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

Swallowable Wireless Capsule Endoscopy: Progress and Technical Challenges

Wireless capsule endoscopy (WCE) offers a feasible noninvasive way to detect the whole gastrointestinal (GI) tract and revolutionizes the diagnosis technology. However, compared with wired endoscopies, the limited working time, the low frame rate, and the low image resolution limit the wider application. The progress of this new technology is reviewed in this paper, and the evolution tendencies are analyzed to be high image resolution, high frame rate, and long working time. Unfortunately, the power supply of capsule endoscope (CE) is the bottleneck. Wireless power transmission (WPT) is the promising solution to this problem, but is also the technical challenge. Active CE is another tendency and will be the next geneion of the WCE. Nevertheless, it will not come true shortly, unless the practical locomotion mechanism of the active CE in GI tract is achieved. The locomotion mechanism is the other technical challenge, besides the challenge of WPT. The progress about the WPT and the active capsule technology is reviewed

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

Application of micro/nanorobot in medicine

The development of micro/nanorobots and their application in medical treatment holds the promise of revolutionizing disease diagnosis and treatment. In comparison to conventional diagnostic and treatment methods, micro/nanorobots exhibit immense potential due to their small size and the ability to penetrate deep tissues. However, the transition of this technology from the laboratory to clinical applications presents significant challenges. This paper provides a comprehensive review of the research progress in micro/nanorobotics, encompassing biosensors, diagnostics, targeted drug delivery, and minimally invasive surgery. It also addresses the key issues and challenges facing this technology. The fusion of micro/nanorobots with medical treatments is poised to have a profound impact on the future of medicine

Design and Evaluation of the SoftSCREEN Capsule for Colonoscopy

Colonoscopy is considered the golden standard for cancer screening of the lower gastrointestinal (GI) tract, with screening programs all over the world considering lowering the recommended screening age. Nonetheless, conventional colonoscopy can cause discomfort to patients due to the forces occurring between colonoscopes and the walls of the colon. Robotic solutions have been proposed to reduce discomfort, and improve accessibility and image quality. Aiming at addressing the limitations of traditional and robotic colonoscopy, in this paper, we present the SoftSCREEN System, a novel Soft Shapeshifting Capsule Robot for Endoscopy based on Eversion Navigation. A plurality of tracks surrounds the body of the system. These tracks are driven by a single motor paired with a worm gear and evert from the internal rigid chassis, enabling fullbody track-based navigation. Two inflatable toroidal chambers enclosing this rigid chassis and passing through the tracks, cause them to displace when inflated. This displacement can be used to regulate the contact with the surrounding wall, thus enabling traction control and adjustment of the overall system diameter to match the local lumen size. The design of the first tethered prototype at 2:1 scale of the SoftSCREEN system is presented in this work. The experimental results show efficient navigation capabilities for different lumen diameters and curvatures, paving the way for a novel robot capable of robust navigation and reliable control of the imaging, with potential for applications beyond colonoscopy, including gastroscopy and capsule endoscopy.Comment: 9 pages, 8 figure

Towards tactile sensing active capsule endoscopy

Examination of the gastrointestinal(GI) tract has traditionally been performed using tethered endoscopy tools with limited reach and more recently with passive untethered capsule endoscopy with limited capability. Inspection of small intestines is only possible using the latter capsule endoscopy with on board camera system. Limited to visual means it cannot detect features beneath the lumen wall if they have not affected the lumen structure or colour. This work presents an improved capsule endoscopy system with locomotion for active exploration of the small intestines and tactile sensing to detect deformation of the capsule outer surface when it follows the intestinal wall. In laboratory conditions this system is capable of identifying sub-lumen features such as submucosal tumours.Through an extensive literary review the current state of GI tract inspection in particular using remote operated miniature robotics, was investigated, concluding no solution currently exists that utilises tactile sensing with a capsule endoscopy. In order to achieve such a platform, further investigation was made in to tactile sensing technologies, methods of locomotion through the gut, and methods to support an increased power requirement for additional electronics and actuation. A set of detailed criteria were compiled for a soft formed sensor and flexible bodied locomotion system. The sensing system is built on the biomimetic tactile sensing device, Tactip, \cite{Chorley2008, Chorley2010, Winstone2012, Winstone2013} which has been redesigned to fit the form of a capsule endoscopy. These modifications have required a $360^{o}$ cylindrical sensing surface with $360^{o}$ panoramic optical system. Multi-material 3D printing has been used to build an almost complete sensor assembly with a combination of hard and soft materials, presenting a soft compliant tactile sensing system that mimics the tactile sensing methods of the human finger. The cylindrical Tactip has been validated using artificial submucosal tumours in laboratory conditions. The first experiment has explored the new form factor and measured the device's ability to detect surface deformation when travelling through a pipe like structure with varying lump obstructions. Sensor data was analysed and used to reconstruct the test environment as a 3D rendered structure. A second tactile sensing experiment has explored the use of classifier algorithms to successfully discriminate between three tumour characteristics; shape, size and material hardness. Locomotion of the capsule endoscopy has explored further bio-inspiration from earthworm's peristaltic locomotion, which share operating environment similarities. A soft bodied peristaltic worm robot has been developed that uses a tuned planetary gearbox mechanism to displace tendons that contract each worm segment. Methods have been identified to optimise the gearbox parameter to a pipe like structure of a given diameter. The locomotion system has been tested within a laboratory constructed pipe environment, showing that using only one actuator, three independent worm segments can be controlled. This configuration achieves comparable locomotion capabilities to that of an identical robot with an actuator dedicated to each individual worm segment. This system can be miniaturised more easily due to reduced parts and number of actuators, and so is more suitable for capsule endoscopy. Finally, these two developments have been integrated to demonstrate successful simultaneous locomotion and sensing to detect an artificial submucosal tumour embedded within the test environment. The addition of both tactile sensing and locomotion have created a need for additional power beyond what is available from current battery technology. Early stage work has reviewed wireless power transfer (WPT) as a potential solution to this problem. Methods for optimisation and miniaturisation to implement WPT on a capsule endoscopy have been identified with a laboratory built system that validates the methods found. Future work would see this combined with a miniaturised development of the robot presented. This thesis has developed a novel method for sub-lumen examination. With further efforts to miniaturise the robot it could provide a comfortable and non-invasive procedure to GI tract inspection reducing the need for surgical procedures and accessibility for earlier stage of examination. Furthermore, these developments have applicability in other domains such as veterinary medicine, industrial pipe inspection and exploration of hazardous environments

Development of a Robotic Colonoscopic Manipulation System, Using Haptic Feedback Algorithm

PURPOSE: Colonoscopy is one of the most effective diagnostic and therapeutic tools for colorectal diseases. We aim to propose a master-slave robotic colonoscopy that is controllable in remote site using conventional colonoscopy. MATERIALS AND METHODS: The master and slave robot were developed to use conventional flexible colonoscopy. The robotic colonoscopic procedure was performed using a colonoscope training model by one expert endoscopist and two unexperienced engineers. To provide the haptic sensation, the insertion force and the rotating torque were measured and sent to the master robot. RESULTS: A slave robot was developed to hold the colonoscopy and its knob, and perform insertion, rotation, and two tilting motions of colonoscope. A master robot was designed to teach motions of the slave robot. These measured force and torque were scaled down by one tenth to provide the operator with some reflection force and torque at the haptic device. The haptic sensation and feedback system was successful and helpful to feel the constrained force or torque in colon. The insertion time using robotic system decreased with repeated procedures. CONCLUSION: This work proposed a robotic approach for colonoscopy using haptic feedback algorithm, and this robotic device would effectively perform colonoscopy with reduced burden and comparable safety for patients in remote site.ope

Design, Actuation, and Functionalization of Untethered Soft Magnetic Robots with Life-Like Motions: A Review

Soft robots have demonstrated superior flexibility and functionality than conventional rigid robots. These versatile devices can respond to a wide range of external stimuli (including light, magnetic field, heat, electric field, etc.), and can perform sophisticated tasks. Notably, soft magnetic robots exhibit unparalleled advantages among numerous soft robots (such as untethered control, rapid response, and high safety), and have made remarkable progress in small-scale manipulation tasks and biomedical applications. Despite the promising potential, soft magnetic robots are still in their infancy and require significant advancements in terms of fabrication, design principles, and functional development to be viable for real-world applications. Recent progress shows that bionics can serve as an effective tool for developing soft robots. In light of this, the review is presented with two main goals: (i) exploring how innovative bioinspired strategies can revolutionize the design and actuation of soft magnetic robots to realize various life-like motions; (ii) examining how these bionic systems could benefit practical applications in small-scale solid/liquid manipulation and therapeutic/diagnostic-related biomedical fields

Development of A Kinetic Model For Loop-Free Colonoscopy Technology

The colonoscope is an important tool in diagnosis and management of diseases of the colon. One of the ongoing challenges with this device is that the colonoscope may form a loop together with the colon during the procedure. The result of the loop is that further insertion of the scope in the colon may not be possible. The loop may also cause risks of perforation of the colon and pain in the patient. There are currently several existing devices to overcome loop formation in colonoscopy, some of which have been introduced in clinical work. However, empirical assessment shows that these devices do not work very well. This is the motivation for the research presented in this thesis. In this thesis, a new paradigm of thinking, “doctor-assisted colonoscopy,” is proposed to overcome loop formation. In this new approach, the physician’s role is enhanced with new information that is acquired by sensors outside the human body and inferred from the mathematical model. It is referred to as a kinetic model due to the fact that this model describes the kinetic behaviour of the scope. This thesis is devoted to development of this kinetic model. In this study, the model of the colonoscope and the model of the colon are developed based on the Timoshenko beam theory, and parameters in both models are determined by the experiments. The following conclusions then are made: (1) self-locking of the colonoscope is the most basic cause for a loop to occur, while structural instability of the colonsocope is dependent on the self-locking; (2) both the scope and the colon can be well represented with the Timoshenko beam elements and the Linear Complementary Problem (LCP) formulation derived from Signorini’s law, and Coulom’s law for representation of interactions between the colon and scope is adequate; (3) there are effects from the location, looping, and tip deflection of the scope on flexural rigidity of the scope. Approximately, the flexural rigidity of the CF-Q160L colonoscope ranges from 300 to 650 N•cm2, and its accuracy is proven by a good agreement between the model predicted result and experimental result; (4) Rayleigh damping for the CF-Q160L colonoscope depends more on the mass matrix [M] of the colonoscope than the stiffness matrix [K], which is evident by the large coefficient value of “alpha” (0.3864) and the small coefficient value of “beta” (0.0164). The contributions of this thesis are: (1) the finding that the main cause of the loop is not structural instability of the colonoscope but rather self-locking of the colonoscope, which could lead to design of a “new-generation” colonoscope to avoid the loop; (2) a systematic evaluation of the existing colonoscopy technologies based on the well-proven Axiomatic Design Theory (ADT), which will serve as a guideline for the development of future new colonoscopes in future; (3) an approach to developing a kinetic model of the colonoscope useful to modeling similar objects such as a catheter guide-wire; (4) a novel ex-vivo colonoscopy test-bed with the kinetic and kinematic measurements useful for validation of new designs in colonoscopy technology and also useful for training physicians who perform the colonoscopy procedure; and (5) a new paradigm of thinking for colonoscopy called “doctor-assisted colonoscopy,” which has potential applications to other medical procedures such as catheter-based procedures