1
|
Fakhr Abdollahi A, Shaheed MH, Thaha MA, Vepa R. A review of modeling and control of remote-controlled capsule endoscopes. Expert Rev Med Devices 2024; 21:293-306. [PMID: 38573192 DOI: 10.1080/17434440.2024.2336135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 03/25/2024] [Indexed: 04/05/2024]
Abstract
INTRODUCTION The significance of this review lies in addressing the limitations of passive locomotion in capsule endoscopes, hindering their widespread use in medical applications. The research focuses on evaluating existing miniature in vivo remote-controlled capsule endoscopes, examining their locomotion designs, and working theories to pave the way for overcoming challenges and enhancing their applicability in diagnostic and treatment settings. AREAS COVERED This paper explores control methods and dynamic system modeling in the context of self-propelled remote-controlled capsule endoscopes with a two-mass arrangement. The literature search, conducted at Queen Mary University of London Library from 2000 to 2022, utilized a systematic approach starting with the broad keyword 'Capsule Endoscope' and progressively narrowing down to specific aspects such as 'Capsule Endoscope Control' and 'Self-propelled Capsule Endoscope' using various criteria. EXPERT OPINION Efficiently driving and controlling remote-controlled capsule endoscopes have the potential to overcome the current limitations in medical technology, offering a viable solution for diagnosing and treating gastrointestinal diseases. Successful control of the remote-controlled capsule endoscope, as demonstrated in this review paper, will lead to a step change in medical engineering, establishing the remote-controlled capsule endoscope as a swift standard in the field.
Collapse
Affiliation(s)
- Afsoon Fakhr Abdollahi
- School of Engineering and Materials Science, Queen Mary University of London, London, UK
| | - Mohammad Hasan Shaheed
- School of Engineering and Materials Science, Queen Mary University of London, London, UK
| | - Mohamed Adhnan Thaha
- Blizard Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK
- Department of Colorectal Surgery, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Ranjan Vepa
- School of Engineering and Materials Science, Queen Mary University of London, London, UK
| |
Collapse
|
2
|
Liu W, Li B, Ji Z. [Research Overview of Internet of Things Technology in Medical Engineering]. Zhongguo Yi Liao Qi Xie Za Zhi 2023; 47:576-581. [PMID: 37753901 DOI: 10.3969/j.issn.1671-7104.2023.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
Internet of Things plays a vital role in the field of healthcare. Smart medical devices, innovative sensors and lightweight communication protocols are making the Internet of Medical Things possible. This paper summarizes the research progress of Internet of Things technology in medical engineering from two aspects of health monitoring system and ingestible sensor monitoring equipment. The health monitoring system is analyzed from heart disease monitoring, diabetes monitoring and brain nerve monitoring. The medical equipment that can absorb sensors is represented by capsule endoscope. This paper further summarizes the relevant situation of smart hospital, and finally discusses the challenges and countermeasures of the Internet of Things technology in medical engineering, in order to lay the foundation and provide ideas for the research of the Internet of Things technology in medical engineering.
Collapse
Affiliation(s)
- Wanrong Liu
- Shanghai Sixth People's Hospital, Shanghai, 201306
| | - Bin Li
- Shanghai Sixth People's Hospital, Shanghai, 201306
| | - Zhiyong Ji
- Shanghai Sixth People's Hospital, Shanghai, 201306
| |
Collapse
|
3
|
Liu W, Choi SJ, George D, Li L, Zhong Z, Zhang R, Choi SY, Selaru FM, Gracias DH. Untethered shape-changing devices in the gastrointestinal tract. Expert Opin Drug Deliv 2023; 20:1801-1822. [PMID: 38044866 PMCID: PMC10872387 DOI: 10.1080/17425247.2023.2291450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 12/01/2023] [Indexed: 12/05/2023]
Abstract
INTRODUCTION Advances in microfabrication, automation, and computer engineering seek to revolutionize small-scale devices and machines. Emerging trends in medicine point to smart devices that emulate the motility, biosensing abilities, and intelligence of cells and pathogens that inhabit the human body. Two important characteristics of smart medical devices are the capability to be deployed in small conduits, which necessitates being untethered, and the capacity to perform mechanized functions, which requires autonomous shape-changing. AREAS COVERED We motivate the need for untethered shape-changing devices in the gastrointestinal tract for drug delivery, diagnosis, and targeted treatment. We survey existing structures and devices designed and utilized across length scales from the macro to the sub-millimeter. These devices range from triggerable pre-stressed thin film microgrippers and spring-loaded devices to shape-memory and differentially swelling structures. EXPERT OPINION Recent studies demonstrate that when fully enabled, tether-free and shape-changing devices, especially at sub-mm scales, could significantly advance the diagnosis and treatment of GI diseases ranging from cancer and inflammatory bowel disease (IBD) to irritable bowel syndrome (IBS) by improving treatment efficacy, reducing costs, and increasing medication compliance. We discuss the challenges and possibilities associated with ensuring safe, reliable, and autonomous operation of these smart devices.
Collapse
Affiliation(s)
- Wangqu Liu
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Soo Jin Choi
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Derosh George
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Ling Li
- Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Zijian Zhong
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Ruili Zhang
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Si Young Choi
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Florin M. Selaru
- Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - David H. Gracias
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
- Department of Chemistry, Johns Hopkins University, Baltimore, MD 21218, USA
- Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
- Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD 21218, USA
- Sidney Kimmel Comprehensive Cancer Center (SKCCC), Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Center for MicroPhysiological Systems (MPS), Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| |
Collapse
|
4
|
Rehan M, Yeo AG, Yousuf MU, Avci E. Anchoring Mechanism for Capsule Endoscope: Mechanical Design, Fabrication and Experimental Evaluation. Micromachines (Basel) 2022; 13:2045. [PMID: 36557344 PMCID: PMC9782074 DOI: 10.3390/mi13122045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/08/2022] [Accepted: 11/18/2022] [Indexed: 06/17/2023]
Abstract
Capsule endoscopes are widely used to diagnose gut-related problems, but they are passive in nature and cannot actively move inside the gut. This paper details the design process and development of an anchoring mechanism and actuation system to hold a capsule in place within the small intestine. The design centres around the mechanical structure of the anchor that makes use of compliant Sarrus linkage legs, which extend to make contact with the intestine, holding the capsule in place. Three variants with 2 legs, 3 legs and 4 legs of the anchoring mechanism were tested using a shape memory alloy spring actuator (5 mm × ϕ 3.4 mm). The experiments determine that all the variants can anchor at the target site and resist peristaltic forces of 346 mN. The proposed design is well suited for an intestine with a diameter of 19 mm. The proposed design allows the capsule endoscopes to anchor at the target site for a better and more thorough examination of the targeted region. The proposed anchoring mechanism has the potential to become a vital apparatus for clinicians to use with capsule endoscopes in the future.
Collapse
Affiliation(s)
- Muhammad Rehan
- Department of Mechanical and Electrical Engineering, Massey University, Palmerston North 4410, New Zealand
- Electronic Engineering Department, Sir Syed University of Engineering & Technology, Karachi 75300, Pakistan
| | - Andrew G. Yeo
- Department of Mechanical and Electrical Engineering, Massey University, Palmerston North 4410, New Zealand
| | - Muhammad Uzair Yousuf
- Department of Mechanical Engineering, NED University of Engineering and Technology, Karachi 75270, Pakistan
| | - Ebubekir Avci
- Department of Mechanical and Electrical Engineering, Massey University, Palmerston North 4410, New Zealand
- MacDiarmid Institute for Advanced Materials and Nanotechnology, Wellington 6140, New Zealand
| |
Collapse
|
5
|
Sun H, Liu J, Wang Q, Lai C, Chi W, Niu C, Wang L, Teng Z, Shi Y, Tian P. In vivo animal study of the magnetic navigation system for capsule endoscope manipulation within the esophagus, stomach, and colorectum. Med Phys 2022; 49:6813-6823. [PMID: 36087029 DOI: 10.1002/mp.15976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 08/22/2022] [Accepted: 08/27/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND/PURPOSES Magnetic navigation capsule endoscopy (MNCE) is considered to be an important means to realize the controllable and precise examination of capsule endoscopy (CE) in the unstructured gastrointestinal (GI) tract. For the current magnetic navigation system (MNS), due to the limitation of workspace, driving force, and control method of the CE, only clinical application in the stomach has been realized, whereas the examination of other parts of the GI tract is still in the experimental stage. More preclinical studies are needed to achieve the multisite examination of the GI tract. METHODS Based on the MNS (Supiee) developed in the laboratory, an X-ray imaging system with magnetic shielding and a commercial CE are integrated to form the MNCE system. Then, in vivo GI tract experiments with a porcine model are performed to verify the clinical feasibility and safety of this system. Moreover, the effects of different control modes on the efficiency and effect of GI tract examination are studied. RESULTS Animal experiments demonstrate that with the MNCE system, it is convenient to achieve steering control in any direction and multiple reciprocating movements of CE in the GI tract. Benefiting from the flexibility of the three basic control modes, the achieved swing movement pattern of CE can effectively reduce the inspection time. It is demonstrated that the esophageal examination time can be reduced from 13.2 to 9.2 min with a maximum movement speed of 5 mm/s. CONCLUSION In this paper, the feasibility, safety, and efficacy of the MNCE system for a one-stop examination of the in vivo GI tract (esophagus, stomach, and colorectum) is first demonstrated. In addition, complex movement patterns of CE such as the swinging are proved to effectively improve examination efficiency and disease detection rates. This study is crucial for the clinical application of the MNCE system.
Collapse
Affiliation(s)
- Hongbo Sun
- Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Jianhua Liu
- Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Qiuliang Wang
- Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Chunxiao Lai
- Department of Gastroenterology, Baiyun Branch, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Wenqiang Chi
- Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing, China
| | - Chaoqun Niu
- College of Information and Communication Engineering, Faculty of Information Technology, Beijing University of Technology, Beijing, China
| | - Lei Wang
- Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Zhifan Teng
- College of Electrical and Information Engineering, Hunan University, Changsha, China
| | - Yang Shi
- School of Mechanical and Electrical Engineering, Xi'an Technological University, Xi'an, China
| | - Peilong Tian
- School of Mechanical and Electrical Engineering, Xi'an Technological University, Xi'an, China
| |
Collapse
|
6
|
Abstract
Background and Aim: Melena, or tarry black stool, is not a rare symptom encountered in pediatric clinical practice, and the bleeding source varies from the upper gastrointestinal tract to the small intestine. Endoscopy is effective in identifying bleeding, but it does not always identify the source of bleeding. Endoscopic examination in children is commonly challenging, and there are no detailed reports about the causes of melena in children. This observational study aimed to validate the cause of melena in children and to investigate more effective and less burdensome examination methods. Methods: We retrospectively reviewed the clinical records of 55 patients who underwent examination for melena. Results: In this research, 38 patients had underlying diseases such as malignancy and severe mental and physical disorders. The bleeding source was identified in 39 patients. The most common final diagnosis was duodenal ulcer (n = 22), and the other diagnoses were gastric ulcer, esophagitis, and esophageal varices. The upper gastrointestinal tract was the most common source of bleeding (n = 34). In five patients, the bleeding source was the small intestine. Vomiting, abnormal abdominal ultrasonography findings, and a hemoglobin level of ≤ 3 g/dL than the lower normal limit were significant factors indicating that the bleeding source can be found on esophagogastroduodenoscopy. Conclusions: The upper gastrointestinal tract was the most common bleeding source of melena in children. As in adults, esophagogastroduodenoscopy is the primary endoscopic method of choice. Furthermore, small bowel capsule endoscopy may be useful in identifying the bleeding source in children without upper gastrointestinal lesions.
Collapse
Affiliation(s)
- Itaru Iwama
- Division of Gastroenterology and Hepatology, Saitama Children's Medical Center, Saitama, Japan
| | - Masashi Yoshida
- Division of Gastroenterology and Hepatology, Saitama Children's Medical Center, Saitama, Japan
| | - Tomoko Hara
- Division of Gastroenterology and Hepatology, Saitama Children's Medical Center, Saitama, Japan
| | - Ryusuke Nambu
- Division of Gastroenterology and Hepatology, Saitama Children's Medical Center, Saitama, Japan
| |
Collapse
|
7
|
Martincek I, Banovcin P, Goraus M, Duricek M. USB capsule endoscope for retrograde imaging of the esophagus. J Biomed Opt 2020; 25:JBO-200142SSR. [PMID: 33078602 PMCID: PMC7569471 DOI: 10.1117/1.jbo.25.10.106002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 10/06/2020] [Indexed: 06/11/2023]
Abstract
SIGNIFICANCE Endoscopes represent electro-optical devices that are used to visualize internal body cavities. The specialized endoscopic procedure of the upper gastrointestinal tract from the esophagus down to the duodenum is called an esophagogastroduodenoscopy. AIM We bring our newly developed capsule endoscopy device as a promising alternative diagnostic method for visualization of the upper gastrointestinal tract. APPROACH Capsule endoscopy has become an attractive method that uses a tiny wireless camera to take pictures of the digestive tract. Existing esophageal capsule endoscopy does not allow a retrograde view of the esophagus while retrograde scanning can provide information on the esophageal pathology. RESULTS In comparison to the existing esophageal capsule endoscopy, our system is much simpler and cheaper due to the need for fewer electronic devices. Moreover, its use is not limited by the capacity of the batteries used by existing capsule endoscopes. The new esophageal endoscopic system was created by combining the universal serial bus (USB) endoscope module with the thin power wires that are routed through the USB port to the computer. CONCLUSIONS The endoscope was tested on a volunteer without any side effects such as nausea, belching, and general discomfort. The examination of the patient is performed in a sitting position and the patient discomfort during the examination is minimal so it can be performed without anesthesia.
Collapse
Affiliation(s)
- Ivan Martincek
- University of Zilina, Department of Physics, Faculty of Electrical Engineering and Information Technology, Zilina, Slovakia
| | - Peter Banovcin
- Comenius University in Bratislava, Department of Gastroenterology, Jessenius Faculty of Medicine in Martin, Martin, Slovakia
| | - Matej Goraus
- University of Zilina, Department of Physics, Faculty of Electrical Engineering and Information Technology, Zilina, Slovakia
| | - Martin Duricek
- Comenius University in Bratislava, Department of Gastroenterology, Jessenius Faculty of Medicine in Martin, Martin, Slovakia
| |
Collapse
|
8
|
Cubero Rego D, Qualia CM, Chismark AD, Strait L, Lee H. Gastrointestinal Diaphragm Disease With Retained Capsule Endoscope, Associated With Crohn's Disease: A Case Report. Pediatr Dev Pathol 2019; 22:75-79. [PMID: 29890901 DOI: 10.1177/1093526618780766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Gastrointestinal diaphragm disease is a rare entity characterized by the formation of thin membranous circumferential mucosal septa, resulting in marked narrowing of the intestinal lumen. The most frequent etiology is the chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs). Idiopathic cases and other possible etiologies have been reported. We present a rare association of diaphragm disease with Crohn's disease in a boy without a history of significant NSAID usage.
Collapse
Affiliation(s)
- David Cubero Rego
- 1 Pathology and Laboratory Medicine, Albany Medical Center, Albany, New York
| | - Cary M Qualia
- 2 Pediatric Gastroenterology, Albany Medical Center, Albany, New York
| | | | - Lauren Strait
- 3 Colorectal Surgery, Albany Medical Center, Albany, New York
| | - Hwajeong Lee
- 1 Pathology and Laboratory Medicine, Albany Medical Center, Albany, New York
| |
Collapse
|
9
|
Le VH, Hernando LR, Lee C, Choi H, Jin Z, Nguyen KT, Go G, Ko SY, Park JO, Park S. Shape memory alloy-based biopsy device for active locomotive intestinal capsule endoscope. Proc Inst Mech Eng H 2016; 229:255-63. [PMID: 25834001 DOI: 10.1177/0954411915576946] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Recently, capsule endoscopes have been used for diagnosis in digestive organs. However, because a capsule endoscope does not have a locomotive function, its use has been limited to small tubular digestive organs, such as small intestine and esophagus. To address this problem, researchers have begun studying an active locomotive intestine capsule endoscope as a medical instrument for the whole gastrointestinal tract. We have developed a capsule endoscope with a small permanent magnet that is actuated by an electromagnetic actuation system, allowing active and flexible movement in the patient's gut environment. In addition, researchers have noted the need for a biopsy function in capsule endoscope for the definitive diagnosis of digestive diseases. Therefore, this paper proposes a novel robotic biopsy device for active locomotive intestine capsule endoscope. The proposed biopsy device has a sharp blade connected with a shape memory alloy actuator. The biopsy device measuring 12 mm in diameter and 3 mm in length was integrated into our capsule endoscope prototype, where the device's sharp blade was activated and exposed by the shape memory alloy actuator. Then the electromagnetic actuation system generated a specific motion of the capsule endoscope to extract the tissue sample from the intestines. The final biopsy sample tissue had a volume of about 6 mm(3), which is a sufficient amount for a histological analysis. Consequently, we proposed the working principle of the biopsy device and conducted an in-vitro biopsy test to verify the feasibility of the biopsy device integrated into the capsule endoscope prototype using the electro-magnetic actuation system.
Collapse
Affiliation(s)
- Viet Ha Le
- School of Mechanical Engineering, Chonnam National University, Gwangju, Korea
| | | | - Cheong Lee
- School of Mechanical Engineering, Chonnam National University, Gwangju, Korea
| | - Hyunchul Choi
- School of Mechanical Engineering, Chonnam National University, Gwangju, Korea
| | - Zhen Jin
- School of Mechanical Engineering, Chonnam National University, Gwangju, Korea
| | - Kim Tien Nguyen
- School of Mechanical Engineering, Chonnam National University, Gwangju, Korea
| | - Gwangjun Go
- School of Mechanical Engineering, Chonnam National University, Gwangju, Korea
| | - Seong-Young Ko
- School of Mechanical Engineering, Chonnam National University, Gwangju, Korea
| | - Jong-Oh Park
- School of Mechanical Engineering, Chonnam National University, Gwangju, Korea
| | - Sukho Park
- School of Mechanical Engineering, Chonnam National University, Gwangju, Korea
| |
Collapse
|
10
|
Zhou H, Alici G, Than TD, Li W. Experimental investigation into biomechanical and biotribological properties of a real intestine and their significance for design of a spiral-type robotic capsule. Proc Inst Mech Eng H 2014; 228:280-6. [PMID: 24519417 DOI: 10.1177/0954411914522783] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
Collapse
Affiliation(s)
- Hao Zhou
- School of Mechanical, Materials and Mechatronic Engineering, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, NSW, Australia
| | | | | | | |
Collapse
|
11
|
Chang VC, Tang SJ, Swain CP, Bergs R, Paramo J, Hogg DC, Fernandez R, Cadeddu JA, Scott DJ. A randomized comparison of laparoscopic, flexible endoscopic, and wired and wireless magnetic cameras on ex vivo and in vivo NOTES surgical performance. Surg Innov 2012; 20:395-402. [PMID: 23060531 DOI: 10.1177/1553350612459110] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The influence of endoscopic video camera (VC) image quality on surgical performance has not been studied. Flexible endoscopes are used as substitutes for laparoscopes in natural orifice translumenal endoscopic surgery (NOTES), but their optics are originally designed for intralumenal use. Manipulable wired or wireless independent VCs might offer advantages for NOTES but are still under development. OBJECTIVE To measure the optical characteristics of 4 VC systems and to compare their impact on the performance of surgical suturing tasks. METHODS VC systems included a laparoscope (Storz 10 mm), a flexible endoscope (Olympus GIF 160), and 2 prototype deployable cameras (magnetic anchoring and guidance system [MAGS] Camera and PillCam). In a randomized fashion, the 4 systems were evaluated regarding standardized optical characteristics and surgical manipulations of previously validated ex vivo (fundamentals of laparoscopic surgery model) and in vivo (live porcine Nissen model) tasks; objective metrics (time and errors/precision) and combined surgeon (n = 2) performance were recorded. RESULTS Subtle differences were detected for color tests, and field of view was variable (65°-115°). Suitable resolution was detected up to 10 cm for the laparoscope and MAGS camera but only at closer distances for the endoscope and PillCam. Compared with the laparoscope, surgical suturing performances were modestly lower for the MAGS camera and significantly lower for the endoscope (ex vivo) and PillCam (ex vivo and in vivo). CONCLUSIONS This study documented distinct differences in VC systems that may be used for NOTES in terms of both optical characteristics and surgical performance. Additional work is warranted to optimize cameras for NOTES. Deployable systems may be especially well suited for this purpose.
Collapse
Affiliation(s)
- Victoria C Chang
- University of Texas Southwestern Medical Center, Dallas, TX 75390-9156, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|