Collaborative Control Framework of a Robotic Transesophageal Echocardiography System for Guiding Structural Heart Interventions

Transesophageal echocardiography (TEE) is important for guiding the surgeon in percutaneous intervention for structural heart diseases. TEE is acquired through a catheterlike probe that must be maneuvered by a sonographer. Also, since X-ray fluoroscopy is adopted along with TEE, surgeons and sonographers must wear heavy protective suits to shield against radiation, leading to fatigue and the long-term risk of musculoskeletal injuries. This work proposes a robotic TEE system with a collaborative control framework designed to autonomously adjust the TEE probe, while relieving sonographers from physical effort and X-ray exposure. To enable accurate task space control in the constrained anatomical environment, a hybrid adaptive controller is introduced, leveraging offline hysteresis data and real-time feedback from electromagnetic (EM) sensors. Experiments conducted on silicone-casted esophagus phantoms with varying thicknesses, as well as path following tests with different patterns, demonstrate the controller's adaptability and accuracy. The framework was further validated through a complete workflow simulation within a cardiac phantom, replicating a transcatheter mitral valve repair procedure. The system maintained a maximum angular error below$3.2^\circ$. The results highlight the potential of the proposed robotic system for clinical applications in robot-assisted intervention procedures.