A Review of Locomotion Systems for Capsule Endoscopy

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

Small intestinal model for electrically propelled capsule endoscopy

The aim of this research is to propose a small intestine model for electrically propelled capsule endoscopy. The electrical stimulus can cause contraction of the small intestine and propel the capsule along the lumen. The proposed model considered the drag and friction from the small intestine using a thin walled model and Stokes' drag equation. Further, contraction force from the small intestine was modeled by using regression analysis. From the proposed model, the acceleration and velocity of various exterior shapes of capsule were calculated, and two exterior shapes of capsules were proposed based on the internal volume of the capsules. The proposed capsules were fabricated and animal experiments were conducted. One of the proposed capsules showed an average (SD) velocity in forward direction of 2.91 ± 0.99 mm/s and 2.23 ± 0.78 mm/s in the backward direction, which was 5.2 times faster than that obtained in previous research. The proposed model can predict locomotion of the capsule based on various exterior shapes of the capsule

Capsule endoscopy of the future: What's on the horizon?

Capsule endoscopes have evolved from passively moving diagnostic devices to actively moving systems with potential therapeutic capability. In this review, we will discuss the state of the art, define the current shortcomings of capsule endoscopy, and address research areas that aim to overcome said shortcomings. Developments in capsule mobility schemes are emphasized in this text, with magnetic actuation being the most promising endeavor. Research groups are working to integrate sensor data and fuse it with robotic control to outperform today's standard invasive procedures, but in a less intrusive manner. With recent advances in areas such as mobility, drug delivery, and therapeutics, we foresee a translation of interventional capsule technology from the bench-top to the clinical setting within the next 10 years

Acoustic Sensing and Ultrasonic Drug Delivery in Multimodal Theranostic Capsule Endoscopy

Video capsule endoscopy (VCE) is now a clinically accepted diagnostic modality in which miniaturized technology, an on-board power supply and wireless telemetry stand as technological foundations for other capsule endoscopy (CE) devices. However, VCE does not provide therapeutic functionality, and research towards therapeutic CE (TCE) has been limited. In this paper, a route towards viable TCE is proposed, based on multiple CE devices including important acoustic sensing and drug delivery components. In this approach, an initial multimodal diagnostic device with high-frequency quantitative microultrasound that complements video imaging allows surface and subsurface visualization and computer-assisted diagnosis. Using focused ultrasound (US) to mark sites of pathology with exogenous fluorescent agents permits follow-up with another device to provide therapy. This is based on an US-mediated targeted drug delivery system with fluorescence imaging guidance. An additional device may then be utilized for treatment verification and monitoring, exploiting the minimally invasive nature of CE. While such a theranostic patient pathway for gastrointestinal treatment is presently incomplete, the description in this paper of previous research and work under way to realize further components for the proposed pathway suggests it is feasible and provides a framework around which to structure further work

Gastroparesis and functional dyspepsia: excerpts from the AGA/ANMS meeting

Despite the relatively high prevelance of gastroparesis and functional dyspepsia, the aetiology and pathophysiology of these disorders remain incompletely understood. Similarly, the diagnostic and treatment options for these two disorders are relatively limited despite recent advances in our understanding of both disorders.This manuscript reviews the advances in the understanding of the epidemiology, pathophysiology, diagnosis, and treatment of gastroparesis and functional dyspepsia as discussed at a recent conference sponsored by the American Gastroenterological Association (AGA) and the American Neurogastroenterology and Motility Society (ANMS). Particular focus is placed on discussing unmet needs and areas for future research.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78690/1/j.1365-2982.2009.01434.x.pd

Wireless capsule endoscope for targeted drug delivery

The diagnosis and treatment of pathologies of the gastrointestinal (GI) tract are performed routinely by gastroenterologists using endoscopes and colonoscopes, however the small intestinal tract is beyond the reach of these conventional systems. Attempts have been made to access the small intestines with wireless capsule endoscopes (WCE). These pill-sized cameras take pictures of the intestinal wall and then relay them back for evaluation. This practice enables the detection and diagnosis of pathologies of the GI tract such as Crohn's disease, small intestinal tumours such as lymphoma and small intestinal cancer. The problems with these systems are that they have limited diagnostic capabilities and they do not offer the ability to perform therapy to the affected areas leaving only the options of administering large quantities of drugs or surgical intervention. To address the issue of administering therapy in the small intestinal tract this thesis presents an active swallowable microrobotic platform which has novel functionality enabling the microrobot to treat pathologies through a targeted drug delivery system. This thesis first reviews the state-of-the-art in WCE through the evaluation of current and past literature. A review of current practises such as flexible sigmoidoscopy, virtual colonoscopy and wireless capsule endoscopy are presented. The following sections review the state-of-the-art in methods of resisting peristalsis, drug targeting systems and drug delivery. A review of actuators is presented, in the context of WCE, with a view to evaluate their acceptability in adding functionality to current WCEs. The thesis presents a novel biologically-inspired holding mechanism which overcomes the issue of resisting natural peristalsis in the GI tract. An analysis of the two components of peristaltic force, circumferential and longitudinal peristaltic contractions, are presented to ensure correct functionality of the holding mechanism. A detailed analysis of the motorised method employed to deploy the expanding mechanism is described and a 5:1 scale prototype is presented which characterises the gearbox and validates the holding mechanism. The functionality of WCE is further extended by the inclusion of a novel targeting mechanism capable of delivering a metered dose of medication to a target site of interest in the GI tract. A solution to the problem of positioning a needle within a 360 degree envelope, operating the needle and safely retracting the needle in the GI tract is discussed. A comprehensive analysis of the mechanism to manoeuvre the needle is presented and validation of the mechanism is demonstrated through the evaluation of scale prototypes. Finally a drug delivery system is presented which can expel a 1 ml dose of medication, stored onboard the capsule, into the subcutaneous tissue of the GI tract wall. An analysis of the force required to expel the medication in a set period of time is presented and the design and analysis of a variable pitch conical compression spring which will be used to deliver the medication is discussed. A thermo mechanical trigger mechanism is presented which will be employed to release the compressed conical spring. Experimental results using 1:1 scale prototype parts validate the performance of the mechanisms.Open Acces

Design and implementation of DSP-based magnetic control system for capsule endoscope

PhD ThesisEarly detection methods are key to reducing morbidity rates from digestive tract cancer which is currently one of the fastest growing cancers in the World. Capsule endoscopes (CEs) are a new technology that can be used to improve early detection of the gastrointestinal (GI) tract disorder. The device integrates the technologies such as image processing, optoelectronic engineering, information communication, and biomedical engineering. The capsule is the size and shape of a pill and contains an optoelectronic camera, antenna, transmitter, battery and optoelectronic illuminating light emitting diodes (LEDs). The small size of these devices enables them to offer many advantages over conventional endoscopes such as accessibility to the entire intestine and minimising the risk of perforation, particularly for patients with difficult anatomy (e.g. post-operative scar tissue). Currently used devices are passive and can only follow the natural transit of the intestines, and hence there is considerable interest in methods of controlled actuation for these devices. In this thesis, a novel actuation system based on magnetic levitation is designed, developed and implemented, utilizing a small permanent magnet embedded within the capsule and an arrangement of digitally controlled electromagnets outside the body. The proposed approach is that the magnet can be moved and oriented by DC magnetic force and torque produced by coils placed outside of the human body, with a suitable position feedback sensor enabling closed-loop control. Theoretical analyses of the proposed actuation system are presented which model the magnetic field, force and torque exerted by electromagnetic coil on the embedded magnet. Based on the distribution of the magnetic field, an optimal geometry for the coils is proposed in order to achieve a levitation distance which is realistic for the inspection of the GI tract. Two types of systems are investigated in the thesis, namely single-input single-output (SISO) and multi-input multi-output (MIMO), and the dynamics of these systems are modelled in state space form and hence linear controllers are designed for capsule actuation. The controllers are simulated using Matlab/ Simulink tools to realize the mathematical analysis of the system, and then implemented digitally in real-time using Texas Instruments (TI) TMS320F2812 Digital Signal Processor (DSP) to validate the proposed actuation system. In the SISO system, a linear one degree of freedom (1DOF) proportionalintegral- derivative (PID) controller is designed to move the inserted magnet in the vertical dimension within an area around the operating point and to maintain it at a desired position. A realistic simulation model is designed and implemented to evaluate the proposed controller. Simulation results have shown that the controller is able to successfully hold the embedded magnet in the desired position. For practical validation, the PID controller is implemented in real-time on the DSP system, where pulse width modulation (PWM) is generated to control the coil current, and Hall effect sensors are used for position feedback. Experimental results are obtained under step and square wave input demand. In the proposed system, high frequency noise on the position sensor is initially rejected by hardware implementation of resistor capacitor-low pass filter (RC-LPF) circuit. The accuracy of the position feedback is increased by calibrating the DSP’s on-chip analogue-digital converter (ADC) in order to reduce conversion error due to inherent gain and offset errors. To further reduce the influence of the position feedback noise, an average of ten repeated samples based on mean filter is implemented by the DSP in order to reduce the influctuation of the sensor reading. The tracking performance of the actuation system based on two Hall effect sensors on the opposite coil’s poles is investigated under step trajectory input. In an improved actuation system, position feedback is provided by using an AC magnetic field to obtain the capsule position information, decoupling this from the DC actuation field. The noise of the position feedback in the improved system is reduced by replacing the PWM current drive with a linear power amplifier driven from a digital to analogue converter (DAC), hence reducing AC interference. Positioning sensor noise was found to be further reduced by implementing digital filtering based on a coherent detector using the DSP, without increasing response time. The performance of the actuation system using these position sensors is compared based on settling time, overshoot, steady-state error, and control input parameters in order to validate the proposed improvement in the position feedback. The experimental results have shown that the controller based on both sensing strategies satisfactory control of the magnet’s position. However, the response of the system based on AC position sensing has the shortest settling time, smallest overshoot value and steady-state error. In the MIMO system, several linear controllers such as pole placement (PP), Entire Eigenstructure Assignment (EEA), and linear Quadratic regulator (LQR) techniques are designed and their tracking performances are compared. Simulation results have shown that, based on acceptable control inputs, the LQR controller has the fastest response with minimal overshoot value and steady state error. However, the LQR controller based on 2DOF is unable to maintain stable control of the magnet due to the insufficient position feedback from the two coil sensors. Specifically, it is not possible to achieve a stable 2D system since the orientation angle of the magnet is not resolvable. Therefore, the position feedback is improved by obtaining the device position and orientation information from a pair of 3-axis orthogonal coils. A realistic simulation model for the 3DOF LQR controller is designed and implemented to evaluate the developed system. Simulation results have shown that this controller is can achieve the necessary stability. In conclusion, based on the results from the 1D control system, the thesis shows that the DC magnetic field, which is used for capsule movement, can be also used to provide the controller acceptable position feedback. However, the use of AC magnetic field for positioning purpose provides more accurate position information. In order to implement 2DOF control system successfully, two 3-axis orthogonal coil sensors are considered which are used to provide the actuation algorithm with more accurate feedback of position and orientation information.Ministry of Higher Education, Iraq