Design, development and testing of miniature instruments for flexible endoscopy

This thesis describes the design and development of single-stitch and chain-stitch endoscopic sewing machines for flexible endoscopy as well as devices and methods for tying knots and cutting thread at flexible endoscopy. The work also includes a comparative study of clipping methods for endoscopic haemostasis and a feasibility study of a wireless endoscope that might allow images to be transmitted from sites in the gastrointestinal tract without wires, cables or fibre optic bundles. The development and testing of simple prototypes of such an endoscope are reported. Chapter 1 reviews the surgical instruments and methods used for tissue approximation in general surgery, laparoscopic surgery and flexible endoscopic surgery. The design of existing, conventional sewing machines and the ways in which they form stitches are also considered. In Chapter 2, a comparative study of clipping methods for endoscopic haemostasis is reported. In Chapter 3, the design and development of new single-stitch endoscopic sewing machines are described, together with data on the clinical use of one of these machines. In Chapter 4, studies of ways of improving endoscopic vision during endoscopic sewing and the effects of needle size and the size and shape of the suction cavity are reported. In Chapter 5, the design and development of novel chain-stitch endoscopic sewing machines are reported. These make use of two new catch mechanisms. In Chapter 6, knot tying at flexible endoscopy is considered, and a number of new devices and methods are described and clinical results reported. In Chapter 7, cutting thread at flexible endoscopy is described. Several new endoscopic thread cutting devices and methods together with results are presented. In Chapter 8, a feasibility study of wireless endoscopy is reported. The study includes tests of the concept of wireless endoscopes made using prototypes constructed from miniature CCD cameras and microwave transmitters. Finally, some concluding remarks relating to the work described in this thesis are given

Low-Cost Technologies for Flexible Endoscopy: Design, Control and Autonomy for a Water-Jet Actuated Soft Continuum Endoscope

Despite the outstanding diagnostic performance brought by new technologies in medicine, cancer remains a significant burden worldwide. In addition to prevention strategies, the ability to detect malignancy early is crucial in enabling effective treatment and dramatically increasing the survival rate of patients. In the case of gastric cancer, diagnosis is generally performed using Flexible Endoscopy (or Endoscope) (FE). The FE has been proven to be a powerful, reliable and cost-effective tool in the fight against gastric cancer. However, its effectiveness strongly depends on the skills of trained Gastro Enterologists (GE) who perform the procedures. Moreover, accessibility and availability of such tools are often limited to people residing in major cities, while remote and rural areas remain poorly served by their health systems. The advent of robotics in medicine offers a new solution to these problems. When possible, automating diagnostic procedures or surgical tasks has the potential to deliver reliable, repeatable and cost-effective alternatives to standard human-in-the-loop procedures. Embedding autonomous capabilities into a machine, optimally designed to execute a specific task, could enable the device to automatically adapt to different conditions and non-skilled personnel to perform the procedure by supervising the actions of the robotic platform. In these scenarios, safety represents a major concern and in the majority of the cases, a safe interaction between the robot and the tissues can be guaranteed by building compliant robots made of soft materials. However, if the possibility of using compliant devices offers a number of advantages to the final user or patient, it defines a series of technical challenges that have to be addressed to deliver a stable and reliable control of the platform. Finally, by adopting low-cost designs, single-use solutions can be realised to address the issue and complication of sterilisation. This dissertation discusses the research effort targeted at the development of a water-jet actuated low-cost, disposable gastroscopy platform to offer a safe, cost-effective, fault-free alternative to standard FE

Mastering Endo-Laparoscopic and Thoracoscopic Surgery

This is an open access book. The book focuses mainly on the surgical technique, OR setup, equipments and devices necessary in minimally invasive surgery (MIS). It serves as a compendium of endolaparoscopic surgical procedures. It is an official publication of the Endoscopic and Laparoscopic Surgeons of Asia (ELSA). The book includes various sections covering basic skills set, devices, equipments, OR setup, procedures by area. Each chapter cover introduction, indications and contraindications, pre-operative patient’s assessment and preparation, OT setup (instrumentation required, patient’s position, etc.), step by step description of surgical procedures, management of complications, post-operative care. It includes original illustrations for better understanding and visualization of specific procedures. The book serves as a practical guide for surgical residents, surgical trainees, surgical fellows, junior surgeons, surgical consultants and anyone interested in MIS. It covers most of the basic and advanced laparoscopic and thoracoscopic surgery procedures meeting the curriculum and examination requirements of the residents

The Standards of Practical Skills in Neonatology

Навчальний посібник охоплює інформацію про основні принципи догляду за новонародженими дітьми, перехідні умови та годування новонароджених, основні принципи реанімації новонароджених. Для англомовних студентів вищих навчальних закладів III-IV рівнів акредитації, аспірантів, неонатологів, сімейних лікарів, педіатрів, терапевтів, акушерів та гінекологів

The Standards of Practical Skills in Neonatology

Навчальний посібник охоплює інформацію про основні принципи догляду за новонародженими дітьми, перехідні умови та годування новонароджених, основні принципи реанімації новонароджених. Для англомовних студентів вищих навчальних закладів III-IV рівнів акредитації, аспірантів, неонатологів, сімейних лікарів, педіатрів, терапевтів, акушерів та гінекологів

Mastering Endo-Laparoscopic and Thoracoscopic Surgery

This is an open access book. The book focuses mainly on the surgical technique, OR setup, equipments and devices necessary in minimally invasive surgery (MIS). It serves as a compendium of endolaparoscopic surgical procedures. It is an official publication of the Endoscopic and Laparoscopic Surgeons of Asia (ELSA). The book includes various sections covering basic skills set, devices, equipments, OR setup, procedures by area. Each chapter cover introduction, indications and contraindications, pre-operative patient’s assessment and preparation, OT setup (instrumentation required, patient’s position, etc.), step by step description of surgical procedures, management of complications, post-operative care. It includes original illustrations for better understanding and visualization of specific procedures. The book serves as a practical guide for surgical residents, surgical trainees, surgical fellows, junior surgeons, surgical consultants and anyone interested in MIS. It covers most of the basic and advanced laparoscopic and thoracoscopic surgery procedures meeting the curriculum and examination requirements of the residents

Volume 07, issue 3

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research. Visit the journal website at http://canjsurg.ca/ for more.https://ir.lib.uwo.ca/cjs/1070/thumbnail.jp

Gastrostomy

The gastrostomy placement is a method of providing nutrition to the patients who are unable to eat. In this book you can find chapters focused on the use of gastrostomy in children, patients with neurological impairment and patients with head and neck tumours. Home enteral nutrition is suitable for all of these groups of patients and is far easier with gastrostomy. The new indications (especially in very young children) required new techniques such as: laparoscopic gastrostomy, laparoscopy assisted endoscopic gastrostomy with/without fundoplication, ultrasonography assisted gastronomy. All information about these techniques can be found in this book. This book does not serve as a basic textbook, but as an interesting reading material and as an aid for physicians who are already familiar with the indication for gastrostomy and want to know more

The Physical Examination of infants and children

ОСМОТР ДЕТЕЙОСМОТР НОВОРОЖДЕННЫХПЕДИАТРИЯПРОПЕДЕВТИКА ДЕТСКИХ БОЛЕЗНЕЙПособие для иностранных студентов знакомит с методикой проведения осмотра новорожденных и детей

Medical Robotics

The first generation of surgical robots are already being installed in a number of operating rooms around the world. Robotics is being introduced to medicine because it allows for unprecedented control and precision of surgical instruments in minimally invasive procedures. So far, robots have been used to position an endoscope, perform gallbladder surgery and correct gastroesophogeal reflux and heartburn. The ultimate goal of the robotic surgery field is to design a robot that can be used to perform closed-chest, beating-heart surgery. The use of robotics in surgery will expand over the next decades without any doubt. Minimally Invasive Surgery (MIS) is a revolutionary approach in surgery. In MIS, the operation is performed with instruments and viewing equipment inserted into the body through small incisions created by the surgeon, in contrast to open surgery with large incisions. This minimizes surgical trauma and damage to healthy tissue, resulting in shorter patient recovery time. The aim of this book is to provide an overview of the state-of-art, to present new ideas, original results and practical experiences in this expanding area. Nevertheless, many chapters in the book concern advanced research on this growing area. The book provides critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies. This book is certainly a small sample of the research activity on Medical Robotics going on around the globe as you read it, but it surely covers a good deal of what has been done in the field recently, and as such it works as a valuable source for researchers interested in the involved subjects, whether they are currently “medical roboticists” or not