Thoracoscopic procedures require an assistant to hold and control the camera while the surgeon performs the surgical task. This paper presents an approach in which surgeons can control camera orientation using their head movements, allowing them to steer a flexible endoscope without the need for a camera assistant during the operation. Additionally, an augmented reality headset has been integrated into the head movement control system to serve as a virtual display monitor capable of following the user's gaze. Experiments were conducted to assess the feasibility of the head-controlled approach compared to the manual control method by conducting camerapointing experiments performed by clinicians and trained nonclinician participants at two difficulty levels. The results from the camera-pointing experiments have shown that the developed head-controlled endoscope has a statistically faster reaching time performance compared to manual use of the flexible endoscope in high difficulty index tasks with clinician participants (p=0.04), and in both lower and high difficulty index tasks with non-clinician participants (p=0.03). The head-controlled robotic endoscope approach enables surgeons to intuitively control the camera during an operation, while simultaneously performing other tasks using their hands, without sacrificing camera steering accuracy.
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