Magnetic air capsule robotic system: proof of concept of a novel approach for painless colonoscopy
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Despite being considered the most effective method for colorectal cancer diagnosis, colonoscopy take-up as a mass-screening procedure is limited mainly due to invasiveness, patient discomfort, fear of pain, and the need for sedation. In an effort to mitigate some of the disadvantages associated with colonoscopy, this work provides a preliminary assessment of a novel endoscopic device consisting in a softly tethered capsule for painless colonoscopy under robotic magnetic steering.
The proposed platform consists of the endoscopic device, a robotic unit, and a control box. In contrast to the traditional insertion method (i.e., pushing from behind), a “front-wheel” propulsion approach is proposed. A compliant tether connecting the device to an external box is used to provide insufflation, passing a flexible operative tool, enabling lens cleaning, and operating the vision module. To assess the diagnostic and treatment ability of the platform, 12 users were asked to find and remove artificially implanted beads as polyp surrogates in an ex vivo model. In vivo testing consisted of a qualitative study of the platform in pigs, focusing on active locomotion, diagnostic and therapeutic capabilities, safety, and usability.
The mean percentage of beads identified by each user during ex vivo trials was 85 ± 11%. All the identified beads were removed successfully using the polypectomy loop. The mean completion time for accomplishing the entire procedure was 678 ± 179 s. No immediate mucosal damage, acute complications such as perforation, or delayed adverse consequences were observed following application of the proposed method in vivo.
Use of the proposed platform in ex vivo and preliminary animal studies indicates that it is safe and operates effectively in a manner similar to a standard colonoscope. These studies served to demonstrate the platform’s added advantages of reduced size, front-wheel drive strategy, and robotic control over locomotion and orientation.
KeywordsColonoscopy Colorectal cancer Robotic endoscopy Wireless capsule endoscopy Advanced colonoscopy Self-propelling colonoscopy
The authors would like to acknowledge Dr. Christian Graf and Karl Storz GmbH for providing the CCD module and related support. Special thanks go to Nicodemo Funaro and the staff of the BioRobotics Institute mechanical workshop for manufacturing the prototypes. The authors are also grateful to Dr. Silvia Burchielli and the staff of the Experimental Surgery Center of San Piero a Grado (Pisa) for their support during in vivo testing. Special thanks to Byron Smith for English proof-reading. Research support for this study was provided by the European Commission within the framework of ARAKNES FP7 European project 224565 and VECTOR FP6 European project 033970.
Authors P. Valdastri, G. Ciuti, A. Verbeni, A. Menciassi, P. Dario, A. Arezzo, and M. Morino have no conflicts of interest or financial ties to disclose.
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