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Bernth JE, Zhang G, Malas D, Abrahams G, Hayee B, Liu H. MorphGI: A Self-Propelling Soft Robotic Endoscope Through Morphing Shape. Soft Robot 2024; 11:670-683. [PMID: 38484296 DOI: 10.1089/soro.2023.0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
Colonoscopy is currently the best method for detecting bowel cancer, but fundamental design and construction have not changed significantly in decades. Conventional colonoscope (CC) is difficult to maneuver and can lead to pain with a risk of damaging the bowel due to its rigidity. We present the MorphGI, a robotic endoscope system that is self-propelling and made of soft material, thus easy to operate and inherently safe to patient. After verifying kinematic control of the distal bending segment, the system was evaluated in: a benchtop colon simulator, using multiple colon configurations; a colon simulator with force sensors; and surgically removed pig colon tissue. In the colon simulator, the MorphGI completed a colonoscopy in an average of 10.84 min. The MorphGI showed an average of 77% and 62% reduction in peak forces compared to a CC in high- and low-stiffness modes, respectively. Self-propulsion was demonstrated in the excised tissue test but not in the live pig test, due to anatomical differences between pig and human colons. This work demonstrates the core features of MorphGI.
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Affiliation(s)
- Julius E Bernth
- Department of Surgical and Interventional Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Guokai Zhang
- Department of Surgical and Interventional Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Dionysios Malas
- Department of Surgical and Interventional Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - George Abrahams
- Department of Surgical and Interventional Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Bu Hayee
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Hongbin Liu
- Department of Surgical and Interventional Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- Institute of Automation, Chinese Academy of Sciences (CAS), Beijing, China
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2
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Yu Y, Feng T, Qiu H, Gu Y, Chen Q, Zuo C, Ma H. Simultaneous photoacoustic and ultrasound imaging: A review. ULTRASONICS 2024; 139:107277. [PMID: 38460216 DOI: 10.1016/j.ultras.2024.107277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 01/09/2024] [Accepted: 02/26/2024] [Indexed: 03/11/2024]
Abstract
Photoacoustic imaging (PAI) is an emerging biomedical imaging technique that combines the advantages of optical and ultrasound imaging, enabling the generation of images with both optical resolution and acoustic penetration depth. By leveraging similar signal acquisition and processing methods, the integration of photoacoustic and ultrasound imaging has introduced a novel hybrid imaging modality suitable for clinical applications. Photoacoustic-ultrasound imaging allows for non-invasive, high-resolution, and deep-penetrating imaging, providing a wealth of image information. In recent years, with the deepening research and the expanding biomedical application scenarios of photoacoustic-ultrasound bimodal systems, the immense potential of photoacoustic-ultrasound bimodal imaging in basic research and clinical applications has been demonstrated, with some research achievements already commercialized. In this review, we introduce the principles, technical advantages, and biomedical applications of photoacoustic-ultrasound bimodal imaging techniques, specifically focusing on tomographic, microscopic, and endoscopic imaging modalities. Furthermore, we discuss the future directions of photoacoustic-ultrasound bimodal imaging technology.
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Affiliation(s)
- Yinshi Yu
- Smart Computational Imaging Laboratory (SCILab), School of Electronic and Optical Engineering, Nanjing University of Science and Technology, Nanjing, Jiangsu Province 210094, China; Smart Computational Imaging Research Institute (SCIRI) of Nanjing University of Science and Technology, Nanjing, Jiangsu Province 210019, China; Jiangsu Key Laboratory of Spectral Imaging & Intelligent Sense, Nanjing, Jiangsu Province 210094, China
| | - Ting Feng
- Academy for Engineering & Technology, Fudan University, Shanghai 200433,China.
| | - Haixia Qiu
- First Medical Center of PLA General Hospital, Beijing, China
| | - Ying Gu
- First Medical Center of PLA General Hospital, Beijing, China
| | - Qian Chen
- Smart Computational Imaging Laboratory (SCILab), School of Electronic and Optical Engineering, Nanjing University of Science and Technology, Nanjing, Jiangsu Province 210094, China; Smart Computational Imaging Research Institute (SCIRI) of Nanjing University of Science and Technology, Nanjing, Jiangsu Province 210019, China; Jiangsu Key Laboratory of Spectral Imaging & Intelligent Sense, Nanjing, Jiangsu Province 210094, China
| | - Chao Zuo
- Smart Computational Imaging Laboratory (SCILab), School of Electronic and Optical Engineering, Nanjing University of Science and Technology, Nanjing, Jiangsu Province 210094, China; Smart Computational Imaging Research Institute (SCIRI) of Nanjing University of Science and Technology, Nanjing, Jiangsu Province 210019, China; Jiangsu Key Laboratory of Spectral Imaging & Intelligent Sense, Nanjing, Jiangsu Province 210094, China.
| | - Haigang Ma
- Smart Computational Imaging Laboratory (SCILab), School of Electronic and Optical Engineering, Nanjing University of Science and Technology, Nanjing, Jiangsu Province 210094, China; Smart Computational Imaging Research Institute (SCIRI) of Nanjing University of Science and Technology, Nanjing, Jiangsu Province 210019, China; Jiangsu Key Laboratory of Spectral Imaging & Intelligent Sense, Nanjing, Jiangsu Province 210094, China.
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3
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Tronel A, Silvent AS, Buelow E, Giai J, Leroy C, Proust M, Martin D, Le Gouellec A, Soranzo T, Mathieu N. Pilot Study: Safety and Performance Validation of an Ingestible Medical Device for Collecting Small Intestinal Liquid in Healthy Volunteers. Methods Protoc 2024; 7:15. [PMID: 38392689 PMCID: PMC10892249 DOI: 10.3390/mps7010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/19/2024] [Accepted: 01/30/2024] [Indexed: 02/24/2024] Open
Abstract
The connection between imbalances in the human gut microbiota, known as dysbiosis, and various diseases has been well established. Current techniques for sampling the small intestine are both invasive for patients and costly for healthcare facilities. Most studies on human gut microbiome are conducted using faecal samples, which do not accurately represent the microbiome in the upper intestinal tract. A pilot clinical investigation, registered as NCT05477069 and sponsored by the Grenoble Alpes University Hospital, is currently underway to evaluate a novel ingestible medical device (MD) designed for collecting small intestinal liquids by Pelican Health. This study is interventional and monocentric, involving 15 healthy volunteers. The primary objective of the study is to establish the safety and the performance of the MD when used on healthy volunteers. Secondary objectives include assessing the device's performance and demonstrating the difference between the retrieved sample from the MD and the corresponding faecal sample. Multi-omics analysis will be performed, including metagenomics, metabolomics, and culturomics. We anticipate that the MD will prove to be safe without any reported adverse effects, and we collected samples suitable for the proposed omics analyses in order to demonstrate the functionality of the MD and the clinical potential of the intestinal content.
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Affiliation(s)
- Alexandre Tronel
- Pelican Health, 107 rue Aristide Briand, 38600 Fontaine, France;
- University Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, 38000 Grenoble, France; (E.B.); (J.G.)
| | - Anne-Sophie Silvent
- University Grenoble Alpes, Inserm, CHU Grenoble Alpes, CIC, 38000 Grenoble, France; (A.-S.S.); (C.L.); (M.P.)
| | - Elena Buelow
- University Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, 38000 Grenoble, France; (E.B.); (J.G.)
| | - Joris Giai
- University Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, 38000 Grenoble, France; (E.B.); (J.G.)
| | - Corentin Leroy
- University Grenoble Alpes, Inserm, CHU Grenoble Alpes, CIC, 38000 Grenoble, France; (A.-S.S.); (C.L.); (M.P.)
| | - Marion Proust
- University Grenoble Alpes, Inserm, CHU Grenoble Alpes, CIC, 38000 Grenoble, France; (A.-S.S.); (C.L.); (M.P.)
| | - Donald Martin
- University Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, 38000 Grenoble, France; (E.B.); (J.G.)
| | - Audrey Le Gouellec
- University Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, 38000 Grenoble, France; (E.B.); (J.G.)
- Service de Biochimie Biologie Moléculaire Toxicologie Environnementale, UM Biochimie des Enzymes et des Protéines, Institut de Biologie et Pathologie, CHU Grenoble-Alpes, 38000 Grenoble, France
- Plateforme de Métabolomique GEMELI-GExiM, Institut de Biologie et Pathologie, CHU Grenoble-Alpes, 38000 Grenoble, France
| | - Thomas Soranzo
- Pelican Health, 107 rue Aristide Briand, 38600 Fontaine, France;
| | - Nicolas Mathieu
- Department of Hepato-Gastroenterology and Digestive Oncology, Grenoble Alpes University Hospital, 38000 Grenoble, France
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4
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Calibrated analytical model for magnetic localization of wireless capsule endoscope based on onboard sensing. ROBOTICA 2023. [DOI: 10.1017/s0263574722001849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Abstract
Wireless capsule endoscopes (WCEs) are pill-sized camera-embedded devices that can provide visualization of the gastrointestinal (GI) tract by capturing and transmitting images to an external receiver. Determination of the exact location of the WCE is crucial for the accurate navigation of the WCE through external guidance, tracking of the GI abnormality, and the treatment of the detected disease. Despite the enormous progress in the real-time tracking of the WCE, a well-calibrated analytical model is still missing for the accurate localization of WCEs by the measurements from different onboard sensing units. In this paper, a well-calibrated analytical model for the magnetic localization of the WCE was established by optimizing the magnetic moment in the magnetic dipole model. The Jacobian-based iterative method was employed to solve the position of the WCE. An error model was established and experimentally verified for the analysis and prediction of the localization errors caused by inaccurate measurements from the magnetic field sensor. The assessment of the real-time localization of the WCE was performed via experimental trials using an external permanent magnet (EPM) mounted on a robotic manipulator and a WCE equipped with a 3-axis magnetic field sensor and an inertial measurement unit (IMU). The localization errors were measured under different translational and rotational motion modes and working spaces. The results showed that the selection of workspace (distance relative to the EPM) could lead to different positioning errors. The proposed magnetic localization method holds great potential for the real-time localization of WCEs when performing complex motions during GI diagnosis.
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5
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Xin Y, Sun ZJ, Gu W, Yu L. Experimental Research on a Capsule Robot with Spring-Connected Legs. MICROMACHINES 2022; 13:2042. [PMID: 36557341 PMCID: PMC9785607 DOI: 10.3390/mi13122042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/13/2022] [Accepted: 11/18/2022] [Indexed: 06/17/2023]
Abstract
Based on a previous study of a novel capsule robot (CR) with spring-connected legs that could collect intestinal juice for biopsy, in this research, an experiment system is designed, and two experiments are carried out. One of the experiments measures the torque and cutting force of this CR, and the other experiment tests and evaluates the biopsy function of this CR. In the measuring experiment, we analyze how the magnetic torque exerted on this CR changes. In the experiment with a biopsy, we decompose the biopsy actions and select the most effective biopsy action. The result of the experiments shows that this CR can collect and store biopsy samples ideally, and the most effective biopsy action is the rotation with legs extended.
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6
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Yan B. Actuators for Implantable Devices: A Broad View. MICROMACHINES 2022; 13:1756. [PMID: 36296109 PMCID: PMC9610948 DOI: 10.3390/mi13101756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/12/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
The choice of actuators dictates how an implantable biomedical device moves. Specifically, the concept of implantable robots consists of the three pillars: actuators, sensors, and powering. Robotic devices that require active motion are driven by a biocompatible actuator. Depending on the actuating mechanism, different types of actuators vary remarkably in strain/stress output, frequency, power consumption, and durability. Most reviews to date focus on specific type of actuating mechanism (electric, photonic, electrothermal, etc.) for biomedical applications. With a rapidly expanding library of novel actuators, however, the granular boundaries between subcategories turns the selection of actuators a laborious task, which can be particularly time-consuming to those unfamiliar with actuation. To offer a broad view, this study (1) showcases the recent advances in various types of actuating technologies that can be potentially implemented in vivo, (2) outlines technical advantages and the limitations of each type, and (3) provides use-specific suggestions on actuator choice for applications such as drug delivery, cardiovascular, and endoscopy implants.
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Affiliation(s)
- Bingxi Yan
- Department of Electrical and Computer Engineering, Ohio State University, Columbus, OH 43210, USA
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7
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B S, P A. Recent developments in wireless capsule endoscopy imaging: Compression and summarization techniques. Comput Biol Med 2022; 149:106087. [PMID: 36115301 DOI: 10.1016/j.compbiomed.2022.106087] [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: 05/11/2022] [Revised: 08/10/2022] [Accepted: 09/03/2022] [Indexed: 11/03/2022]
Abstract
Wireless capsule endoscopy (WCE) can be viewed as an innovative technology introduced in the medical domain to directly visualize the digestive system using a battery-powered electronic capsule. It is considered a desirable substitute for conventional digestive tract diagnostic methods for a comfortable and painless inspection. Despite many benefits, WCE results in poor video quality due to low frame resolution and diagnostic accuracy. Many research groups have presented diversified, low-complexity compression techniques to economize battery power consumed in the radio-frequency transmission of the captured video, which allows for capturing the images at high resolution. Many vision-based computational methods have been developed to improve the diagnostic yield. These methods include approaches for automatically detecting abnormalities and reducing the amount of time needed for video analysis. Though various research works have been put forth in the WCE imaging field, there is still a wide gap between the existing techniques and the current needs. Hence, this article systematically reviews recent WCE video compression and summarization techniques. The review's objectives are as follows: First, to provide the details of the requirement, challenges and design percepts for the low complexity WCE video compressor. Second, to discuss the most recent compression methods, emphasizing simple distributed video coding methods. Next, to review the most recent summarization techniques and the significance of using deep neural networks. Further, this review aims to provide a quantitative analysis of the state-of-the-art methods along with their advantages and drawbacks. At last, to discuss existing problems and possible future directions for building a robust WCE imaging framework.
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Affiliation(s)
- Sushma B
- Image Processing and Analysis Lab (iPAL), Department of Electronics and Communication Engineering, National Institute of Technology Karnataka-Surathkal, Mangalore 575025, Karnataka, India; Department of Electronics and Communication Engineering, CMR Institute of Technology, Bengaluru 560037, Karnataka, India.
| | - Aparna P
- Image Processing and Analysis Lab (iPAL), Department of Electronics and Communication Engineering, National Institute of Technology Karnataka-Surathkal, Mangalore 575025, Karnataka, India
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8
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Wu L, Lu K. Experimental investigation of a new type of driving concept for capsule robot. INTEL SERV ROBOT 2022. [DOI: 10.1007/s11370-022-00443-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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9
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Raj A, Sebastin A, Subbu N, Sp P, Sivaprakasam M. Enhanced Vascular Features in Porcine Gastrointestinal Endoscopy Using Multispectral Imaging. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:2228-2231. [PMID: 36086222 DOI: 10.1109/embc48229.2022.9871634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Endoscopic investigation is a predominant stan-dard while assessing the gastrointestinal tract. Even though it has been rigorously used in diagnostics for many decades, a high miss rate has been recorded. Advanced endoscopic imaging still has not found solutions to problems like early cancer detection, polyp generality, disease classification, etc. One of the less explored techniques to study early cancer detection is spectral imaging which deals with the absorption and reflection spectra of various wavelengths of light by different layers of tissue. To study tissues under various illumination, a multi-spectral light source unit that can be used along with an endoscopy system was developed with 10 different LEDs of very narrow bandwidths. Using this light source, a feasibility study was per-formed on an animal in which the upper GI tract of a porcine model was imaged and sample images were taken for processing from five different sections. Some wavelengths showed better contrast enhancements for visualization of vascular structures. Wavelength 420 nm (violet light) showed better contrast and the gradient of the line profile histogram showed the highest intensity change between the blood vessels and the surrounding mucosa. These enhancements showed that spectral imaging can potentially help in studying tissues for early cancer detection and improved visualization of the G I tract using endoscopy.
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Barducci L, Scaglioni B, Martin J, Obstein KL, Valdastri P. Active Stabilization of Interventional Tasks Utilizing a Magnetically Manipulated Endoscope. Front Robot AI 2022; 9:854081. [PMID: 35494547 PMCID: PMC9047764 DOI: 10.3389/frobt.2022.854081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/17/2022] [Indexed: 01/16/2023] Open
Abstract
Magnetically actuated robots have become increasingly popular in medical endoscopy over the past decade. Despite the significant improvements in autonomy and control methods, progress within the field of medical magnetic endoscopes has mainly been in the domain of enhanced navigation. Interventional tasks such as biopsy, polyp removal, and clip placement are a major procedural component of endoscopy. Little advancement has been done in this area due to the problem of adequately controlling and stabilizing magnetically actuated endoscopes for interventional tasks. In the present paper we discuss a novel model-based Linear Parameter Varying (LPV) control approach to provide stability during interventional maneuvers. This method linearizes the non-linear dynamic interaction between the external actuation system and the endoscope in a set of equilibria, associated to different distances between the magnetic source and the endoscope, and computes different controllers for each equilibrium. This approach provides the global stability of the overall system and robustness against external disturbances. The performance of the LPV approach is compared to an intelligent teleoperation control method (based on a Proportional Integral Derivative (PID) controller), on the Magnetic Flexible Endoscope (MFE) platform. Four biopsies in different regions of the colon and at two different system equilibria are performed. Both controllers are asked to stabilize the endoscope in the presence of external disturbances (i.e. the introduction of the biopsy forceps through the working channel of the endoscope). The experiments, performed in a benchtop colon simulator, show a maximum reduction of the mean orientation error of the endoscope of 45.8% with the LPV control compared to the PID controller.
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Affiliation(s)
- Lavinia Barducci
- STORM Lab United Kingdom, Institute of Robotics, Autonomous Systems and Sensing, School of Electronic and Electrical Engineering, University of Leeds, Leeds, United Kingdom
| | - Bruno Scaglioni
- STORM Lab United Kingdom, Institute of Robotics, Autonomous Systems and Sensing, School of Electronic and Electrical Engineering, University of Leeds, Leeds, United Kingdom
| | - James Martin
- STORM Lab United Kingdom, Institute of Robotics, Autonomous Systems and Sensing, School of Electronic and Electrical Engineering, University of Leeds, Leeds, United Kingdom
| | - Keith L. Obstein
- STORM Lab United States, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Pietro Valdastri
- STORM Lab United Kingdom, Institute of Robotics, Autonomous Systems and Sensing, School of Electronic and Electrical Engineering, University of Leeds, Leeds, United Kingdom
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Ding Z, Wang W, Zhang K, Ming F, Yangdai T, Xu T, Shi H, Bao Y, Yao H, Peng H, Han C, Jiang W, Liu J, Hou X, Lin R. Novel scheme for non-invasive gut bioinformation acquisition with a magnetically controlled sampling capsule endoscope. Gut 2021; 70:2297-2306. [PMID: 33452177 DOI: 10.1136/gutjnl-2020-322465] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 01/01/2021] [Accepted: 01/04/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Intestinal flora and metabolites are associated with multiple systemic diseases. Current approaches for acquiring information regarding microbiota/metabolites have limitations. We aimed to develop a precise magnetically controlled sampling capsule endoscope (MSCE) for the convenient, non-invasive and accurate acquisition of digestive bioinformation for disease diagnosis and evaluation. DESIGN The MSCE and surgery were both used for sampling both jejunal and ileal GI content in the control and antibiotic-induced diarrhoea groups. The GI content was then used for microbiome profiling and metabolomics profiling. RESULTS Compared with surgery, our data showed that the MSCE precisely acquired data regarding the intestinal flora and metabolites, which was effectively differentiated in different intestinal regions and disease models. Using MSCE, we detected a dramatic decrease in the abundance of Bacteroidetes, Patescibacteria and Actinobacteria and hippuric acid levels, as well as an increase in the abundance of Escherichia-Shigella and the 2-pyrrolidinone levels were detected in the antibiotic-induced diarrhoea model by MSCE. MSCE-mediated sampling revealed specific gut microbiota/metabolites including Enterococcus, Lachnospiraceae, acetyl-L-carnitine and succinic acid, which are related to metabolic diseases, cancers and nervous system disorders. Additionally, the MSCE exhibited good sealing characteristics with no contamination after sampling. CONCLUSIONS We present a newly developed MSCE that can non-invasively and accurately acquire intestinal bioinformation via direct visualization under magnetic control, which may further aid in disease prevention, diagnosis, prognosis and treatment.
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Affiliation(s)
- Zhen Ding
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weijun Wang
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kun Zhang
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fanhua Ming
- R&D department, ANKON Technologies, Wuhan, China
| | | | - Tao Xu
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huiying Shi
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuhui Bao
- R&D department, ANKON Technologies, Wuhan, China
| | - Hailing Yao
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hangyu Peng
- R&D department, ANKON Technologies, Wuhan, China
| | - Chaoqun Han
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weiwei Jiang
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Liu
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaohua Hou
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rong Lin
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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12
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Rudiman R. Advances in gastrointestinal surgical endoscopy. Ann Med Surg (Lond) 2021; 72:103041. [PMID: 34888040 PMCID: PMC8636781 DOI: 10.1016/j.amsu.2021.103041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/06/2021] [Accepted: 11/09/2021] [Indexed: 11/22/2022] Open
Abstract
Surgeons have a role in observing, detect abnormalities, disease, and other deficiencies in function which could be treated. Diagnosing and treating back days were challenging for many reasons. However, technology's innovation enhances surgeons' ability to treat their patients. The term endoscopy refers to the Greek prefix endo- ("within") and the verb skopein ("to view or observe"). Endoscopy is practical both in the diagnosis and treatment of various pathologies. Technological advances, especially in endoscopy, gradually progress and discover many possibilities which allow rapid advancement. Endoscopy development aims to assess human orifice that has not been inspected, probed, and examined over the centuries. Endoscopy over these decades is improving, which led to new problem solving using advanced technological approaches. Thus, a surgeon can solve any issues from examination, diagnosis, and treatment using progressive endoscopy evolution. This review delivers a brief history of advances in surgical endoscopy and describes current endoscopy development.
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Affiliation(s)
- Reno Rudiman
- Division of Digestive Surgery, Department of General Surgery, School of Medicine, Padjadjaran University, Hasan Sadikin General Hospital, Bandung, Indonesia
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13
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McCandless M, Gerald A, Carroll A, Aihara H, Russo S. A Soft Robotic Sleeve for Safer Colonoscopy Procedures. IEEE Robot Autom Lett 2021; 6:5292-5299. [PMID: 34027062 PMCID: PMC8132950 DOI: 10.1109/lra.2021.3073651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Colonoscopy is the gold standard for colorectal cancer diagnosis; however, limited instrument dexterity and no sensor feedback can hamper procedure safety and acceptance. We propose a soft robotic sleeve to provide sensor feedback and additional actuation capabilities to improve safety during navigation in colonoscopy. The robot can be mounted around current endoscopic instrumentation as a disposable "add-on", avoiding the need for dedicated or customized instruments and without disrupting current surgical workflow. We focus on design, finite element analysis, fabrication, and experimental characterization and validation of the soft robotic sleeve. The device integrates soft optical sensors to monitor contact interaction forces between the colon and the colonoscope and soft robotic actuators that can be automatically deployed if excessive force is detected, to guarantee pressure redistribution on a larger contact area of the colon. The system can be operated by a surgeon via a graphic user interface that displays contact force values and enables independent or coordinated pressurization of the soft actuators upon demand, in case deemed necessary to aid navigation or distend colon tissue.
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Affiliation(s)
- Max McCandless
- Mechanical Engineering Department, Boston University, Boston, MA 02215 USA
| | - Arincheyan Gerald
- Mechanical Engineering Department, Boston University, Boston, MA 02215 USA
| | - Ashlyn Carroll
- Mechanical Engineering Department, Boston University, Boston, MA 02215 USA
| | - Hiroyuki Aihara
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115 USA
| | - Sheila Russo
- Mechanical Engineering Department, Boston University, Boston, MA 02215 USA
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14
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Naz J, Sharif M, Yasmin M, Raza M, Khan MA. Detection and Classification of Gastrointestinal Diseases using Machine Learning. Curr Med Imaging 2021; 17:479-490. [PMID: 32988355 DOI: 10.2174/1573405616666200928144626] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/07/2020] [Accepted: 07/23/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Traditional endoscopy is an invasive and painful method of examining the gastrointestinal tract (GIT) not supported by physicians and patients. To handle this issue, video endoscopy (VE) or wireless capsule endoscopy (WCE) is recommended and utilized for GIT examination. Furthermore, manual assessment of captured images is not possible for an expert physician because it's a time taking task to analyze thousands of images thoroughly. Hence, there comes the need for a Computer-Aided-Diagnosis (CAD) method to help doctors analyze images. Many researchers have proposed techniques for automated recognition and classification of abnormality in captured images. METHODS In this article, existing methods for automated classification, segmentation and detection of several GI diseases are discussed. Paper gives a comprehensive detail about these state-of-theart methods. Furthermore, literature is divided into several subsections based on preprocessing techniques, segmentation techniques, handcrafted features based techniques and deep learning based techniques. Finally, issues, challenges and limitations are also undertaken. RESULTS A comparative analysis of different approaches for the detection and classification of GI infections. CONCLUSION This comprehensive review article combines information related to a number of GI diseases diagnosis methods at one place. This article will facilitate the researchers to develop new algorithms and approaches for early detection of GI diseases detection with more promising results as compared to the existing ones of literature.
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Affiliation(s)
- Javeria Naz
- Department of Computer Science, COMSATS University Islamabad, Wah Campus, Pakistan
| | - Muhammad Sharif
- Department of Computer Science, COMSATS University Islamabad, Wah Campus, Pakistan
| | - Mussarat Yasmin
- Department of Computer Science, COMSATS University Islamabad, Wah Campus, Pakistan
| | - Mudassar Raza
- Department of Computer Science, COMSATS University Islamabad, Wah Campus, Pakistan
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15
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Deng J, Ding QM, Jia MX, Li W, Zuberi Z, Wang JH, Ren JL, Fu D, Zeng XX, Luo JF. Biosafety risk assessment of nanoparticles: Evidence from food case studies. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 275:116662. [PMID: 33582638 DOI: 10.1016/j.envpol.2021.116662] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 12/21/2020] [Accepted: 02/02/2021] [Indexed: 05/04/2023]
Abstract
Nanotechnology provides a wide range of benefits in the food industry in improving food tastes, textures, sensations, quality, shelf life, and food safety. Recently, potential adverse effects such as toxicity and safety concerns have been associated with the increasing use of engineered nanoparticles in food industry. Additionally, very limited information is known concerning the behavior, properties and effects of food nano-materials in the gastrointestinal tract. There is explores the current advances and provides insights of the potential risks of nanoparticles in the food industry. Specifically, characteristics of food nanoparticles and their absorption in the gastrointestinal tract, the effects of food nanoparticles against the gastrointestinal microflora, and the potential toxicity mechanisms in different organs and body systems are discussed. This review would provide references for further investigation of nano-materials toxicity effect in foods and their molecular mechanisms. It will help to develop safer foods and expand nano-materials applications in safe manner.
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Affiliation(s)
- Jing Deng
- National Engineering Laboratory for Deep Process of Rice and Byproducts, Hunan Province Key Laboratory of Edible Forestry Resources Safety and Processing Utilization, Hunan Key Laboratory of Processed Food for Special Medical Purpose, College of Food Science and Engineering, Central South University of Forestry and Technology, Changsha, 410004, Hunan, China; College of Packaging and Material Engineering, College of Life Sciences and Chemistry, Hunan University of Technology, Zhuzhou, 412007, China
| | - Quan Ming Ding
- College of Packaging and Material Engineering, College of Life Sciences and Chemistry, Hunan University of Technology, Zhuzhou, 412007, China
| | - Ming Xi Jia
- National Engineering Laboratory for Deep Process of Rice and Byproducts, Hunan Province Key Laboratory of Edible Forestry Resources Safety and Processing Utilization, Hunan Key Laboratory of Processed Food for Special Medical Purpose, College of Food Science and Engineering, Central South University of Forestry and Technology, Changsha, 410004, Hunan, China
| | - Wen Li
- National Engineering Laboratory for Deep Process of Rice and Byproducts, Hunan Province Key Laboratory of Edible Forestry Resources Safety and Processing Utilization, Hunan Key Laboratory of Processed Food for Special Medical Purpose, College of Food Science and Engineering, Central South University of Forestry and Technology, Changsha, 410004, Hunan, China; College of Packaging and Material Engineering, College of Life Sciences and Chemistry, Hunan University of Technology, Zhuzhou, 412007, China.
| | - Zavuga Zuberi
- Department of Science and Laboratory Technology, Dar Es Salaam Institute of Technology, P.O. Box 2958, Dar Es Salaam, Tanzania
| | - Jian Hui Wang
- School of Chemistry and Food Engineering, Changsha University of Science and Technology, Changsha, Hunan, 410114, China
| | - Jia Li Ren
- National Engineering Laboratory for Deep Process of Rice and Byproducts, Hunan Province Key Laboratory of Edible Forestry Resources Safety and Processing Utilization, Hunan Key Laboratory of Processed Food for Special Medical Purpose, College of Food Science and Engineering, Central South University of Forestry and Technology, Changsha, 410004, Hunan, China
| | - Da Fu
- Central Laboratory for Medical Research, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
| | - Xiao Xi Zeng
- College of Packaging and Material Engineering, College of Life Sciences and Chemistry, Hunan University of Technology, Zhuzhou, 412007, China
| | - Jun Fei Luo
- National Engineering Laboratory for Deep Process of Rice and Byproducts, Hunan Province Key Laboratory of Edible Forestry Resources Safety and Processing Utilization, Hunan Key Laboratory of Processed Food for Special Medical Purpose, College of Food Science and Engineering, Central South University of Forestry and Technology, Changsha, 410004, Hunan, China
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16
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Kim H, Kim J, You JM, Lee SW, Kyung KU, Kwon DS. A Sigmoid-Colon-Straightening Soft Actuator With Peristaltic Motion for Colonoscopy Insertion Assistance: Easycolon. IEEE Robot Autom Lett 2021. [DOI: 10.1109/lra.2021.3060391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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17
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Liaqat A, Khan MA, Sharif M, Mittal M, Saba T, Manic KS, Al Attar FNH. Gastric Tract Infections Detection and Classification from Wireless Capsule Endoscopy using Computer Vision Techniques: A Review. Curr Med Imaging 2021; 16:1229-1242. [PMID: 32334504 DOI: 10.2174/1573405616666200425220513] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 01/14/2020] [Accepted: 01/30/2020] [Indexed: 11/22/2022]
Abstract
Recent facts and figures published in various studies in the US show that approximately
27,510 new cases of gastric infections are diagnosed. Furthermore, it has also been reported that
the mortality rate is quite high in diagnosed cases. The early detection of these infections can save
precious human lives. As the manual process of these infections is time-consuming and expensive,
therefore automated Computer-Aided Diagnosis (CAD) systems are required which helps the endoscopy
specialists in their clinics. Generally, an automated method of gastric infection detections
using Wireless Capsule Endoscopy (WCE) is comprised of the following steps such as contrast preprocessing,
feature extraction, segmentation of infected regions, and classification into their relevant
categories. These steps consist of various challenges that reduce the detection and recognition
accuracy as well as increase the computation time. In this review, authors have focused on the importance
of WCE in medical imaging, the role of endoscopy for bleeding-related infections, and
the scope of endoscopy. Further, the general steps and highlighting the importance of each step
have been presented. A detailed discussion and future directions have been provided at the end.
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Affiliation(s)
- Amna Liaqat
- Department of Computer Science, COMSATS University Islamabad, Wah Cantt, Pakistan
| | | | - Muhammad Sharif
- Department of Computer Science, COMSATS University Islamabad, Wah Cantt, Pakistan
| | - Mamta Mittal
- Department of Computer Science & Engineering, G.B. Pant Govt. Engineering College, New Delhi, India
| | - Tanzila Saba
- Department of Computer and Information Sciences, Prince Sultan University, Riyadh, Saudi Arabia
| | - K. Suresh Manic
- Department of Electrical & Computer Engineering, National University of Science & Technology, Muscat, Oman
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18
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Zhang F, Ye D, Song S. Design of a Legged and Clamper-Based Capsule Robot With Active Locomotion Function. J Med Device 2021. [DOI: 10.1115/1.4049311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Abstract
This paper presents a legged and clamper-based capsule robot (CR) with active locomotion function. The CR utilizes the extension and contraction of the anchoring legs to expand the collapsed intestinal wall, crawl in the intestinal tract, and stand in large spaces such as the stomach and large intestine organs. The mechanical structure design, kinematic analysis, principle of locomotion, and force analysis of the CR are presented. The design concept and locomotion principles of the proposed CR are verified by a prototype with the diameter of 13 mm and length of 39 mm. Three experiments were conducted to test the locomotion performance of the proposed CR. In the experiments, the prototype successfully expands the collapsed phantom intestine, stands on the plane, and moves forward in transparent tube at a promising speed. Experimental results indicate that the CR has good locomotion capabilities.
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Affiliation(s)
- Fan Zhang
- Mechanical Engineering, Harbin Institute of Technology (Shenzhen), Shenzhen 518055, China
| | - Dongxu Ye
- Mechanical Engineering, Harbin Institute of Technology (Shenzhen), Shenzhen 518055, China
| | - Shuang Song
- Mechanical Engineering, Harbin Institute of Technology (Shenzhen), Shenzhen 518055, China
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19
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Kinematic Optimization for the Design of a Collaborative Robot End-Effector for Tele-Echography. ROBOTICS 2021. [DOI: 10.3390/robotics10010008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Tele-examination based on robotic technologies is a promising solution to solve the current worsening shortage of physicians. Echocardiography is among the examinations that would benefit more from robotic solutions. However, most of the state-of-the-art solutions are based on the development of specific robotic arms, instead of exploiting COTS (commercial-off-the-shelf) arms to reduce costs and make such systems affordable. In this paper, we address this problem by studying the design of an end-effector for tele-echography to be mounted on two popular and low-cost collaborative robots, i.e., the Universal Robot UR5, and the Franka Emika Panda. In the case of the UR5 robot, we investigate the possibility of adding a seventh rotational degree of freedom. The design is obtained by kinematic optimization, in which a manipulability measure is an objective function. The optimization domain includes the position of the patient with regards to the robot base and the pose of the end-effector frame. Constraints include the full coverage of the examination area, the possibility to orient the probe correctly, have the base of the robot far enough from the patient’s head, and a suitable distance from singularities. The results show that adding a degree of freedom improves manipulability by 65% and that adding a custom-designed actuated joint is better than adopting a native seven-degrees-freedom robot.
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20
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Abstract
In order to improve the reliability, safety and whole digestive applicability of the gastrointestinal microrobot (GMR), a novel inchworm-like GMR is proposed in this paper. The expanding mechanism of the robot adopts an overlapping expanding arm structure. This structure increases the variable diameter ratio (ratio of fully expanded diameter to fully folded diameter) of the robot to 3.3, making the robot more applicable to the intestines in various parts of the human body. The mechanical model of the expanding arm is established, and the expanding force at different expanding radii is obtained. And then the expanding force is tested by a force test platform. The force test results: the maximum expanding force is 6.5 N, and the minimum expanding force is 1.3 N. The trend of the experimental and theoretical values is the same, and the experimental value is less than the theoretical value. A position limiting device based on Hall sensor is designed, which detects whether the mechanism reaches the limit position by non-contact method. This device alleviates the problem of sharp voltage drop caused by motor stall and improves the stability of the control circuit. The results of the Hall-type position limiting device (HPLD) testing show that the working currents of the expanding mechanism and the telescoping mechanism with HPLD are respectively 0.066A and 0.110A, and the robot control circuit works stably. Finally, the robot is tested in the intestine of the living pig, and the safety and reliability of the robot are verified. However, due to the decrease of the efficiency of wireless power transmission in vivo experiments and the change of the position of the receiving coil relative to the transmitting coil, sometimes the power supply is insufficient.
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Affiliation(s)
- Wei Wang
- Shanghai Jiao Tong University, Shanghai, China
| | | | - Ding Han
- Shanghai Jiao Tong University, Shanghai, China
| | - Yicun Meng
- Shanghai Jiao Tong University, Shanghai, China
| | - Pengxian Pu
- Shanghai Jiao Tong University, Shanghai, China
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21
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Kim MC, Kim ES, Park JO, Choi E, Kim CS. Robotic Localization Based on Planar Cable Robot and Hall Sensor Array Applied to Magnetic Capsule Endoscope. SENSORS 2020; 20:s20205728. [PMID: 33050155 PMCID: PMC7601872 DOI: 10.3390/s20205728] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 12/11/2022]
Abstract
Recently an active locomotive capsule endoscope (CE) for diagnosis and treatment in the digestive system has been widely studied. However, real-time localization to achieve precise feedback control and record suspicious positioning in the intestine is still challenging owing to the limitation of capsule size, relatively large diagnostic volume, and compatibility of other devices in clinical site. To address this issue, we present a novel robotic localization sensing methodology based on the kinematics of a planar cable driven parallel robot (CDPR) and measurements of the quasistatic magnetic field of a Hall effect sensor (HES) array. The arrangement of HES and the Levenberg-Marquardt (LM) algorithm are applied to estimate the position of the permanent magnet (PM) in the CE, and the planar CDPR is incorporated to follow the PM in the CE. By tracking control of the planar CDPR, the position of PM in any arbitrary position can be obtained through robot forward kinematics with respect to the global coordinates at the bedside. The experimental results show that the root mean square error (RMSE) for the estimated position value of PM was less than 1.13 mm in the X, Y, and Z directions and less than 1.14° in the θ and φ orientation, where the sensing space could be extended to ±70 mm for the given 34 × 34 mm2 HES array and the average moving distance in the Z-direction is 40 ± 2.42 mm. The proposed method of the robotic sensing with HES and CDPR may advance the sensing space expansion technology by utilizing the provided single sensor module of limited sensible volume.
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Affiliation(s)
- Min-Cheol Kim
- School of Mechanical Engineering, Chonnam National University, Gwangju 61186, Korea; (M.-C.K.); (J.-O.P.); (E.C.)
| | - Eui-Sun Kim
- Korea Institute of Medical Microrobotics, Gwangju 61011, Korea;
| | - Jong-Oh Park
- School of Mechanical Engineering, Chonnam National University, Gwangju 61186, Korea; (M.-C.K.); (J.-O.P.); (E.C.)
- Korea Institute of Medical Microrobotics, Gwangju 61011, Korea;
| | - Eunpyo Choi
- School of Mechanical Engineering, Chonnam National University, Gwangju 61186, Korea; (M.-C.K.); (J.-O.P.); (E.C.)
| | - Chang-Sei Kim
- School of Mechanical Engineering, Chonnam National University, Gwangju 61186, Korea; (M.-C.K.); (J.-O.P.); (E.C.)
- Korea Institute of Medical Microrobotics, Gwangju 61011, Korea;
- Correspondence:
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22
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da Veiga T, Chandler JH, Lloyd P, Pittiglio G, Wilkinson NJ, Hoshiar AK, Harris RA, Valdastri P. Challenges of continuum robots in clinical context: a review. ACTA ACUST UNITED AC 2020. [DOI: 10.1088/2516-1091/ab9f41] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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23
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Qiu Y, Huang Y, Zhang Z, Cox BF, Liu R, Hong J, Mu P, Lay HS, Cummins G, Desmulliez MPY, Clutton E, Zheng H, Qiu W, Cochran S. Ultrasound Capsule Endoscopy With a Mechanically Scanning Micro-ultrasound: A Porcine Study. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:796-804. [PMID: 31902446 DOI: 10.1016/j.ultrasmedbio.2019.12.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 11/21/2019] [Accepted: 12/03/2019] [Indexed: 06/10/2023]
Abstract
Wireless capsule endoscopy has been used for the clinical examination of the gastrointestinal (GI) tract for two decades. However, most commercially available devices only utilise optical imaging to examine the GI wall surface. Using this sensing modality, pathology within the GI wall cannot be detected. Micro-ultrasound (μUS) using high-frequency (>20 MHz) ultrasound can provide a means of transmural or cross-sectional image of the GI tract. Depth of imaging is approximately 10 mm with a resolution of between 40-120 μm that is sufficient to differentiate between subsurface histologic layers of the various regions of the GI tract. Ultrasound capsule endoscopy (USCE) uses a capsule equipped with μUS transducers that are capable of imaging below the GI wall surface, offering thereby a complementary sensing technique to optical imaging capsule endoscopy. In this work, a USCE device integrated with a ∼30 MHz ultrasonic transducer was developed to capture a full 360° image of the lumen. The performance of the device was initially evaluated using a wire phantom, indicating an axial resolution of 69.0 μm and lateral resolution of 262.5 μm. Later, in vivo imaging performance was characterised in the oesophagus and small intestine of anaesthetized pigs. The reconstructed images demonstrate clear layer differentiation of the lumen wall. The tissue thicknesses measured from the B-scan images show good agreement with ex vivo images from the literature. The high-resolution ultrasound images in the in vivo porcine model achieved with this device is an encouraging preliminary step in the translation of these devices toward future clinical use.
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Affiliation(s)
- Yongqiang Qiu
- School of Engineering, University of Glasgow, Glasgow, UK
| | - Yaocai Huang
- Shenzhen key laboratory of ultrasound imaging and therapy, Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Zhiqiang Zhang
- Shenzhen key laboratory of ultrasound imaging and therapy, Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | | | - Rong Liu
- Shenzhen key laboratory of ultrasound imaging and therapy, Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Jiehan Hong
- Shenzhen key laboratory of ultrasound imaging and therapy, Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Peitian Mu
- Shenzhen key laboratory of ultrasound imaging and therapy, Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Holly S Lay
- School of Engineering, University of Glasgow, Glasgow, UK
| | - Gerard Cummins
- School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, UK
| | - Marc P Y Desmulliez
- School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, UK
| | - Eddie Clutton
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, UK
| | - Hairong Zheng
- Shenzhen key laboratory of ultrasound imaging and therapy, Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Weibao Qiu
- School of Engineering, University of Glasgow, Glasgow, UK; Shenzhen key laboratory of ultrasound imaging and therapy, Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
| | - Sandy Cochran
- School of Engineering, University of Glasgow, Glasgow, UK
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24
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Bansal R, Khan R, Scaffidi MA, Gimpaya N, Genis S, Bukhari A, Dhillon J, Dao K, Bonneau C, Grover SC. Undisclosed payments by pharmaceutical and medical device manufacturers to authors of endoscopy guidelines in the United States. Gastrointest Endosc 2020; 91:266-273. [PMID: 31738925 DOI: 10.1016/j.gie.2019.11.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 11/03/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Payments from pharmaceutical and medical device manufacturers to authors of clinical practice guidelines (CPGs) may influence practice recommendations. It is therefore important to evaluate the completeness of financial conflict of interest (FCOI) declarations among CPG authors. METHODS We performed a cross-sectional analysis of industry payments to authors of endoscopy guidelines published by 5 GI societies between 2014 and 2017. For each author we identified payments using the disclosure section of CPGs and the Centers for Medicare & Medicaid Services Open Payments (CMS-OP) database. We calculated the prevalence, monetary value, and type of declared and undeclared payments among authors. Payments were assessed for the calendar year of and before publication. RESULTS Thirty-seven CPGs were included in the analysis comprising 569 author entries (91 unique individuals; 66.43% men, 92.6% physicians, 66.4% academically affiliated). Four hundred fifty-one episodes (79%) involved FCOIs, 451 (79%) had undisclosed FCOIs in the CMS-OP, and 445 (77%) had FCOIs relevant to a CPG recommendation. The median undisclosed payment value was $4807.26 (interquartile range, $334.84-$20,579.75). Male authors (odds ratio, 2.23; 95% confidence interval, 1.47-3.39) and academically affiliated authors (odds ratio, 8.87; 95% confidence interval, 5.57-14.13) were significantly more likely to have undeclared payments (P < .001). No CPGs met all National Academy of Medicine criteria. CONCLUSIONS Recognizing concerns about the accuracy of the CMS-OP, there are substantial discrepancies between industry-reported payments and author self-disclosure. Additionally, there is a high prevalence of undisclosed payments by pharmaceutical and medical device manufacturers to these authors. Given the potential impact of these discrepancies and undisclosed payments on CPGs, more accurate reporting and alternative strategies for managing FCOI are needed.
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Affiliation(s)
- Rishi Bansal
- Division of Gastroenterology, University of Toronto, Toronto, Ontario, Canada
| | - Rishad Khan
- Division of Gastroenterology, University of Toronto, Toronto, Ontario, Canada
| | - Michael A Scaffidi
- Division of Gastroenterology, University of Toronto, Toronto, Ontario, Canada
| | - Nikko Gimpaya
- Division of Gastroenterology, University of Toronto, Toronto, Ontario, Canada
| | - Shai Genis
- Division of Gastroenterology, University of Toronto, Toronto, Ontario, Canada
| | - Abbas Bukhari
- Division of Gastroenterology, University of Toronto, Toronto, Ontario, Canada
| | - Jeevan Dhillon
- Division of Gastroenterology, University of Toronto, Toronto, Ontario, Canada
| | - Kathy Dao
- Division of Gastroenterology, University of Toronto, Toronto, Ontario, Canada
| | - Chris Bonneau
- Division of Gastroenterology, University of Toronto, Toronto, Ontario, Canada
| | - Samir C Grover
- Division of Gastroenterology, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
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25
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Hoang MC, Choi E, Kang B, Park JO, Kim CS. A Miniaturized Capsule Endoscope Equipped a Marking Module for Intestinal Tumor Localization. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:3712-3715. [PMID: 31946681 DOI: 10.1109/embc.2019.8856868] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study introduces a miniaturized capsule endoscope equipped with a marking module for intestinal tumor or lesion localization. The design concept is based on an active wireless capsule endoscope platform that is manipulated by an external electromagnetic actuation (EMA) system. The magnetic response of a permanent magnet inside the capsule is designed to have flexible movement in viscous environment of bowel. This magnet is also utilized to activate tattooing process by triggering a gas-generated chemical reaction. Once approaching to a target region, gradient magnetic field from EMA system is induced to push magnet down, releasing water to dry chemical powder mixture. Then the gas pressure increases and pushes the piston move to inject ink into target point. During traveling in digestive organs, injection needle is stowed inside the capsule to avoid damage to the organs. The whole procedure is manipulated by EMA system, the injection consumes no internal battery and is observable through capsule's camera which provides clinician vision. Basic tests were conducted to evaluate the performance of proposed robotic capsule. The success of creating a black visible bled from serosa of intestine proves the feasibility and potential of the design. This study could be an alternative for traditional tattooing endoscopy and motivate other research groups for further development of functional wireless capsule endoscope.
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26
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A Robotic Biopsy Endoscope with Magnetic 5-DOF Locomotion and a Retractable Biopsy Punch. MICROMACHINES 2020; 11:mi11010098. [PMID: 31963402 PMCID: PMC7020148 DOI: 10.3390/mi11010098] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/11/2020] [Accepted: 01/15/2020] [Indexed: 12/20/2022]
Abstract
Capsule endoscopes (CEs) have emerged as an advanced diagnostic technology for gastrointestinal diseases in recent decades. However, with regard to robotic motions, they require active movability and multi-functionalities for extensive, untethered, and precise clinical utilization. Herein, we present a novel wireless biopsy CE employing active five degree-of-freedom locomotion and a biopsy needle punching mechanism for the histological analysis of the intestinal tract. A medical biopsy punch is attached to a screw mechanism, which can be magnetically actuated to extrude and retract the biopsy tool, for tissue extraction. The external magnetic field from an electromagnetic actuation (EMA) system is utilized to actuate the screw mechanism and harvest biopsy tissue; therefore, the proposed system consumes no onboard energy of the CE. This design enables observation of the biopsy process through the capsule's camera. A prototype with a diameter of 12 mm and length of 30 mm was fabricated with a medical biopsy punch having a diameter of 1.5 mm. Its performance was verified through numerical analysis, as well as in-vitro and ex-vivo experiments on porcine intestine. The CE could be moved to target lesions and obtain sufficient tissue samples for histological examination. The proposed biopsy CE mechanism utilizing punch biopsy and its wireless extraction-retraction technique can advance untethered intestinal endoscopic capsule technology at clinical sites.
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27
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Waimin JF, Nejati S, Jiang H, Qiu J, Wang J, Verma MS, Rahimi R. Smart capsule for non-invasive sampling and studying of the gastrointestinal microbiome. RSC Adv 2020; 10:16313-16322. [PMID: 35498852 PMCID: PMC9052936 DOI: 10.1039/c9ra10986b] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 03/30/2020] [Indexed: 12/12/2022] Open
Abstract
Microbes in regions within the gut, which have been inaccessible so far, can now be retrieved and analyzed through a passive sampling mechanism in the form of a 3D printed capsule equipped with a superabsorbent hydrogel.
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Affiliation(s)
- Jose Fernando Waimin
- School of Materials Engineering
- Purdue University
- West Lafayette
- USA
- Birck Nanotechnology Center
| | - Sina Nejati
- School of Materials Engineering
- Purdue University
- West Lafayette
- USA
- Birck Nanotechnology Center
| | - Hongjie Jiang
- Birck Nanotechnology Center
- Purdue University
- West Lafayette
- USA
- School of Electrical Engineering
| | - Jake Qiu
- Birck Nanotechnology Center
- Purdue University
- West Lafayette
- USA
- Department of Agricultural and Biological Engineering
| | - Jianghsan Wang
- Birck Nanotechnology Center
- Purdue University
- West Lafayette
- USA
- Department of Agricultural and Biological Engineering
| | - Mohit S. Verma
- Birck Nanotechnology Center
- Purdue University
- West Lafayette
- USA
- Department of Agricultural and Biological Engineering
| | - Rahim Rahimi
- School of Materials Engineering
- Purdue University
- West Lafayette
- USA
- Birck Nanotechnology Center
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28
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Chen Z, Liu J, Wang S, Zuo S. A bio-inspired self-propelling endoscopic device for inspecting the large intestine. BIOINSPIRATION & BIOMIMETICS 2019; 14:066013. [PMID: 31533088 DOI: 10.1088/1748-3190/ab45c9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This article presents an inchworm-inspired, pneumatic, endoscopic device intended to navigate inside a colon. The device consists of a propulsion segment with two linear balloons and two gripper segments with four twisted balloons. The three segments can be sequentially actuated by pressurized air, which achieves a propulsive motion like an inchworm. Experimental results of the pneumatic characteristics show that the device has excellent adaptability to pipes of different diameters and good controllability of the propulsion velocity. The device is flexible enough to pass through an elbow pipe without requiring special controls, and the inspection performance of a device equipped with a camera in a flexible pipe is also presented. Moreover, the device is able to advance in an excised swine colon, which shows its great potential for applications in colonoscopy.
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Affiliation(s)
- Zhiwei Chen
- Key Laboratory of Mechanism Theory and Equipment Design of Ministry of Education, Tianjin University, Tianjin 300072, People's Republic of China
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29
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Affiliation(s)
- Jihong Min
- Andrew and Peggy Cherng Department of Medical EngineeringDivision of Engineering and Applied ScienceCalifornia Institute of Technology Pasadena CA 91125 USA
| | - Yiran Yang
- Andrew and Peggy Cherng Department of Medical EngineeringDivision of Engineering and Applied ScienceCalifornia Institute of Technology Pasadena CA 91125 USA
| | - Zhiguang Wu
- Andrew and Peggy Cherng Department of Medical EngineeringDivision of Engineering and Applied ScienceCalifornia Institute of Technology Pasadena CA 91125 USA
| | - Wei Gao
- Andrew and Peggy Cherng Department of Medical EngineeringDivision of Engineering and Applied ScienceCalifornia Institute of Technology Pasadena CA 91125 USA
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30
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Manfredi L, Capoccia E, Ciuti G, Cuschieri A. A Soft Pneumatic Inchworm Double balloon (SPID) for colonoscopy. Sci Rep 2019; 9:11109. [PMID: 31367005 PMCID: PMC6668406 DOI: 10.1038/s41598-019-47320-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 07/08/2019] [Indexed: 12/24/2022] Open
Abstract
The design of a smart robot for colonoscopy is challenging because of the limited available space, slippery internal surfaces, and tortuous 3D shape of the human colon. Locomotion forces applied by an endoscopic robot may damage the colonic wall and/or cause pain and discomfort to patients. This study reports a Soft Pneumatic Inchworm Double balloon (SPID) mini-robot for colonoscopy consisting of two balloons connected by a 3 degrees of freedom soft pneumatic actuator. SPID has an external diameter of 18 mm, a total length of 60 mm, and weighs 10 g. The balloons provide anchorage into the colonic wall for a bio-inspired inchworm locomotion. The proposed design reduces the pressure applied to the colonic wall and consequently pain and discomfort during the procedure. The mini-robot has been tested in a deformable plastic colon phantom of similar shape and dimensions to the human anatomy, exhibiting efficient locomotion by its ability to deform and negotiate flexures and bends. The mini-robot is made of elastomer and constructed from 3D printed components, hence with low production costs essential for a disposable device.
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Affiliation(s)
- Luigi Manfredi
- Institute for Medical Science and Technology (IMSaT), Division of Imaging and Technology, School of Medicine, University of Dundee, Dundee, DD2 1FD, UK.
| | - Elisabetta Capoccia
- Institute for Medical Science and Technology (IMSaT), Division of Imaging and Technology, School of Medicine, University of Dundee, Dundee, DD2 1FD, UK
| | - Gastone Ciuti
- The BioRobotics Institute, Scuola Superiore Sant'Anna, 56025, Pisa, Italy
| | - Alfred Cuschieri
- Institute for Medical Science and Technology (IMSaT), Division of Imaging and Technology, School of Medicine, University of Dundee, Dundee, DD2 1FD, UK
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31
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Filippeschi A, Brizzi F, Ruffaldi E, Jacinto Villegas JM, Landolfi L, Avizzano CA. Evaluation of diagnostician user interface aspects in a virtual reality-based tele-ultrasonography simulation. Adv Robot 2019. [DOI: 10.1080/01691864.2019.1635909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Filippo Brizzi
- Scuola Superiore Sant'Anna, TeCIP Institute, San Cataldo, Pisa, Italy
| | | | | | - Lorenzo Landolfi
- Scuola Superiore Sant'Anna, TeCIP Institute, San Cataldo, Pisa, Italy
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32
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33
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Wang M, Shi Q, Song S, Hu C, Meng MQH. A Novel Relative Position Estimation Method for Capsule Robot Moving in Gastrointestinal Tract. SENSORS 2019; 19:s19122746. [PMID: 31248092 PMCID: PMC6630487 DOI: 10.3390/s19122746] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/14/2019] [Accepted: 06/16/2019] [Indexed: 12/19/2022]
Abstract
Recently, a variety of positioning and tracking methods have been proposed for capsule robots moving in the gastrointestinal (GI) tract to provide real-time unobstructed spatial pose results. However, the current absolute position-based result cannot match the GI structure due to its unstructured environment. To overcome this disadvantage and provide a proper position description method to match the GI tract, we here present a relative position estimation method for tracking the capsule robot, which uses the moving distance of the robot along the GI tract to indicate the position result. The procedure of the proposed method is as follows: firstly, the absolute position results of the capsule robot are obtained with the magnetic tracking method; then, the moving status of the robot along the GI tract is determined according to the moving direction; and finally, the movement trajectory of the capsule robot is fitted with the Bézier curve, where the moving distance can then be evaluated using the integral method. Compared to state-of-the-art capsule tracking methods, the proposed method can directly help to guide medical instruments by providing physicians the insertion distance in patients’ bodies, which cannot be done based on absolute position results. Moreover, as relative distance information was used, no reference tracking objects needed to be mounted onto the human body. The experimental results prove that the proposed method achieves a good distance estimation of the capsule robot moving in the simulation platform.
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Affiliation(s)
- Min Wang
- Shenzhen Engineering Lab for Medical Intelligent Wireless Ultrasonic Imaging Technology, Harbin Institute of Technolgoy, Shenzhen 518055, China.
| | - Qinyuan Shi
- Shenzhen Engineering Lab for Medical Intelligent Wireless Ultrasonic Imaging Technology, Harbin Institute of Technolgoy, Shenzhen 518055, China.
| | - Shuang Song
- Shenzhen Engineering Lab for Medical Intelligent Wireless Ultrasonic Imaging Technology, Harbin Institute of Technolgoy, Shenzhen 518055, China.
| | - Chao Hu
- Ningbo Institute of Technology, Zhejiang University, Ningbo 315000, China.
| | - Max Q-H Meng
- Robotics, Perception and Artificial Intelligence Lab, The Chinese University of Hong Kong, N.T., Hong Kong 999077, China.
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34
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Troccaz J, Dagnino G, Yang GZ. Frontiers of Medical Robotics: From Concept to Systems to Clinical Translation. Annu Rev Biomed Eng 2019; 21:193-218. [DOI: 10.1146/annurev-bioeng-060418-052502] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Medical robotics is poised to transform all aspects of medicine—from surgical intervention to targeted therapy, rehabilitation, and hospital automation. A key area is the development of robots for minimally invasive interventions. This review provides a detailed analysis of the evolution of interventional robots and discusses how the integration of imaging, sensing, and robotics can influence the patient care pathway toward precision intervention and patient-specific treatment. It outlines how closer coupling of perception, decision, and action can lead to enhanced dexterity, greater precision, and reduced invasiveness. It provides a critical analysis of some of the key interventional robot platforms developed over the years and their relative merit and intrinsic limitations. The review also presents a future outlook for robotic interventions and emerging trends in making them easier to use, lightweight, ergonomic, and intelligent, and thus smarter, safer, and more accessible for clinical use.
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Affiliation(s)
- Jocelyne Troccaz
- Université Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, F-38000 Grenoble, France
| | - Giulio Dagnino
- The Hamlyn Centre for Robotic Surgery, Imperial College London, London SW7 2AZ, United Kingdom;,
| | - Guang-Zhong Yang
- The Hamlyn Centre for Robotic Surgery, Imperial College London, London SW7 2AZ, United Kingdom;,
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35
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Faragasso A, Bimbo JO, Yamashita A, Asama H. Disposable Stiffness Sensor for Endoscopic Examination. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2018:4309-4312. [PMID: 30441307 DOI: 10.1109/embc.2018.8513350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Since direct manual palpation is not possible in minimally invasive procedures, there is an active field of applied research which aims to retrieve the human sense of touch and feedback tissue properties through artificial tactile feedback. This paper presents an innovative stiffness sensor to be embedded at the tip of a commercial endoscopic camera. The sensor structure is based on multiple cantilever beams, which act as springs with different stiffness when indented into soft tissue. Geometric features mounted on the beams are tracked during physical contact. Movements of thecantilevers result in shape variations of the features in the camera images. The feature size is then segmented and related to the force exerted into the contact location. As beams of different elasticity are integrated, it is possible to estimate the stiffness properties of the soft tissue by employing only visual information. In this paper, Finite Element Analysis (FEA) was implemented to simulate and estimate how contact forces will affect the material and design of the prototype. A calibration device has been developed and used to validate the outcome of the FEA simulations. An experimental test showed the ability of the proposed mechanism to compute the stiffness of a soft phantom.
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36
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Prendergast JM, Formosa GA, Rentschler ME. A Platform for Developing Robotic Navigation Strategies in a Deformable, Dynamic Environment. IEEE Robot Autom Lett 2018. [DOI: 10.1109/lra.2018.2827168] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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37
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Taddese AZ, Slawinski PR, Pirotta M, De Momi E, Obstein KL, Valdastri P. Enhanced Real-Time Pose Estimation for Closed-Loop Robotic Manipulation of Magnetically Actuated Capsule Endoscopes. Int J Rob Res 2018; 37:890-911. [PMID: 30150847 PMCID: PMC6108552 DOI: 10.1177/0278364918779132] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Pose estimation methods for robotically guided magnetic actuation of capsule endoscopes have recently enabled trajectory following and automation of repetitive endoscopic maneuvers. However, these methods face significant challenges in their path to clinical adoption including the presence of regions of magnetic field singularity, where the accuracy of the system degrades, and the need for accurate initialization of the capsule's pose. In particular, the singularity problem exists for any pose estimation method that utilizes a single source of magnetic field if the method does not rely on the motion of the magnet to obtain multiple measurements from different vantage points. We analyze the workspace of such pose estimation methods with the use of the point-dipole magnetic field model and show that singular regions exist in areas where the capsule is nominally located during magnetic actuation. Since the dipole model can approximate most magnetic field sources, the problem discussed herein pertains to a wider set of pose estimation techniques. We then propose a novel hybrid approach employing static and time-varying magnetic field sources and show that this system has no regions of singularity. The proposed system was experimentally validated for accuracy, workspace size, update rate and performance in regions of magnetic singularity. The system performed as well or better than prior pose estimation methods without requiring accurate initialization and was robust to magnetic singularity. Experimental demonstration of closed-loop control of a tethered magnetic device utilizing the developed pose estimation technique is provided to ascertain its suitability for robotically guided capsule endoscopy. Hence, advances in closed-loop control and intelligent automation of magnetically actuated capsule endoscopes can be further pursued toward clinical realization by employing this pose estimation system.
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Affiliation(s)
- Addisu Z. Taddese
- Science and Technology of Robotics in Medicine (STORM) Laboratory USA, Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Piotr R. Slawinski
- Science and Technology of Robotics in Medicine (STORM) Laboratory USA, Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Marco Pirotta
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Elena De Momi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Keith L. Obstein
- Science and Technology of Robotics in Medicine (STORM) Laboratory USA, Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, USA
- Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Pietro Valdastri
- Science and Technology of Robotics in Medicine (STORM) Laboratory UK, School of Electronic and Electrical Engineering, University of Leeds, Leeds, UK
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38
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Ryan P, Diller E. Magnetic Actuation for Full Dexterity Microrobotic Control Using Rotating Permanent Magnets. IEEE T ROBOT 2017. [DOI: 10.1109/tro.2017.2719687] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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39
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Bernth JE, Arezzo A, Liu H. A Novel Robotic Meshworm With Segment-Bending Anchoring for Colonoscopy. IEEE Robot Autom Lett 2017; 2:1718-1724. [DOI: 10.1109/lra.2017.2678540] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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40
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Umay I, Fidan B, Barshan B. Localization and Tracking of Implantable Biomedical Sensors. SENSORS (BASEL, SWITZERLAND) 2017; 17:E583. [PMID: 28335384 PMCID: PMC5375869 DOI: 10.3390/s17030583] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 02/27/2017] [Accepted: 03/06/2017] [Indexed: 01/20/2023]
Abstract
Implantable sensor systems are effective tools for biomedical diagnosis, visualization and treatment of various health conditions, attracting the interest of researchers, as well as healthcare practitioners. These systems efficiently and conveniently provide essential data of the body part being diagnosed, such as gastrointestinal (temperature, pH, pressure) parameter values, blood glucose and pressure levels and electrocardiogram data. Such data are first transmitted from the implantable sensor units to an external receiver node or network and then to a central monitoring and control (computer) unit for analysis, diagnosis and/or treatment. Implantable sensor units are typically in the form of mobile microrobotic capsules or implanted stationary (body-fixed) units. In particular, capsule-based systems have attracted significant research interest recently, with a variety of applications, including endoscopy, microsurgery, drug delivery and biopsy. In such implantable sensor systems, one of the most challenging problems is the accurate localization and tracking of the microrobotic sensor unit (e.g., robotic capsule) inside the human body. This article presents a literature review of the existing localization and tracking techniques for robotic implantable sensor systems with their merits and limitations and possible solutions of the proposed localization methods. The article also provides a brief discussion on the connection and cooperation of such techniques with wearable biomedical sensor systems.
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Affiliation(s)
- Ilknur Umay
- Department of Mechanical and Mechatronics Engineering, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada.
| | - Barış Fidan
- Department of Mechanical and Mechatronics Engineering, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada.
| | - Billur Barshan
- Department of Electrical and Electronics Engineering, Bilkent University, Bilkent, Ankara TR-06800, Turkey.
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41
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Mancini GJ. Hardware design for a cable-free fully insertable wireless laparoscopic robotic camera. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2016:5128-5131. [PMID: 28269421 DOI: 10.1109/embc.2016.7591881] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The field of insertable laparoscopic robotic camera is gaining increasing attentions from researchers, surgeons, and also patients. Although many insertable laparoscope prototypes have been introduced, few of them get rid of the encumbrance tethering cable. In this paper, we proposed a hardware architecture for a magnetic actuated robotic surgical (MARS) camera, which facilitates a cable-free fully insertable laparoscopic surgical robotic camera with adequate in-vivo mobility. Modular design and preliminary test of on-board functional payloads have shown feasibility of a cable-free insertable wireless laparoscopic surgical camera based on off-the-shelf electronics and industrial wireless standards operating in ISM frequency bands at 2.4GHz. Potential improvements for laparoscopic surgery benefited from this hardware architecture include more dexterous in-vivo camera mobility and intuitive closed-loop robotic camera control.
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42
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Slawinski PR, Taddese AZ, Musto KB, Obstein KL, Valdastri P. Autonomous Retroflexion of a Magnetic Flexible Endoscope. IEEE Robot Autom Lett 2017; 2:1352-1359. [PMID: 28289703 DOI: 10.1109/lra.2017.2668459] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Retroflexion during colonoscopy is typically only practiced in the wider proximal and distal ends of the large intestine owing to the stiff nature of the colonoscope. This inability to examine the proximal side of the majority of colon folds contributes to today's suboptimal colorectal cancer detection rates. We have developed an algorithm for autonomous retroflexion of a flexible endoscope that is actuated magnetically from the tip. The magnetic wrench applied on the tip of the endoscope is optimized in real-time with data from pose detection to compute motions of the actuating magnet. This is the first example of a completely autonomous maneuver by a magnetic endoscope for exploration of the gastrointestinal tract. The proposed approach was validated in plastic tubes of various diameters with a success rate of 98.8% for separation distances up to 50 mm. Additionally, a set of trials was conducted in an excised porcine colon observing a success rate of 100% with a mean time of 19.7 s. In terms of clinical safety, the maximum stress that is applied on the colon wall with our methodology is an order of magnitude below what would damage tissue.
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Affiliation(s)
- Piotr R Slawinski
- The Science and Technology of Robotics in Medicine (STORM) Laboratory, Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Addisu Z Taddese
- The Science and Technology of Robotics in Medicine (STORM) Laboratory, Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Kyle B Musto
- The Science and Technology of Robotics in Medicine (STORM) Laboratory, Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Keith L Obstein
- The Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN, USA; The Science and Technology of Robotics in Medicine (STORM) Laboratory, Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Pietro Valdastri
- The Institute of Robotics, Autonomous Systems and Sensing, School of Electronic and Electrical Engineering, University of Leeds, Leeds, UK; The Science and Technology of Robotics in Medicine (STORM) Laboratory, Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, USA
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43
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Dehghani H, Welch CR, Pourghodrat A, Nelson CA, Oleynikov D, Dasgupta P, Terry BS. Design and preliminary evaluation of a self-steering, pneumatically driven colonoscopy robot. J Med Eng Technol 2017; 41:223-236. [PMID: 28122477 DOI: 10.1080/03091902.2016.1275853] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Colonoscopy is a diagnostic procedure to detect pre-cancerous polyps and tumours in the colon, and is performed by inserting a long tube equipped with a camera and biopsy tools. Despite the medical benefits, patients undergoing this procedure often complain about the associated pain and discomfort. This discomfort is mostly due to the rough handling of the tube and the creation of loops during the insertion. The overall goal of this work is to minimise the invasiveness of traditional colonoscopy. In pursuit of this goal, this work presents the development of a semi-autonomous colonoscopic robot with minimally invasive locomotion. The proposed robotic approach allows physicians to concentrate mainly on the diagnosis rather than the mechanics of the procedure. In this paper, an innovative locomotion approach for robotic colonoscopy is addressed. Our locomotion approach takes advantage of longitudinal expansion of a latex tube to propel the robot's tip along the colon. This soft and compliant propulsion mechanism, in contrast to minimally invasive mechanisms used in, for example, inchworm-like robots, has shown promising potential. In the preliminary ex vivo experiments, the robot successfully advanced 1.5 metres inside an excised curvilinear porcine colon with average speed of 28 mm/s, and was capable of traversing bends up to 150 degrees. The robot creates less than 6 N of normal force at its tip when it is pressurised with 90 kPa. This maximum force generates pressure of 44.17 mmHg at the tip, which is significantly lower than safe intraluminal human colonic pressure of 80 mmHg. The robot design inherently prevents loop formation in the colon, which is recognised as the main cause of post procedural pain in patients. Overall, the robot has shown great promise in an ex vivo experimental setup. The design of an autonomous control system and in vivo experiments are left as future work.
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Affiliation(s)
- Hossein Dehghani
- a Department of Mechanical and Materials Engineering , University of Nebraska-Lincoln , Lincoln , NE , USA
| | - C Ross Welch
- a Department of Mechanical and Materials Engineering , University of Nebraska-Lincoln , Lincoln , NE , USA
| | - Abolfazl Pourghodrat
- a Department of Mechanical and Materials Engineering , University of Nebraska-Lincoln , Lincoln , NE , USA
| | - Carl A Nelson
- a Department of Mechanical and Materials Engineering , University of Nebraska-Lincoln , Lincoln , NE , USA.,b Center for Advanced Surgical Technology (CAST), University of Nebraska Medical Center , Omaha , NE , USA
| | - Dmitry Oleynikov
- b Center for Advanced Surgical Technology (CAST), University of Nebraska Medical Center , Omaha , NE , USA.,c Department of Surgery , University of Nebraska Medical Center , Omaha , NE , USA
| | - Prithviraj Dasgupta
- d Computer Science Department , University of Nebraska at Omaha , Omaha , NE , USA
| | - Benjamin S Terry
- a Department of Mechanical and Materials Engineering , University of Nebraska-Lincoln , Lincoln , NE , USA.,b Center for Advanced Surgical Technology (CAST), University of Nebraska Medical Center , Omaha , NE , USA
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44
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Zou C, Wu B, Dong Y, Song Z, Zhao Y, Ni X, Yang Y, Liu Z. Biomedical photoacoustics: fundamentals, instrumentation and perspectives on nanomedicine. Int J Nanomedicine 2016; 12:179-195. [PMID: 28053532 PMCID: PMC5191855 DOI: 10.2147/ijn.s124218] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Photoacoustic imaging (PAI) is an integrated biomedical imaging modality which combines the advantages of acoustic deep penetration and optical high sensitivity. It can provide functional and structural images with satisfactory resolution and contrast which could provide abundant pathological information for disease-oriented diagnosis. Therefore, it has found vast applications so far and become a powerful tool of precision nanomedicine. However, the investigation of PAI-based imaging nanomaterials is still in its infancy. This perspective article aims to summarize the developments in photoacoustic technologies and instrumentations in the past years, and more importantly, present a bright outlook for advanced PAI-based imaging nanomaterials as well as their emerging biomedical applications in nanomedicine. Current challenges and bottleneck issues have also been discussed and elucidated in this article to bring them to the attention of the readership.
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Affiliation(s)
- Chunpeng Zou
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University
| | - Beibei Wu
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University
| | - Yanyan Dong
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University
| | - Zhangwei Song
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University
| | - Yaping Zhao
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University
| | - Xianwei Ni
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University
| | - Yan Yang
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University
| | - Zhe Liu
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University
- Wenzhou Institute of Biomaterials and Engineering, Chinese Academy of Sciences
- Wenzhou Institute of Biomaterials and Engineering, Wenzhou Medical University, Wenzhou, People’s Republic of China
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45
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Taddese AZ, Slawinski PR, Obstein KL, Valdastri P. Nonholonomic Closed-loop Velocity Control of a Soft-tethered Magnetic Capsule Endoscope. PROCEEDINGS OF THE ... IEEE/RSJ INTERNATIONAL CONFERENCE ON INTELLIGENT ROBOTS AND SYSTEMS. IEEE/RSJ INTERNATIONAL CONFERENCE ON INTELLIGENT ROBOTS AND SYSTEMS 2016; 2016:1139-1144. [PMID: 28316873 DOI: 10.1109/iros.2016.7759192] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
In this paper, we demonstrate velocity-level closed-loop control of a tethered magnetic capsule endoscope that is actuated via serial manipulator with a permanent magnet at its end-effector. Closed-loop control (2 degrees-of-freedom in position, and 2 in orientation) is made possible with the use of a real-time magnetic localization algorithm that utilizes the actuating magnetic field and thus does not require additional hardware. Velocity control is implemented to create smooth motion that is clinically necessary for colorectal cancer diagnostics. Our control algorithm generates a spline that passes through a set of input points that roughly defines the shape of the desired trajectory. The velocity controller acts in the tangential direction to the path, while a secondary position controller enforces a nonholonomic constraint on capsule motion. A soft nonholonomic constraint is naturally imposed by the lumen while we enforce a strict constraint for both more accurate estimation of tether disturbance and hypothesized intuitiveness for a clinician's teleoperation. An integrating disturbance force estimation control term is introduced to predict the disturbance of the tether. This paper presents the theoretical formulations and experimental validation of our methodology. Results show the system's ability to achieve a repeatable velocity step response with low steady-state error as well as ability of the tethered capsule to maneuver around a bend.
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Affiliation(s)
- Addisu Z Taddese
- Mechanical Engineering Department, Vanderbilt University, Nashville, TN, USA
| | - Piotr R Slawinski
- Mechanical Engineering Department, Vanderbilt University, Nashville, TN, USA
| | - Keith L Obstein
- Mechanical Engineering Department, Vanderbilt University, Nashville, TN, USA; Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Pietro Valdastri
- School of Electronic and Electrical Engineering, University of Leeds, Leeds, UK; Mechanical Engineering Department, Vanderbilt University, Nashville, TN, USA
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46
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A method for measuring the attachment strength of the cestode Hymenolepis diminuta to the rat intestine. J Helminthol 2016; 91:762-766. [PMID: 27809941 DOI: 10.1017/s0022149x1600078x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A unique adaptation of many internal parasites of mammals is their ability to stay in the intestine for extended periods of time and resist the normal peristaltic movements and forces that push and expel material. To better understand parasite adhesion behaviour and replicate their attachment method in medical devices, an experiment was designed and performed using the rat tapeworm, Hymenolepis diminuta. The experiment employed a tensile test machine and a digital scale and was designed to calculate the attachment strength of the scolex to the mucosa through the change of the value of the digital scale during the tensile test. The attachment force of H. diminuta is 0.021 ± 0.011 g. This method could be applied in studies of parasite biomechanics and the results may help medical device researchers to better mimic the unique functional morphology of this species of parasite.
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Liu L, Towfighian S, Hila A. A Review of Locomotion Systems for Capsule Endoscopy. IEEE Rev Biomed Eng 2016; 8:138-51. [PMID: 26292162 DOI: 10.1109/rbme.2015.2451031] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
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.
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Di Natali C, Beccani M, Simaan N, Valdastri P. Jacobian-Based Iterative Method for Magnetic Localization in Robotic Capsule Endoscopy. IEEE T ROBOT 2016; 32:327-338. [PMID: 27087799 PMCID: PMC4826733 DOI: 10.1109/tro.2016.2522433] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The purpose of this study is to validate a Jacobian-based iterative method for real-time localization of magnetically controlled endoscopic capsules. The proposed approach applies finite-element solutions to the magnetic field problem and least-squares interpolations to obtain closed-form and fast estimates of the magnetic field. By defining a closed-form expression for the Jacobian of the magnetic field relative to changes in the capsule pose, we are able to obtain an iterative localization at a faster computational time when compared with prior works, without suffering from the inaccuracies stemming from dipole assumptions. This new algorithm can be used in conjunction with an absolute localization technique that provides initialization values at a slower refresh rate. The proposed approach was assessed via simulation and experimental trials, adopting a wireless capsule equipped with a permanent magnet, six magnetic field sensors, and an inertial measurement unit. The overall refresh rate, including sensor data acquisition and wireless communication was 7 ms, thus enabling closed-loop control strategies for magnetic manipulation running faster than 100 Hz. The average localization error, expressed in cylindrical coordinates was below 7 mm in both the radial and axial components and 5° in the azimuthal component. The average error for the capsule orientation angles, obtained by fusing gyroscope and inclinometer measurements, was below 5°.
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Affiliation(s)
- Christian Di Natali
- STORM Laboratory Department of Mechanical Engineering, Vanderbilt University, Nashville, TN 37235 USA
| | - Marco Beccani
- STORM Laboratory Department of Mechanical Engineering, Vanderbilt University, Nashville, TN 37235 USA
| | - Nabil Simaan
- ARMA Laboratory Department of Mechanical Engineering, Vanderbilt University, Nashville, TN 37235 USA
| | - Pietro Valdastri
- STORM Laboratory Department of Mechanical Engineering, Vanderbilt University, Nashville, TN 37235 USA
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Shadfan AH, Pawlowski ME, Tkaczyk TS. Development of tunable miniature piezoelectric-based scanners validated by the combination of two scanners in a direct image relay technique. OPTICAL ENGINEERING (REDONDO BEACH, CALIF.) 2016; 55:013104. [PMID: 28579655 PMCID: PMC5450973 DOI: 10.1117/1.oe.55.1.013104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Miniature piezoelectric actuators are commonly used as a compact means to relay images for numerous endoscopic applications. These scanners normally consist of an electrically driven lead zirconate titanate (PZT) tube that oscillates an optical fiber at its resonant frequency. The diameter and length of the PZT and fiber, the attachment of the fiber to the PZT, as well as the driving signal determine the main characteristics of the scan-frequency and amplitude of vibration. We present a new, robust, and repeatable method for producing miniature PZT actuators. The described technology allows for continuous tuning of the scanner mechanical properties during the assembly stage, enabling adjustment of resonant frequency and subsequent amplitude of vibration without a priori knowledge of the fiber's mechanical properties. The method consists of manufacturing high-precision fiber-holding plastic inserts with diamond turning lathes that allow for the fiber length to be quickly varied and locked during operation in order to meet the preferred performance. This concept of tuned PZTs was demonstrated with an imaging technique that combined two scanners oscillating in unison at the ends of a single optical fiber to relay images without the need to correlate the driving signal with a detector.
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Affiliation(s)
- Adam Harbi Shadfan
- Rice University, Bioengineering Department, 6100 Main Street, Houston, Texas 77005-1892, United States
| | - Michal Emanuel Pawlowski
- Rice University, Bioengineering Department, 6100 Main Street, Houston, Texas 77005-1892, United States
| | - Tomasz S. Tkaczyk
- Rice University, Bioengineering Department, 6100 Main Street, Houston, Texas 77005-1892, United States
- Rice University, Electrical and Computer Engineering Department, 6100 Main Street, Houston, Texas 77005-1892, United States
- Address all correspondence to: Tomasz S. Tkaczyk,
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