves. The front segment,
paper was recommended for publication by Associate Editor H. Liao and Ed- equipped with a camera and biopsy tool is able to orient the end
itor A. Bicchi upon evaluation of the reviewers’ comments. This work was
supported by the EPSRC under Grant EP/N508986/1. (Corresponding author: segment.
Hongbin Liu.) In general, the above research prototypes use segments that
J. E. Bernth and H. Liu are with the Centre for Robotic Research (CoRe), have a single degree-of-freedom (DOF). Given that it is nec-
Department of Informatics, King’s College London, London WC2R 2LS, U.K.
(e-mail: [email protected]; [email protected]). essary to have control of camera orientation and steering in
A. Arezzo is with the Department of Surgical Sciences, University of Turin, endoscopy, a single DOF system will not be sufficient. The
10126 Turin, Italy (e-mail: [email protected]). commercial designs (for the most part) allow for camera ori-
This letter has supplementary downloadable material available at http:// iee-
explore.ieee.org, provided by the authors. entation and steering. All but Endotics rely on force being ap-
Digital Object Identifier 10.1109/LRA.2017.2678540 plied externally to the colon in order to propel the endoscope.

This work is licensed under a Creative Commons Attribution 3.0 License. For more information, see http://creativecommons.org/licenses/by/3.0/
BERNTH et al.: NOVEL ROBOTIC MESHWORM WITH SEGMENT-BENDING ANCHORING FOR COLONOSCOPY 1719

Fig. 1. Assembled prototype with an endoscopic camera mounted on the end

of the device.
Fig. 2. Cut-away sections of computer models of the 3-DOF segment (top)
The Endotics design uses two separate mechanisms for anchor- and the 1-DOF segment (bottom).
ing and camera orientation/steering. The advantage of the de-
sign proposed in this letter is that it uses only one mechanism to
achieve both anchoring and camera orientation/steering. There-
fore, the complexity of the design is reduced relative to Endotics.
Given that endoscopes are required to be very small in diameter,
a reduction in complexity can lead to an increase in reliability.
Additionally, this device is able to adapt to a varying colon
diameter through use of the bending-anchoring method.

II. DESIGN
A. Overview
The robot (see Fig. 1) consists of three separate segments. Fig. 3. Front view of the two drive assemblies and end cap showing where
wires and working channels could be passed through. The yellow area repre-
Each segment consists of an elastic mesh structure which is an- sents housing which could easily be redesigned to accommodate more wires or
tagonistically driven by tendons. The tendons are wound around working channels. The grey areas represent critical components which are more
pulleys which are mounted on DC motors. As the motors rotate, challenging to redesign.
the lengths of the tendons change, either compressing or extend-
ing the mesh body. Contraction of each segment is achieved by been heat treated around a specially designed mould, creating
shortening a tendon, thus actively pulling the mesh. Extension a ribbed structure. The flexible section of each mesh is approx-
is achieved by giving the tendons slack and allowing the mesh imately 80 mm long and has a stiffness equal to 0.223 N/mm
to passively expand due to its natural elasticity. The front and over a strain range between 0 to 50%, which was sufficient for
rear segments are actuated by three motors. Therefore, they have this design. The outer mesh could be made water tight and dis-
one linear DOF to accomplish contraction and extension and two posable to ensure sterilisation, allowing the drive assemblies to
rotational DOFs allowing bending about two axes. The middle be reused with minimal cleaning and sterilisation effort.
segment only has a single, linear DOF for contraction and exten- The outer diameter of all of the collars is 26 mm. The maxi-
sion. The design is modular – segments can be fitted together in mum outer diameter of the mesh when uncompressed is approx-
any order and motor housings can be swapped between meshes imately 31 mm and 35 mm when compressed. Given that the
at will. With this in mind, the fundamental structure of any given mesh is a soft material, these diameters are of less concern com-
segment is the same. This basic structure is shown in Fig. 2. pared to that of the rigid collar/drive assemblies. As the colon
In order to evaluate the system’s ability to function as an is around 26 mm in diameter at its narrowest [16], however,
endoscope, a miniature USB camera (6 mm diameter, 640 × the device’s diameter will need to be reduced in future design
480 resolution) with illuminating LEDs was mounted on the iterations. Significant diameter reductions can be achieved by
end of the prototype. The final prototype was approximately redesigning the sensing system (see Section III-B).
50 cm in length. The camera cables were passed through the
drive assemblies using specially designed passages (see Fig. 3). B. Locomotion Strategy
The sizes of these passages can be easily increased in the future. The proposed locomotion strategy (see Fig. 4) takes advan-
The camera is fixed in a plastic housing, attached at the tip tage of the end segments’ ability to bend in order to selectively
of the front segment, where it would be possible in the future to increase frictional forces between the colon wall and the skin
mount additional equipment such as a biopsy tool. of the robot. As it is assumed that the device will always be
The body of the robot is comprised of the polyethylene tereph- travelling in a tubular environment, bending one segment to a
thalate (PET) mesh material proposed in [15]. The mesh has sufficiently large angle will “jam” it into place. As the tip of the
1720 IEEE ROBOTICS AND AUTOMATION LETTERS, VOL. 2, NO. 3, JULY 2017

Fig. 4. Illustration of a single iteration of the proposed locomotion sequence.

bending segment presses against one side of the colonic wall,

the curved middle section of the segment is pressed against the
opposite wall. As the mesh is compliant, it will deform, avoid-
Fig. 5. Simplified diagram of the locomotion sequence.
ing damaging the colon and increasing the friction between the
colonic wall and the bent segment, thus anchoring it into place.
A primary advantage of this method is that the bending angle of
the segment can be adjusted to adapt to changing colon diam- the speed, modifications to the sequence itself could also po-
eters. As the diameter of the human colon varies significantly tentially improve performance. The sequence shown in Fig. 5
depending on location in the colon [16], this adaptability is only permits a single segment to move at any given time. By
highly useful for endoscopy. allowing segments to move simultaneously, stages of the orig-
Forward motion is achieved by having only one of the end inal sequence may be skipped, and thus decrease Δttot . This
segments anchored. The middle segment is then able to move the is achieved by combining stages of the basic sequence so that
unanchored end segment relative to the anchor by contracting or segments move simultaneously. For example, if the anchoring
extending. Thus, when done in the correct sequence, forward or and unanchoring stages were performed simultaneously for the
backward locomotion may be achieved. Additionally, as each two end segments, then only four stages would be required,
of the end segments can bend, they are able to actively steer as opposed to six. In other words, the stages at t0 and t3 are
the device around turns and control the orientation of a camera removed. This is shown in Fig. 6.
mounted on the end. Given that the human colon can be highly In order to have a clearer understanding of how the device
tortuous [16], this ability to steer is critical. performs, the efficiency of locomotion may be defined as
vreal
ηlo c = (2)
C. Locomotion Analysis videal
In each iteration of the proposed locomotion sequence, the where ηlo c is the locomotive efficiency and vreal is the measured
theoretical distance by which the tip of the robot will advance speed of the device. There are two primary ways in which loco-
is equal to the contraction distance of the middle segment motive efficiency could drop, as illustrated in Fig. 6. Firstly, the
Δxe,ideal . This is illustrated in Fig. 5. Additionally, the total middle segment could fail to extend completely due to external
time taken for each iteration is equal to Δttot . Hence, the ideal friction. Since it is not possible to directly control the extension
speed of the robot may be expressed as of the mesh (it is only possible to “allow” it to passively extend),
this middle segment may not extend completely during opera-
Δxe,ideal
videal = . (1) tion. Secondly, the anchoring force could be insufficient on one
Δttot of the end segments and result in an anchored segment slipping.
Thus, it is possible to define the actual distance moved forward
From (1), it is clear that to increase speed either Δxe,ideal
each iteration Δxf as
must be increased or Δttot must be decreased. While simply
making each segment move as fast as possible would increase Δxf = Δxe − Δxs (3)
BERNTH et al.: NOVEL ROBOTIC MESHWORM WITH SEGMENT-BENDING ANCHORING FOR COLONOSCOPY 1721

TABLE I
SUMMARY OF RELEVANT MOTOR PROPERTIES

Property Motor

3-DOF 1-DOF

Rated Voltage / V 3 3
Diameter / mm 6 12
Length / mm 24.0 20.8
Rated Torque / mN-m 10 40
Rated Speed / rpm 37 22
Pulley Radius / mm 2 5
Rated segment contraction speed / mm/s 7.75 11.5
Rated segment contraction distance / mm 67 36

Fig. 6. Diagram of a single iteration of the improved locomotion sequence

where non-idealities occur. Δsi refers to the distance slipped by and Δxe
denotes the actual extension distance of the middle segment.

where Δxs = Δs1 + Δs2 . The real velocity may then be de-
fined as
Δxe − Δxs Δxf
vreal = = . (4)
Δttot Δttot
With this, additional locomotive efficiencies may be defined Fig. 7. View of underside of a pulley to illustrate the sensing system’s
functionality.
in order to better understand the behaviour of the device. Sub-
stituting (1) and (4) into (2) yields
Δxf Δxe Δxf
ηlo c = = · = ηe ηa (5) time taken for a single contraction/extension stage. In (6), only
Δxe,ideal Δxe,ideal Δxe Nanch is dependent on the design of the locomotion sequence
Δx itself. The variables Δxe,ideal , Δtcon and Δtanch are dependent
where ηe = Δ xΔe ,xi dee a l and ηa = Δ xfe . The expansion efficiency
on the limitations of the actuators and hardware used in the
ηe measures how much of the theoretical expansion is achieved.
device. Therefore, Nanch is the defining variable which may
The anchoring efficiency ηa measures how effectively the sys-
identify a given locomotion sequence. In this case, Nanch = 2.
tem is able to anchor during the locomotion sequence. Thus, two
separate quantities can be measured to evaluate the two primary
performance aspects of the device. III. DESIGN FEATURES
A. Actuator Selection
D. Sequence Implementation
Miniature DC motors were selected to actuate the robot due to
In order to easily implement the locomotion sequence, it is their wide availability and low cost. The Precision Microdrives
useful to split each sequence into two separate parts: anchor- 206-10C was selected to drive the 3-DOF segment and the larger
ing/unanchoring and contraction/extension. It is reasonable to Precision Microdrives 212-103 12mm DC motor was chosen for
assume that each individual part will always take the same time the 1-DOF segment. The relevant properties of these motors are
to perform. Also, regardless of the details of the locomotion se- summarised in Table I.
quence, there will necessarily have to be a contraction stage and With these values, the parameters of the locomotion sequence
an extension stage for the middle segment in order to produce were selected as follows: Δxe,ideal = 45 mm, Δtanch = 3 s
forward movement. Hence, (1) may be rewritten as and Δtcon = 4 s.
Δxe,ideal
videal = (6)
Nanch Δtanch + 2Δtcon B. Sensing
where Nanch refers to the number of anchoring/unanchoring In order to implement feedback control on each tendon, a Hall
stages present in the sequence, Δtanch refers to the time taken Effect-based sensor system was used. The principle is shown in
for a single anchoring/unanchoring stage and Δtcon refers to the Fig. 7. A ring-shaped magnet, diametrically magnetized, was
1722 IEEE ROBOTICS AND AUTOMATION LETTERS, VOL. 2, NO. 3, JULY 2017

Fig. 9. Block diagram of the control system implemented.

Fig. 8. Plot of a comparison between the angle measured with the poten-
tiometer (the “True angle”) and the angle measured with the Hall Effect sensing
system (“Calculated angle”).

embedded in the bottom of each pulley. Two Hall Effect sen-

sors were placed 90° apart around the perimeter of the pulley.
The signal of each sensor varied sinusoidally with the pulley’s
angular position. As the two sensors were physically 90° apart,
the sinusoidal sensor signals were also 90° out of phase. After
Fig. 10. Step response of the middle section for various contraction distances.
linearly mapping the two signals such that they each had a value The dashed lines indicate the demanded path while the solid lines indicate the
in the range [1, 1], the angle of the pulley could be computed actual position of the end of the segment.
using

θ (t) = Atan2 [h1 (t) , h2 (t)] (7)

where h1 (t) and h2 (t) are the Hall Effect sensor readings after
mapping. With the absolute angle of the pulley known at any
time, it was possible to calculate the length of each tendon with
knowledge of some initial tendon length and the associated
pulley angle:

L (t) = L (0) + [θ (t) − θ (0)] · rpulley . (8)

To evaluate the sensing system, a potentiometer was rigidly Fig. 11. A time-lapse series of the chosen locomotion squence. The positions
attached to a pulley to provide a reliable measurement of the of the markers are indicated as red dots. A corresponding view from the on-board
pulley angle. A comparison between the two readings is shown camera can be found to the right of each picture.
in Fig. 8.
IV. EXPERIMENT
C. Control Two experiments were carried out. Firstly, the middle segment
step response was evaluated to investigate the effectiveness of
A simple PID controller was chosen to control the length of
the contraction/extension movement. Secondly, the prototype
each tendon. This was implemented on a single microcontroller
was run through a simulated colon.
(MCU) board which would process the signals from the Hall
Effect sensors in each segment and compute the PID control
A. Step Response
output. A secondary path planning MCU would compute high
level path control information and send this to the other MCU In order to ensure that the middle segment was accurately
via I2 C bus. This is shown in Fig. 9. contracting, a simple step response test was carried out on the
BERNTH et al.: NOVEL ROBOTIC MESHWORM WITH SEGMENT-BENDING ANCHORING FOR COLONOSCOPY 1723

Fig. 12. Results of the locomotion test in the simulated colon. (a) Plot of the middle and rear segment positions over the whole experiment in comparison to
their theoretical positions. (b) The average position of the middle segment during one sequence iteration. For simplicity, the results were normalised in order to
show that the middle segment always starts at zero. (c) The average extension of the middle segment over a single sequence iteration.

fully assembled prototype. This involved commanding the cen- TABLE II

AVERAGE LOCOMOTION TEST RESULTS
tral segment to contract from an un-extended state to a given
new length and then back to its original length. A vision system
v r e a l /m m /s Δ x f /m m Δ x e /m m Δ x s /m m ηlo c ηe ηa
was used to evaluate the true position of a marker on the end of
the central segment. 1.21 16.99 39.70 22.71 0.38 0.88 0.43
The results of this are shown in Fig. 10. It is clear from this
that the system shows some problems with regard to tracking
a dynamic path. The system is, however, sufficiently accurate The average speed of the device was calculated by measuring
in reaching the final target position. Upon extending back to the total distance travelled and the total time taken for the worm
its original length, on the other hand, the segment does not to reach its final position. This then allowed ηlo c to be calculated
reach its original position. This is most likely due to the low with knowledge of the ideal speed discussed previously.
restoring forces present at low extensions which are insufficient The raw data was then separated to allow for each iteration
to overcome friction. to be analysed individually. Data from each individual iteration
was then compared at fixed 1 s intervals. With this data, it was
B. Simulated Colon possible to produce an average trajectory for a given marker
A sheet of flexible plastic “bubble wrapping” was rolled into during a single iteration. These results may be seen in Fig. 12(b)
a tube to create a simulated colon. This was selected as an and (c).
appropriate experimental simulacrum primarily due to its soft The extension at each iteration was calculated by noting the
and compliant properties. The tube was approximately 50 mm initial distance between x1 and x2 , denoted as ΔL0 . Then,
in diameter and 1200 mm long. Its internal surface was dry and for each iteration, the total extension for each iteration was
smooth. The tube was laid on a bench on top of a number of calculated according to
additional layers of bubble wrapping. In order to better account
for the fact that the colon is only partially hung and is therefore Δxe = x2 (t4 ) − x1 (t3 ) − ΔL0 + Δxe,ideal (9)
mobile in the abdominal cavity, only one end of the tube was where t3 = 10 s and t4 = 14 s relative to the beginning of each
fixed to the table, while the other was allowed to move freely. iteration respectively. Also, Δxe,ideal was added such that when
The robot would start a run at the free end of the tube and move the segment had contracted, a value of zero would be obtained
toward the fixed end. and if a full extension occurred, a value equal to Δxe,ideal
The bending angles of the two end segments were chosen would be obtained. The results of the analysis on the average
by trial and error while testing in the simulated colon. It was trajectories are shown in Table II.
found that with all segments straight and extended, the robot was
subject to around 1.1 N of static frictional force. With the front
segment bent, this frictional force increased to around 2.0 N, V. DISCUSSION & CONCLUSION
thus validating that the segment jamming strategy could work The prototype performed reasonably well overall. With the
in a real colon. average speed of 1.21 mm/s found in the experiment, the device
A time-lapse sequence of a single iteration of the locomotion would be able to move from one end of the average human colon
sequence is shown in Fig. 11. The position of two markers on with a length of 1850 mm [16] to the other in under 30 min (or
the body of the worm were used to calculate the locomotion just under an hour in order to complete both forward and return
parameters discussed in Section II. A plot of the position of journeys). This is consistent with the existing technology of
the rear and front points of the middle segment (x1 and x2 flexible endoscopy, which entails approximately 45 min for an
respectively) is shown in Fig. 12(a). entire procedure [17], but with the advantage of potentially less
1724 IEEE ROBOTICS AND AUTOMATION LETTERS, VOL. 2, NO. 3, JULY 2017

pain, if no pain at all – even without sedation, which is required In conclusion, a novel design for a robotic mesh worm was
during standard flexible colonoscopy. presented for use in colonoscopy. The device employs a novel
The extension efficiency was reasonably high. Looking be- new anchoring technique which allows the device to achieve for-
tween t = 10 s and t = 14 s in Fig. 12(c), the segment is able ward locomotion, camera orientation and anchoring with only
to extend most of its desired length, but as the compressive en- a single mechanism. A theoretical framework through which to
ergy is reduced, external friction begins to play a larger role and understand the locomotive performance of the device was es-
slows down the rate of extension. Therefore, it is not able to tablished. The device was fabricated and tested in a simulated
complete the full extension during the allocated 4 s. colon, achieving an average speed of 1.21 mm/s. In the future,
As a result, during the first anchoring/unanchoring stage of the theoretical framework will utilised to identify design im-
each sequence, some extension would occur in addition to that provements which will allow the device to be more efficient and
which had happened during the previous sequence. This can be achieve higher velocities.
seen from t = 0 s to 3 s in Fig. 12(b) and (c). It can also be
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