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Li B, Liao C, Cai Z, Zhou J, Zhao C, Jing L, Wang J, Xiong C, Xu L, Wang Y, Wang Y. Femtosecond laser 3D printed micro objective lens for ultrathin fiber endoscope. FUNDAMENTAL RESEARCH 2024; 4:123-130. [PMID: 38933834 PMCID: PMC11197503 DOI: 10.1016/j.fmre.2022.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/26/2022] [Accepted: 05/29/2022] [Indexed: 10/17/2022] Open
Abstract
The most important optical component in an optical fiber endoscope is its objective lens. To achieve a high imaging performance level, the development of an ultra-compact objective lens is thus the key to an ultra-thin optical fiber endoscope. In this work, we use femtosecond laser 3D printing to develop a series of micro objective lenses with different optical designs. The imaging resolution and field-of-view performances of these printed micro objective lenses are investigated via both simulations and experiments. For the first time, multiple micro objective lenses with different fields of view are printed on the end face of a single imaging optical fiber, thus realizing the perfect integration of an optical fiber and objective lenses. This work demonstrates the considerable potential of femtosecond laser 3D printing in the fabrication of micro-optical systems and provides a reliable solution for the development of an ultrathin fiber endoscope.
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Affiliation(s)
- Bozhe Li
- Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education/Guangdong Province, College of Physics and Optoelectronic Engineering, Shenzhen University, Shenzhen 518060, China
- Shenzhen Key Laboratory of Photonic Devices and Sensing Systems for Internet of Things, Guangdong and Hong Kong Joint Research Centre for Optical Fibre Sensors, Shenzhen University, Shenzhen 518060, China
| | - Changrui Liao
- Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education/Guangdong Province, College of Physics and Optoelectronic Engineering, Shenzhen University, Shenzhen 518060, China
- Shenzhen Key Laboratory of Photonic Devices and Sensing Systems for Internet of Things, Guangdong and Hong Kong Joint Research Centre for Optical Fibre Sensors, Shenzhen University, Shenzhen 518060, China
| | - Zhihao Cai
- Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education/Guangdong Province, College of Physics and Optoelectronic Engineering, Shenzhen University, Shenzhen 518060, China
- Shenzhen Key Laboratory of Photonic Devices and Sensing Systems for Internet of Things, Guangdong and Hong Kong Joint Research Centre for Optical Fibre Sensors, Shenzhen University, Shenzhen 518060, China
| | - Jie Zhou
- Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education/Guangdong Province, College of Physics and Optoelectronic Engineering, Shenzhen University, Shenzhen 518060, China
- Shenzhen Key Laboratory of Photonic Devices and Sensing Systems for Internet of Things, Guangdong and Hong Kong Joint Research Centre for Optical Fibre Sensors, Shenzhen University, Shenzhen 518060, China
| | - Cong Zhao
- Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education/Guangdong Province, College of Physics and Optoelectronic Engineering, Shenzhen University, Shenzhen 518060, China
- Shenzhen Key Laboratory of Photonic Devices and Sensing Systems for Internet of Things, Guangdong and Hong Kong Joint Research Centre for Optical Fibre Sensors, Shenzhen University, Shenzhen 518060, China
| | - Liqing Jing
- Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education/Guangdong Province, College of Physics and Optoelectronic Engineering, Shenzhen University, Shenzhen 518060, China
- Shenzhen Key Laboratory of Photonic Devices and Sensing Systems for Internet of Things, Guangdong and Hong Kong Joint Research Centre for Optical Fibre Sensors, Shenzhen University, Shenzhen 518060, China
| | - Jiaqi Wang
- Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education/Guangdong Province, College of Physics and Optoelectronic Engineering, Shenzhen University, Shenzhen 518060, China
- Shenzhen Key Laboratory of Photonic Devices and Sensing Systems for Internet of Things, Guangdong and Hong Kong Joint Research Centre for Optical Fibre Sensors, Shenzhen University, Shenzhen 518060, China
| | - Cong Xiong
- Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education/Guangdong Province, College of Physics and Optoelectronic Engineering, Shenzhen University, Shenzhen 518060, China
- Shenzhen Key Laboratory of Photonic Devices and Sensing Systems for Internet of Things, Guangdong and Hong Kong Joint Research Centre for Optical Fibre Sensors, Shenzhen University, Shenzhen 518060, China
| | - Lei Xu
- School of Electronic and Communication Engineering, Shenzhen Polytechnic University, Shenzhen 518055, China
| | - Ying Wang
- Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education/Guangdong Province, College of Physics and Optoelectronic Engineering, Shenzhen University, Shenzhen 518060, China
- Shenzhen Key Laboratory of Photonic Devices and Sensing Systems for Internet of Things, Guangdong and Hong Kong Joint Research Centre for Optical Fibre Sensors, Shenzhen University, Shenzhen 518060, China
| | - Yiping Wang
- Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education/Guangdong Province, College of Physics and Optoelectronic Engineering, Shenzhen University, Shenzhen 518060, China
- Shenzhen Key Laboratory of Photonic Devices and Sensing Systems for Internet of Things, Guangdong and Hong Kong Joint Research Centre for Optical Fibre Sensors, Shenzhen University, Shenzhen 518060, China
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Lim S, Haboubi HN, Anderson SHC, Dawson P, Machado AP, Mangsat E, Santos S, Wong T, Zeki S, Dunn J. Transnasal endoscopy: moving from endoscopy to the clinical outpatient-blue sky thinking in oesophageal testing. Frontline Gastroenterol 2022; 13:e65-e71. [PMID: 35812036 PMCID: PMC9234731 DOI: 10.1136/flgastro-2022-102129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/03/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND COVID-19 has severely affected UK endoscopy services with an estimate 86% loss of activity during the first wave. Subsequent delays in diagnostic and surveillance procedures highlight the need for novel solutions to tackle the resultant backlog. Transnasal endoscopy (TNE) provides an attractive option compared with conventional upper gastrointestinal endoscopy given its limited use of space, no sedation and reduced nursing resources. OUR EXPERIENCE We describe piloting and then establishing an outpatient model TNE service in the pandemic era and the implications on resource allocation, training and workforce. We also discuss our experiences and outline ways in which services can evolve to undertake more complex endoscopic diagnostic and therapeutic work. Over 90% of patients describe no discomfort and those who have previously experienced conventional transoral endoscopy preferred the transnasal approach. We describe a low complication rate (0.8%) comprising two episodes of mild epistaxis. The average procedure duration was reasonable (9.9±5.0 min) with full adherence to Joint Advisory Group quality standards. All biopsies assessed were deemed sufficient for diagnosis including those for surveillance procedures. DISCUSSION TNE can offer a safe, tolerable, high-quality service outside of a conventional endoscopy setting. Expanding procedural capacity without impacting on the current endoscopy footprint has great potential in recovering endoscopy services following the COVID-19 pandemic. Looking forward, TNE has potential to be used both within the endoscopy suite as part of therapeutic procedures, or outside of the endoscopy unit in outpatient clinics, community hospitals, or mobile units and to achieve this in a more sustainable and environmentally friendly way.
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Affiliation(s)
- Samuel Lim
- Gastroenterology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Hasan Nadim Haboubi
- Gastroenterology, University Hospital Llandough, Cardiff, UK,Institute of Life Sciences, Swansea University, Swansea, UK
| | - Simon H C Anderson
- Gastroenterology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Patrick Dawson
- Gastroenterology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ana Paula Machado
- Gastroenterology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Edna Mangsat
- Gastroenterology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Sara Santos
- Gastroenterology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Terry Wong
- Gastroenterology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Sebastian Zeki
- Gastroenterology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK,Comprehensive Cancer Centre, King's College London, London, UK
| | - Jason Dunn
- Gastroenterology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK,Comprehensive Cancer Centre, King's College London, London, UK
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Abstract
PURPOSE OF REVIEW Gastroesophageal varices are common complications of chronic liver diseases (CLDs) and portal hypertension. Small varices have the risk of progressing to larger varices, causing bleeding or even death. Thus, early detection and appropriate management of small varices are necessary. The purpose of this review is to summarize the advance in the recent 5years about diagnosing and managing the small varices in CLDs. RECENT FINDINGS The diagnosing methods of small varices in recent studies include improved endoscopic examinations, such as capsule endoscopy, and many noninvasive methods, including blood tests, ultrasound, computed tomography and magnetic resonance. For the management of small varices, though it is controversial, prevention using nonselective beta-blockers is still an essential part. SUMMARY In this review, we summarize the classification of varices, the invasive and noninvasive diagnostic methods, their performances, and the emerging progression in the management of small varices in the recent 5 years. We hope that this review provides relevant information to understand better and appropriately manage small varices.
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Affiliation(s)
- Ying Zhu
- Department of Infectious Diseases, The First Affiliated Hospital of Dalian Medical University, Dalian
| | - Hui Cheng
- Department of Infectious Diseases, The First Affiliated Hospital of Dalian Medical University, Dalian
- Department of Gastroenterology, The Second Affiliated Hospital of Dalian Medical University, Dalian
| | - Jianyong Chen
- Department of Gastroenterology, Jiangxi Provincial People's Hospital, Nanchang
| | - Yifei Huang
- CHESS Center, Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou, China
| | - Hao Liu
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Xiaolong Qi
- CHESS Center, Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou, China
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Grant RK, Brindle WM, Robertson AR, Kalla R, Plevris JN. Unsedated Transnasal Endoscopy: A Safe, Well-Tolerated and Accurate Alternative to Standard Diagnostic Peroral Endoscopy. Dig Dis Sci 2022; 67:1937-1947. [PMID: 35239094 PMCID: PMC8893049 DOI: 10.1007/s10620-022-07432-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/30/2022] [Indexed: 12/23/2022]
Abstract
Diagnostic unsedated transnasal endoscopy (uTNE) has been proven to be a safe and well-tolerated procedure. Although its utilization in the United Kingdom (UK) is increasing, it is currently available in only a few centers. Through consideration of recent studies, we aimed to perform an updated review of the technological advances in uTNE, consider their impact on diagnostic accuracy, and to determine the role of uTNE in the COVID-19 era. Current literature has shown that the diagnostic accuracy of uTNE for identification of esophageal pathology is equivalent to conventional esophagogastroduodenoscopy (cEGD). Concerns regarding suction and biopsy size have been addressed by the introduction of TNE scopes with working channels of 2.4 mm. Advances in imaging have improved detection of early gastric cancers. The procedure is associated with less cardiac stress and reduced aerosol production; when combined with no need for sedation and improved rates of patient turnover, uTNE is an efficient and safe alternative to cEGD in the COVID-19 era. We conclude that advances in technology have improved the diagnostic accuracy of uTNE to the point where it could be considered the first line diagnostic endoscopic investigation in the majority of patients. It could also play a central role in the recovery of diagnostic endoscopic services during the COVID-19 pandemic.
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Affiliation(s)
- Rebecca K. Grant
- The Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - William M. Brindle
- The Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, UK
| | | | - Rahul Kalla
- The Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - John N. Plevris
- The Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, UK
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Xavier AT, Alvares AV, Iyer PG, Arantes VN. Unsedated Transnasal Endoscopy for Preoperative Examination of Bariatric Patients: a Prospective Study. Obes Surg 2020; 30:238-243. [PMID: 31377993 DOI: 10.1007/s11695-019-04120-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Esophagogastroduodenoscopy is a preoperative examination commonly required for candidates to bariatric surgery (BS). Overweight individuals have a greater risk of cardiorespiratory complications during endoscopy under sedation. This study aimed to investigate the feasibility, tolerance, and cardiovascular stress of transnasal endoscopy (TNE) without sedation in obese patients eligible for BS. METHODS This prospective study enrolled obese adult patients with indication for BS that consented to undergo unsedated preoperative TNE. All examinations were carried out in an outpatient center. The outcomes assessed were endoscopic findings, procedural success, patients' tolerance according to a visual analogic scale, cardiovascular stress estimated by double product (i.e., systolic blood pressure × heart rate) and adverse events. Statistical analyses were used to compare each patient's double product among different examination periods. RESULTS Ninety-four patients (77.6% female) completed the study, with an average body mass index (BMI) of 53 kg/m2 (range, 35-73.4 kg/m2). There were 63 super-obese individuals (67%), with BMI > 50 kg/m2. In 93 patients (98.9%), unsedated TNE was successfully completed up to the second part of the duodenum. TNE failed in one patient. Tolerance was rated as excellent or good in 95.7%. Minimal cardiovascular stress was noted in obese individuals, whereas the double product remained stable throughout the procedure in super-obese patients. Three patients (3.2%) had self-limited epistaxis. CONCLUSIONS Unsedated TNE for preoperative endoscopic evaluation of obese patients is feasible, safe, and well tolerated and should be preferentially considered when examining super-obese patients.
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Affiliation(s)
- Amaury Teixeira Xavier
- Endoscopy Unit, Alfa Institute of Gastroenterology, Clinics Hospital, Federal University of Minas Gerais, Belo Horizonte, Brazil. .,Instituto Alfa de Gatroenterologia, Universidade Federal de Minas Gerais - Medicine, Avenida Professor Alfredo Balena, 110, Santa Efigenia, Belo Horizonte, Minas Gerais, 30130-100, Brazil.
| | - Arthur V Alvares
- Endoscopy Unit, Military Hospital of Minas Gerais, Belo Horizonte, Brazil
| | - Prasad G Iyer
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, USA
| | - Vitor N Arantes
- Endoscopy Unit, Alfa Institute of Gastroenterology, Clinics Hospital, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Nishizawa T, Sakitani K, Suzuki H, Yamakawa T, Takahashi Y, Yoshida S, Nakai Y, Hata K, Ebinuma H, Koike K, Toyoshima O. Small-caliber endoscopes are more fragile than conventional endoscopes. Endosc Int Open 2019; 7:E1729-E1732. [PMID: 31828209 PMCID: PMC6904235 DOI: 10.1055/a-1036-6186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 10/07/2019] [Indexed: 02/07/2023] Open
Abstract
Background and study aims The repair costs of gastrointestinal endoscopes account for a significant proportion of the total budget of an endoscopy unit. This study evaluated the repair costs of small-caliber endoscopes and conventional endoscopes used in esophagogastroduodenoscopy (EGD). Patients and methods A retrospective analysis of upper gastrointestinal endoscope damage and repair costs between April 2012 and May 2019 was performed at the Toyoshima Endoscopy Clinic. Conventional endoscopes (GIF-H260, GIF-HQ290, and GIF-H290Z) were used for transoral EGD while small-caliber endoscopes (GIF-XP260N and GIF-XP290N) were used for transnasal or transoral EGD. Results Three small-caliber endoscopes and five conventional endoscopes were used for 1,031 procedures and 31,192 procedures, respectively. The number of procedures/damage incidence for small-caliber endoscope and conventional endoscopes was 344 and 1950, respectively. Damage incidence for small-caliber endoscopes was significantly higher than for conventional endoscopes ( P = 0.014). Repair costs/procedure were $ 5.95 ± $132 for small-caliber endoscopes and $2.41 ± $115 for conventional endoscopes. Repair costs/procedure for small-caliber endoscopes were more than twice those for conventional endoscopes. Conclusions Small-caliber endoscopes are more fragile than conventional endoscopes.
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Affiliation(s)
- Toshihiro Nishizawa
- Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan,Department of Gastroenterology and Hepatology, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Kosuke Sakitani
- Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan,Gastroenterology, Sakitani Endoscopy Clinic, Chiba-Tsudanuma, Japan
| | - Hidekazu Suzuki
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Tokyo, Japan
| | | | | | - Shuntaro Yoshida
- Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan,Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yousuke Nakai
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Keisuke Hata
- Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan,Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hirotoshi Ebinuma
- Department of Gastroenterology and Hepatology, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Kazuhiko Koike
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Osamu Toyoshima
- Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan,Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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