Frictional resistance characteristics of a capsule inside the intestine for microendoscope design

Resistance model of an active capsule endoscope in a peristaltic intestine

In the past studies, the resistance of magnetically controlled capsules running through the small intestine has been modeled assuming that the small intestine was a circular tube with a constant diameter. Peristalsis is an important character of the human gastrointestinal system, and it would result in some changes in the diameter of the intestine, meaning that the existing resistance models would no longer be applicable. In this paper, based on the assumption that intestinal peristalsis is actually a sinusoidal wave, a resistance model of the capsule running in the peristaltic intestine is established, and then it is validated experimentally. The model provides a realistic foundation for the optimization and control of the magnetically controlled endoscopy.

Wave-like Robotic Locomotion between Highly Flexible Surfaces and Comparison to Worm Robot Locomotion

In a recent study, we developed a minimally actuated robot that utilizes wave-like locomotion and analyzed its kinematics. In this paper, we present an analysis of the robot's locomotion between two highly flexible surfaces. Initially, we created a simulation model of the robot between two surfaces and determined its speed and the conditions of locomotion based on the flexibility of the surface, the geometrical parameters, and the coefficient of friction for horizontal locomotion and climbing at different angles. Our findings indicate that wave locomotion is capable of consistently advancing along the surface, even when the surface is highly flexible. Next, we developed an experimental setup and conducted multiple experiments to validate the accuracy of our simulation. The results indicate an average relative difference of approximately 11% between the speed and advance ratio of the wave crawling between the two surfaces of our simulation model and the experimental results were performed using an actual robot. Lastly, we compared the wave locomotion results to those of the worm locomotion and discovered that wave locomotion outperforms worm locomotion, especially at a higher surface flexibility.

Analysis of the ‘Endoworm’ prototype’s ability to grip the bowel in in vitro and ex vivo models

Access to the small bowel by means of an enteroscope is difficult, even using current devices such as single-balloon or double-balloon enteroscopes. Exploration time and patient discomfort are the main drawbacks. The prototype ‘Endoworm’ analysed in this paper is based on a pneumatic translation system that, gripping the bowel, enables the endoscope to move forward while the bowel slides back over its most proximal part. The grip capacity is related to the pressure inside the balloon, which depends on the insufflate volume of air. Different materials were used as in vitro and ex vivo models: rigid polymethyl methacrylate, flexible silicone, polyester urethane and ex vivo pig small bowel. On measuring the pressure–volume relationship, we found that it depended on the elastic properties of the lumen and that the frictional force depended on the air pressure inside the balloons and the lumen’s elastic properties. In the presence of a lubricant, the grip on the simulated intestinal lumens was drastically reduced, as was the influence of the lumen’s properties. This paper focuses on the Endoworm’s ability to grip the bowel, which is crucial to achieving effective endoscope forward advance and bowel folding.

A Locomotion Control Platform With Dynamic Electromagnetic Field for Active Capsule Endoscopy

Conventional radiological and endoscopic techniques utilizing long tubes were ineffective in visualizing the small bowel mucosa until the development of wireless capsule endoscopy (WCE). WCE is a revolutionary endoscopic technology that can diagnose the complete gastrointestinal tract. However, the existing capsule technologies are passive, and thus they cannot be navigated to or held in a specific location. The design of an active capsule will present the opportunity to move and stop a device at any targeted locations leading to numerous medical applications such as drug delivery or collecting tissue samples for examinations in the laboratory. This paper implements a new locomotion methodology for WCE systems using an electromagnetic platform. The platform produces a dynamic electromagnetic field to control the motion of the capsule. The strength and the direction of the electromagnetic field that is generated by the platform are continuously adjusted in order to maintain the equilibrium state during the capsule movement. We present the detailed design of the proposed platform with an experimental setup with polyvinyl chloride tubes and ex vivo to demonstrate the performance of the capsule motion.

Single actuator wave-like robot (SAW): design, modeling, and experiments

In this paper, we present a single actuator wave-like robot, a novel bioinspired robot which can move forward or backward by producing a continuously advancing wave. The robot has a unique minimalistic mechanical design and produces an advancing sine wave, with a large amplitude, using only a single motor but with no internal straight spine. Over horizontal surfaces, the robot does not slide relative to the surface and its direction of locomotion is determined by the direction of rotation of the motor. We developed a kinematic model of the robot that accounts for the two-dimensional mechanics of motion and yields the speed of the links relative to the motor. Based on the optimization of the kinematic model, and accounting for the mechanical constraints, we have designed and built multiple versions of the robot with different sizes and experimentally tested them (see movie). The experimental results were within a few percentages of the expectations. The larger version attained a top speed of 57 cm s(-1) over a horizontal surface and is capable of climbing vertically when placed between two walls. By optimizing the parameters, we succeeded in making the robot travel by 13% faster than its own wave speed.

A Review of Locomotion Systems for Capsule Endoscopy

Wireless capsule endoscopy for gastrointestinal (GI) tract is a modern technology that has the potential to replace conventional endoscopy techniques. Capsule endoscopy is a pill-shaped device embedded with a camera, a coin battery, and a data transfer. Without a locomotion system, this capsule endoscopy can only passively travel inside the GI tract via natural peristalsis, thus causing several disadvantages such as inability to control and stop, and risk of capsule retention. Therefore, a locomotion system needs to be added to optimize the current capsule endoscopy. This review summarizes the state-of-the-art locomotion methods along with the desired locomotion features such as size, speed, power, and temperature and compares the properties of different methods. In addition, properties and motility mechanisms of the GI tract are described. The main purpose of this review is to understand the features of GI tract and diverse locomotion methods in order to create a future capsule endoscopy compatible with GI tract properties.

Design of Endoscopic Capsule With Multiple Cameras

In order to reduce the miss rate of the wireless capsule endoscopy, in this paper, we propose a new system of the endoscopic capsule with multiple cameras. A master-slave architecture, including an efficient bus architecture and a four level clock management architecture, is applied for the Multiple Cameras Endoscopic Capsule (MCEC). For covering more area of the gastrointestinal tract wall with low power, multiple cameras with a smart image capture strategy, including movement sensitive control and camera selection, are used in the MCEC. To reduce the data transfer bandwidth and power consumption to prolong the MCEC's working life, a low complexity image compressor with PSNR 40.7 dB and compression rate 86% is implemented. A chipset is designed and implemented for the MCEC and a six cameras endoscopic capsule prototype is implemented by using the chipset. With the smart image capture strategy, the coverage rate of the MCEC prototype can achieve 98% and its power consumption is only about 7.1 mW.

Interaction model between capsule robot and intestine based on nonlinear viscoelasticity

Active capsule endoscope could also be called capsule robot, has been developed from laboratory research to clinical application. However, the system still has defects, such as poor controllability and failing to realize automatic checks. The imperfection of the interaction model between capsule robot and intestine is one of the dominating reasons causing the above problems. A model is hoped to be established for the control method of the capsule robot in this article. It is established based on nonlinear viscoelasticity. The interaction force of the model consists of environmental resistance, viscous resistance and Coulomb friction. The parameters of the model are identified by experimental investigation. Different methods are used in the experiment to obtain different values of the same parameter at different velocities. The model is proved to be valid by experimental verification. The achievement in this article is the attempted perfection of an interaction model. It is hoped that the model can optimize the control method of the capsule robot in the future.

Experimental investigation into biomechanical and biotribological properties of a real intestine and their significance for design of a spiral-type robotic capsule

This article reports on the results and implications of our experimental investigation into the biomechanical and biotribological properties of a real intestine for the optimal design of a spiral-type robotic capsule. Dynamic shear experiments were conducted to evaluate how the storage and loss moduli and damping factor of the small intestine change with the speed or the angular frequency. The sliding friction between differently shaped test pieces, with a topology similar to that of the spirals, and the intestine sample was experimentally determined. Our findings demonstrate that the intestine's biomechanical and biotribological properties are coupled, suggesting that the sliding friction is strongly related to the internal friction of the intestinal tissue. The significant implication of this finding is that one can predict the reaction force between the capsule with a spiral-type traction topology and the intestine directly from the intestine's biomechanical measurements rather than employing complicated three-dimensional finite element analysis or an inaccurate analytical model. Sliding friction experiments were also conducted with bar-shaped solid samples to determine the sliding friction between the samples and the small intestine. This sliding friction data will be useful in determining spiral material for an optimally designed robotic capsule.

Preliminary mechanical characterization of the small bowel for in vivo robotic mobility

In this work we present test methods, devices, and preliminary results for the mechanical characterization of the small bowel for intra luminal robotic mobility. Both active and passive forces that affect mobility are investigated. Four investigative devices and testing methods to characterize the active and passive forces are presented in this work: (1) a novel manometer and a force sensor array that measure force per cm of axial length generated by the migrating motor complex, (2) a biaxial test apparatus and method for characterizing the biomechanical properties of the duodenum, jejunum, and ileum, (3) a novel in vitro device and protocol designed to measure the energy required to overcome the self-adhesivity of the mucosa, and (4) a novel tribometer that measures the in vivo coefficient of friction between the mucus membrane and the robot surface. The four devices are tested on a single porcine model to validate the approach and protocols. Mean force readings per cm of axial length of intestine that occurred over a 15 min interval in vivo were 1.34 ± 0.14 and 1.18 ± 0.22 N cm(-1) in the middle and distal regions, respectively. Based on the biaxial stress/stretch tests, the tissue behaves anisotropically with the circumferential direction being more compliant than the axial direction. The mean work per unit area for mucoseparation of the small bowel is 0.08 ± 0.03 mJ cm(-2). The total energy to overcome mucoadhesion over the entire length of the porcine small bowel is approximately 0.55 J. The mean in vivo coefficient of friction (COF) of a curved 6.97 cm(2) polycarbonate sled on live mucosa traveling at 1 mm s(-1) is 0.016 ± 0.002. This is slightly lower than the COF on excised tissue, given the same input parameters. We have initiated a comprehensive program and suite of test devices and protocols for mechanically characterizing the small bowel for in vivo mobility. Results show that each of the four protocols and associated test devices has successfully gathered preliminary data to confirm the validity of our test approach.

Gastric transit and small intestinal transit time and motility assessed by a magnet tracking system

Background

Tracking an ingested magnet by the Magnet Tracking System MTS-1 (Motilis, Lausanne, Switzerland) is an easy and minimally-invasive method to assess gastrointestinal transit. The aim was to test the validity of MTS-1 for assessment of gastric transit time and small intestinal transit time, and to illustrate transit patterns detected by the system.

Methods

A small magnet was ingested and tracked by an external matrix of 16 magnetic field sensors (4 × 4) giving a position defined by 5 coordinates (position: x, y, z, and angle: θ, ϕ). Eight healthy subjects were each investigated three times: (1) with a small magnet mounted on a capsule endoscope (PillCam); (2) with the magnet alone and the small intestine in the fasting state; and (3) with the magnet alone and the small intestine in the postprandial state.

Results

Experiment (1) showed good agreement and no systematic differences between MTS-1 and capsule endoscopy when assessing gastric transit (median difference 1 min; range: 0-6 min) and small intestinal transit time (median difference 0.5 min; range: 0-52 min). Comparing experiments (1) and (2) there were no systematic differences in gastric transit or small intestinal transit when using the magnet-PillCam unit and the much smaller magnetic pill. In experiments (2) and (3), short bursts of very fast movements lasting less than 5% of the time accounted for more than half the distance covered during the first two hours in the small intestine, irrespective of whether the small intestine was in the fasting or postprandial state. The mean contraction frequency in the small intestine was significantly lower in the fasting state than in the postprandial state (9.90 min^-1 vs. 10.53 min^-1) (p = 0.03).

Conclusion

MTS-1 is reliable for determination of gastric transit and small intestinal transit time. It is possible to distinguish between the mean contraction frequency of small intestine in the fasting state and in the postprandial state.

Small intestinal model for electrically propelled capsule endoscopy

The aim of this research is to propose a small intestine model for electrically propelled capsule endoscopy. The electrical stimulus can cause contraction of the small intestine and propel the capsule along the lumen. The proposed model considered the drag and friction from the small intestine using a thin walled model and Stokes' drag equation. Further, contraction force from the small intestine was modeled by using regression analysis. From the proposed model, the acceleration and velocity of various exterior shapes of capsule were calculated, and two exterior shapes of capsules were proposed based on the internal volume of the capsules. The proposed capsules were fabricated and animal experiments were conducted. One of the proposed capsules showed an average (SD) velocity in forward direction of 2.91 ± 0.99 mm/s and 2.23 ± 0.78 mm/s in the backward direction, which was 5.2 times faster than that obtained in previous research. The proposed model can predict locomotion of the capsule based on various exterior shapes of the capsule.

Design and fabrication of a magnetic propulsion system for self-propelled capsule endoscope

This paper investigates design, modeling, simulation, and control issues related to self-propelled endoscopic capsule navigated inside the human body through external magnetic fields. A novel magnetic propulsion system is proposed and fabricated, which has great potential of being used in the field of noninvasive gastrointestinal endoscopy. Magnetic-analysis model is established and finite-element simulations as well as orthogonal design are performed for obtaining optimized mechanical and control parameters for generating appropriate external magnetic field. Simulated intestinal tract experiments are conducted, demonstrating controllable movement of the capsule under the developed magnetic propulsion system.

Stopping mechanism for capsule endoscope using electrical stimulus

An ingestible capsule, which has the ability to stop at certain locations in the small intestine, was designed and implemented to monitor intestinal diseases. The proposed capsule can contract the small intestine by using electrical stimuli; this contraction causes the capsule to stop when the maximum static frictional force (MSFF) is larger than the force of natural peristalsis. In vitro experiments were carried out to verify the feasibility of the capsule, and the results showed that the capsule was successfully stopped in the small intestine. Various electrodes and electrical stimulus parameters were determined on the basis of the MSFF. A moderate increment of the MSFF (12.7 +/- 4.6 gf at 5 V, 10 Hz, and 5 ms) and the maximum increment of the MSFF (56.5 +/- 9.77 gf at 20 V, 10 Hz, and 5 ms) were obtained, and it is sufficient force to stop the capsule.

Finite-difference modeling of micromachine for use in gastrointestinal endoscopy

An on-going research project is to develop a micromachine driven actively and wirelessly by external magnetic field. The micromachine has great potential for being used in medical fields such as gastrointestinal endoscopy. The ultimate goal is to develop a control mechanism capable of moving the wireless endoscope through the human's gastrointestinal tract in any direction with minimum level of harm to human body. This paper establishes fluid dynamics model suitable for micromachine's movement in intestinal tract, simulates pressure distributions of micromachine's surface, and further calculates driving and load torques. Based on the fluid simulation results, parameters for generating appropriate rotating magnetic field can be calculated. This fluid dynamics simulation method provides a novel approach to analyze biomedical micromachine's mechanical properties under external electromagnetic equipment.

Biotribological investigation of a multi-tube foot for traction generation in a medical microrobot

In recent years, efforts to develop microrobots for medical applications have been expanding. One of the key design issues in such microrobots is to attain adequate frictional interaction between the robotic foot and the organ tissue. In particular, it is important to generate the necessary frictional force without damaging the tissue. In this work, a design for the robotic foot was proposed on the basis of the frictional behaviour of a tube structure. Fundamental experiments were initially performed to understand the biotribological behaviour of the tube and rod structures. The design was then modified to a multi-tube structure to achieve adequate frictional behaviour. Biotribological investigation of a multi-tube foot in contact with a small intestine specimen of a pig was conducted using a pin-on-reciprocator type biotribotester. It was found that there is an optimum number and arrangement of the tubes for generating high frictional force. Experimental results showed that a nine-tube foot had the highest initial friction coefficient of about 1.5. The major frictional mechanism was determined to be interlocking between the tubes and the surface structures of the intestine specimen. The results of this work will aid the optimum design of frictional surface for medical microrobots and other biological devices.

Implemented edge shape of an electrical stimulus capsule

BACKGROUND

Recently, a capsule endoscope has been developed and many researchers have been trying to develop locomotive capsules. To develop locomotive capsules, the inner volume of the capsule has to be large enough to insert actuators, and the edge shape of the exterior capsule has to be suitable for locomotion. There are many locomotional methods, but an electrical stimulus method provides the appropriate power consumption, plus the shape of the capsule is the same as general telemetry capsules. In this paper, the optimal shape of the electrical stimulus capsule (ESC) was designed and implemented to provide the appropriate inner volume and moving speed of the capsule.

METHODS

A simple mathematical model was used to simulate various capsule shapes, and simple mathematical formulae were used to simulate the relationship between the shape of the edge of the capsule and the contraction force of the small intestine. The optimal edge shape of the capsule was decided based on the crossing point of the volume and moving speed. To verify the simulation, two capsules were implemented as the control and experimental groups.

RESULTS

From the in vitro experiments, four fresh intestines were used to measure the moving speed of the capsules. The average speed of the proposed capsule was 0.125 +/- 0.096 cm/s (20 V, 10 ms, 20 Hz), while the control group capsule was only 0.016 +/- 0.33 cm/s (20 V, 10 ms, 20 Hz), and both groups showed a significant difference from the statistical analysis (p < 0.001, Mann-Whitney rank sum test).

CONCLUSIONS

This paper presents a proposed design for the external shape of the ESC that could fill the need of researchers who want more inner volume and doctors who want to prevent the capsule from being stuck in the intestine.

Magnetic maneuvering of endoscopic capsules by means of a robotic navigation system

The use of video capsules for noninvasive explorations of the digestive tube is progressively increasing today. At present, the motion of these wireless endoscopic devices cannot be controlled and they proceed by means of visceral peristalsis and gravity. Aimed at enabling a motion control, the technique described here uses an external magnetic field applied to the video capsule, previously coated with a magnetic shell. As a source of controlled magnetic field, a robotic magnetic navigation system, recently introduced in the clinical practice to magnetically steer cardiovascular interventional devices, was suggested in a previous study to be deserving of investigation. The attractive potentialities of this system, along with its current limitations, in order to maneuver endoscopic capsules were studied in this work for the first time, both from a theoretical and an experimental point of view. The actual capabilities were experimentally assessed with preliminary motion control tests on a conventional video capsule inside a human-sized plastic phantom. Results demonstrated the possibility of achieving controlled magnetic maneuvers within the considered environment.

Mucoadhesive films inside the colonic tube: performance in a three-dimensional world

A self-propelling colonoscopic device moving inside the colonic tube should be able to periodically grip safely to the colonic wall as well as to manipulate the generated friction. The feasibility of achieving high grip and friction manipulation by covering the device with mucoadhesive films is experimentally tested. More precisely, the frictional behaviour of mucoadhesive films inside the colonic tube is tested in vitro in porcine colon. It appears that mucoadhesive films generate significantly higher friction than conventional materials (ANOVA p=0, 95% CIs=-3.04, -2.14). The geometry of the film plays a role as well. When holes are, for instance, present in the film geometry and are large enough so that the colonic tissue can wrap their borders, friction can be significantly increased (ANOVA p=0, 95% CIs=-2.53, -1.26). By altering the contact area or the film geometry, friction manipulation can be achieved. Moreover, a simple theoretical model is developed and experimentally verified (R=0.92). The model can be used to estimate the level of the friction generated by three-dimensional configurations of mucoadhesive films as a function of their geometric characteristics and the material properties of the colon.

Analytical model development for the prediction of the frictional resistance of a capsule endoscope inside an intestine

For the purpose of optimizing the design of the locomotion mechanism as well as the body shape of a self-propelled capsule endoscope, an analytical model for the prediction of frictional resistance of the capsule moving inside the small intestine was first developed. The model was developed by considering the contact geometry and viscoelasticity of the intestine, based on the experimental investigations on the material properties of the intestine and the friction of the capsule inside the small intestine. In order to verify the model and to investigate the distributions of various stress components applied to the capsule, finite element (FE) analyses were carried out. The comparison of the frictional resistance between the predicted and the experimental values suggested that the proposed model could predict the frictional force of the capsule with reasonable accuracy. Also, the FE analysis results of various stress components revealed the stress relaxation of the intestine and explained that such stress relaxation characteristics of the intestine resulted in lower frictional force as the speed of the capsule decreased. These results suggested that the frontal shape of the capsule was critical to the design of the capsule with desired frictional performance. It was shown that the proposed model can provide quantitative estimation of the frictional resistance of the capsule under various moving conditions inside the intestine. The model is expected to be useful in the design optimization of the capsule locomotion inside the intestine.