New inductive proximity sensor platform for precise localization of small colorectal tumors

A Metal Detector for Clip Location Tracking of Stomach and Colon Cancer during Laparoscopic Surgery

In laparoscopic surgery for colorectal and gastric cancer, it is difficult to locate the tumor in the cavity for excision. Tumors in the colon or stomach are blocked by mucous membranes; thus, the view from the cavity is obscured. Therefore, to determine the location of the tumor, a marker can be installed around the tumor and the location of the tumor can be found using a sensor. Until now, most of the clip-detectors that have been developed can detect the location of tumors for either colorectal or gastric cancer. The research on the development of a detector that can detect the location of tumors for both colorectal and gastric cancer, is insufficient. Most detectors for tumor location determination are devised using a magnet by connecting a wire to a clip. In this method, the position of the magnet moves along the length of the wire. Therefore, it is difficult for the detector to detect the exact location of the tumor. Based on this method, this study designs a clip maker to determine the location of a tumor and a detector that can detect the clip. The clip and the sensing element are directly connected. The clip is developed using ferrite and coil to generate a magnetic field induced by an eddy current in the metal (clip), and the detector is designed using the Colpitts oscillator to induce a magnetic field. After installing the prepared clip at the tumor location, the detector is used to detect the clip, and accordingly, the location of the tumor can be identified using the detector. To test the performance of the clip and detector, we conducted animal experiments. In the course of the animal experiment, four clips were installed in the colon and stomach, and we succeeded in detecting all the clips. Because the clip-detector is used to locate the tumor during laparoscopic surgery, an endoscope must be used. Therefore, it is predicted that the demand for laparoscopic surgery and endoscopic medical industry will increase because of the clip-detector.

Clip-Detector Using a Neodymium Magnet to Locate Malignant Tumors during Laparoscopic Surgery

During laparoscopic surgery for colorectal or gastric cancers, locating the tumor for excision is difficult owing to it being obscured by mucous membranes. Therefore, a clip can be installed around the tumor, which can be located using a sensor. Most of the clip-detectors developed thus far can only detect tumors in either the colon or stomach and require a wire to connect the clip and detector. This study designs a clip and detector that can locate a tumor in the stomach and colon. The clip contains a neodymium magnet that generates a magnetic field, and the detector includes a Colpitts oscillator that allows magnetic coupling of the clip and detector. After installing the prepared clip at the tumor location, the detector is used to locate the clip. To test the clip and detector, we conducted animal experiments, during which four clips were installed in the colon and stomach of a mini pig. We succeeded in locating the clips within 2.17 and 3.14 s in the stomach and colon, respectively, which were shorter than the detection times reported in previous studies. The demand for laparoscopic surgery and endoscopes is predicted to increase owing to this method.

Non-invasive laparoscopic detection of small tumors of the digestive tract using inductive sensors of proximity

The precise location of gastric and colorectal tumors is of paramount importance for the oncological surgeon as it dictates the limits of resection and the extent of lymphadenectomy. However, this task proves sometimes to be very challenging, especially in the laparoscopic setting when the tumors are small, have a soft texture, and do not invade the serosa. In this view, our research team has developed a new instrument adapted to minimally-invasive surgery, and manipulated solely by the operating surgeon which has the potential to locate precisely tumors of the digestive tract. It consists of an inductive proximity sensor and an electronic block encapsulated into an autoclavable stainless-steel cage that works in tandem with an endoscopic hemostatic clip whose structure was modified to increase detectability. By scanning the serosal side of the colon or stomach, the instrument is capable to accurately pinpoint the location of the clip placed previously during diagnostic endoscopy on the normal bowel mucosa, adjacent to the tumor. In the current in-vivo experiments performed on large animals, the modified clips were transported without difficulties to the point of interest and attached to the mucosa of the bowel. Using a laparoscopic approach, the detection rate of this system reached 65% when the sensor scanned the bowel at a speed of 0.3 cm/s, and applying slight pressure on the serosa. This value increased to 95% when the sensor was guided directly on the point of clip attachment. The detection rate dropped sharply when the scanning speed exceeded 1 cm/s and when the sensor-clip distance exceeded the cut-off value of 3 mm. In conclusion, the proposed detection system demonstrated its potential to offer a swift and convenient solution for the digestive laparoscopic surgeons, however its detection range still needs to be improved to render it useful for the clinical setting.

Cardiac Rehabilitation Early after Sternotomy Using New Assistive VR-Enhanced Robotic Exoskeleton-Study Protocol for a Randomised Controlled Trial

(1) Background and objective: Cardiac rehabilitation (CR) means delivering health education by structured exercises with the means of risk reduction, in a cost-effective manner. Well-conducted CR improves functional capacity, decreases re-hospitalization, and reduces mortality up to 25%. We bring to attention the protocol of a randomised control trial with the aim of validating the prototype of an assistive upper-body robotic exoskeleton system enhanced with a non-immersive virtual reality exergame (CardioVR-ReTone) in patients who undergone cardiac surgery. (2) Methods: Description of the CardioVR-ReTone system and the technical specification, followed by the group selection, randomization and evaluated variables. (3) Expected results: The primary outcome measurement is the modification of life quality at the end of the CR exercise training program. Secondary outcomes will encompass measurements of sternal stability, muscular activity, cardiac response to exercise, pain level and compliance/adherence to CR. (4) Conclusions: Implementing these novel features of the CardioVR-ReTone system, addressability, and efficacy of CR, so problematic in certain situations and especially in cardiac surgery, will be greatly facilitated, being independent of the skills and availability of the rehabilitation therapist.