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Soft hybrid intrinsically motile robot for wireless small bowel enteroscopy
BACKGROUND: Difficulties in establishing diagnosis of small bowel (SB) disorders, prevented their effective treatment. This problem was largely resolved by wireless capsule endoscopy (WCE), which has since become the first line investigation for suspected SB disorders. Several types of WCE pills are...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9085689/ https://www.ncbi.nlm.nih.gov/pubmed/35102429 http://dx.doi.org/10.1007/s00464-021-09007-7 |
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author | Khan, Hamza Alijani, Afshin Mowat, Craig Cuschieri, Alfred |
author_facet | Khan, Hamza Alijani, Afshin Mowat, Craig Cuschieri, Alfred |
author_sort | Khan, Hamza |
collection | PubMed |
description | BACKGROUND: Difficulties in establishing diagnosis of small bowel (SB) disorders, prevented their effective treatment. This problem was largely resolved by wireless capsule endoscopy (WCE), which has since become the first line investigation for suspected SB disorders. Several types of WCE pills are now used in clinical practice, despite their limitations and complications. WCE pills are large, rigid and immotile capsules. When swallowed, they provide SB enteroscopy downloaded to a data logger carried by the patient. Most of the complications of WCEs result from lack of intrinsic locomotion: incomplete examination, capsule retention and impaction within strictures. In addition, the rigid nature and size of current generation of WCE pills is accompanied by 0.1% inability to swallow the pill by patients with normal esophageal motility. METHODS: The aim of this communication is to describe the initial prototype, P(1), which is thinner and slightly longer than the current generation of WCEs. In addition, it exhibits intrinsic active locomotion, produced by vibrating silicon legs. These generate a controlled-skid locomotion on the small bowel mucosal surface, rendered slippery by surface mucus and intraluminal surfactant bile salts. We demonstrate the mechanism responsible for the active locomotion of P(1), which we consider translatable into a working prototype, suitable for further R&D for eventual clinical translation. RESULTS: The shape and attachment of the rubber vibrating legs to vibrating actuators, have been designed specifically to produce a tight clockwise circular motion. When inserted inside a circular tube in vitro of equivalent diameter to human small intestine, the intrinsic circular clockwise motion of P(1) translates into a linear locomotion by the constraints imposed by the surrounding circular walls of SB and rest of the gastrointestinal tract. This design ensures device stability during transit, essential for imaging and targeting lesions encountered during the enteroscopy. We preformed two experiments: (i) transit of P(1) through a phantom consisting of a segment of PVC tube placed on a horizontal surface and (ii) transit through a transparent slippery nylon sleeve insufflated with air. In the PVC tube, its transit rate averages 15.6 mm/s, which is too fast for endoscopy: whereas inside the very slippery nylon sleeve insufflated with air, the average transit rate of P(1) is reduced to 5.9 mm/s, i.e., ideal for inspection endoscopy. CONCLUSIONS: These in-vitro experiments indicate that the P(1) hybrid soft robot prototype has the potential specifically for clinical translation for SB enteroscopy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00464-021-09007-7. |
format | Online Article Text |
id | pubmed-9085689 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-90856892022-05-11 Soft hybrid intrinsically motile robot for wireless small bowel enteroscopy Khan, Hamza Alijani, Afshin Mowat, Craig Cuschieri, Alfred Surg Endosc 2021 EAES Oral Dynamic BACKGROUND: Difficulties in establishing diagnosis of small bowel (SB) disorders, prevented their effective treatment. This problem was largely resolved by wireless capsule endoscopy (WCE), which has since become the first line investigation for suspected SB disorders. Several types of WCE pills are now used in clinical practice, despite their limitations and complications. WCE pills are large, rigid and immotile capsules. When swallowed, they provide SB enteroscopy downloaded to a data logger carried by the patient. Most of the complications of WCEs result from lack of intrinsic locomotion: incomplete examination, capsule retention and impaction within strictures. In addition, the rigid nature and size of current generation of WCE pills is accompanied by 0.1% inability to swallow the pill by patients with normal esophageal motility. METHODS: The aim of this communication is to describe the initial prototype, P(1), which is thinner and slightly longer than the current generation of WCEs. In addition, it exhibits intrinsic active locomotion, produced by vibrating silicon legs. These generate a controlled-skid locomotion on the small bowel mucosal surface, rendered slippery by surface mucus and intraluminal surfactant bile salts. We demonstrate the mechanism responsible for the active locomotion of P(1), which we consider translatable into a working prototype, suitable for further R&D for eventual clinical translation. RESULTS: The shape and attachment of the rubber vibrating legs to vibrating actuators, have been designed specifically to produce a tight clockwise circular motion. When inserted inside a circular tube in vitro of equivalent diameter to human small intestine, the intrinsic circular clockwise motion of P(1) translates into a linear locomotion by the constraints imposed by the surrounding circular walls of SB and rest of the gastrointestinal tract. This design ensures device stability during transit, essential for imaging and targeting lesions encountered during the enteroscopy. We preformed two experiments: (i) transit of P(1) through a phantom consisting of a segment of PVC tube placed on a horizontal surface and (ii) transit through a transparent slippery nylon sleeve insufflated with air. In the PVC tube, its transit rate averages 15.6 mm/s, which is too fast for endoscopy: whereas inside the very slippery nylon sleeve insufflated with air, the average transit rate of P(1) is reduced to 5.9 mm/s, i.e., ideal for inspection endoscopy. CONCLUSIONS: These in-vitro experiments indicate that the P(1) hybrid soft robot prototype has the potential specifically for clinical translation for SB enteroscopy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00464-021-09007-7. Springer US 2022-01-31 2022 /pmc/articles/PMC9085689/ /pubmed/35102429 http://dx.doi.org/10.1007/s00464-021-09007-7 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | 2021 EAES Oral Dynamic Khan, Hamza Alijani, Afshin Mowat, Craig Cuschieri, Alfred Soft hybrid intrinsically motile robot for wireless small bowel enteroscopy |
title | Soft hybrid intrinsically motile robot for wireless small bowel enteroscopy |
title_full | Soft hybrid intrinsically motile robot for wireless small bowel enteroscopy |
title_fullStr | Soft hybrid intrinsically motile robot for wireless small bowel enteroscopy |
title_full_unstemmed | Soft hybrid intrinsically motile robot for wireless small bowel enteroscopy |
title_short | Soft hybrid intrinsically motile robot for wireless small bowel enteroscopy |
title_sort | soft hybrid intrinsically motile robot for wireless small bowel enteroscopy |
topic | 2021 EAES Oral Dynamic |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9085689/ https://www.ncbi.nlm.nih.gov/pubmed/35102429 http://dx.doi.org/10.1007/s00464-021-09007-7 |
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