Robotic magnetic steering and locomotion of capsule endoscope for diagnostic and surgical endoluminal procedures

Ciuti, Gastone; Valdastri, Pietro; Menciassi, Arianna; Dario, P.

doi:10.1017/s0263574709990361

Cited by 260 publications

(158 citation statements)

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“…As correctly stated in [29], the physical nature of the colonoscope needs to change if the procedure is to improve. The novel approach proposed in this paper comes from authors' experience in magnetic locomotion and steering of wireless capsule endoscopes (WCE) [24,25]. The main limit of this approach to WCE was related to the lack of tissue insufflation, which prevented effective magnetic control of the wireless device.…”

Section: Discussionmentioning

confidence: 99%

“…Magnetic steering and control of endoscopic capsules has been reported by several groups worldwide [22][23][24], with authors always identifying the need for insufflation, and lack of instrumentation for tissue interaction, as main limitations. In this work, robotic magnetic control and steering, reported elsewhere for wireless capsule locomotion [25], is applied to an endoscopic device containing a frontal magnetic camera (diameter 11 mm, length 26 mm) connected to an external control box by a 5.4-mm-wide soft tether. This multilumen connection is used for providing insufflation, passing an operative flexible tool, enabling lens cleaning, and operating the vision module.…”

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confidence: 99%

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Magnetic air capsule robotic system: proof of concept of a novel approach for painless colonoscopy

et al. 2011

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Background 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. Methods 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. Results 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. Conclusions 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.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Magnetic air capsule robotic system: proof of concept of a novel approach for painless colonoscopy

et al. 2011

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“…To the best of our knowledge, none of the platforms proposed thus far for magnetic control of endoscopic capsules (Rey et al 2012, Salerno et al 2013, Yim & Sitti 2012, Mahoney & Abbott 2011, Zhou et al 2013, Ciuti et al 2010) implements a real-time tracking of capsule position and intermagnetic force. Integrating the methods proposed in this work in a platform such as the one reported in (Valdastri, Ciuti, Verbeni, Menciassi, Dario, Arezzo & Morino 2012) would enable "closed-loop control" of magnetic locomotion, by adjusting in real time the external source of the magnetic field to optimize the coupling with the capsule at any given point in time.…”

Section: Discussionmentioning

confidence: 99%

“…It is desirable for the endoscopist to be able to maneuver the camera arbitrarily rather than relying on peristalsis to drive the capsule for adequate visualization of GI mucosa. For this reason, a relevant number of technical solutions have been recently proposed to provide active locomotion to WCE, including walking (Valdastri et al 2009) or crawling (Sliker et al 2012) capsules, remote magnetic manipulation (Ciuti et al 2010, Rey et al 2012, Keller et al 2011, and hybrid approaches , Yim & Sitti 2012.…”

Section: Introductionmentioning

confidence: 99%

A wireless platform forin vivomeasurement of resistance properties of the gastrointestinal tract

et al. 2014

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Abstract. Active locomotion of wireless capsule endoscopes has the potential improve the diagnostic yield of this painless technique for the diagnosis of gastrointestinal tract disease. In order to design effective locomotion mechanisms, a quantitative measure of the propelling force required to effectively move a capsule inside the gastrointestinal tract is necessary.In this study, we introduce a novel wireless platform that is able to measure the force opposing capsule motion, without perturbing the physiologic conditions with physical connections to the outside of the gastrointestinal tract. The platform takes advantage of a wireless capsule that is magnetically coupled with an external permanent magnet. A secondary contribution of this manuscript is to present a real-time method to estimate the axial magnetic force acting on a wireless capsule manipulated by an external magnetic field. In addition to the intermagnetic force, the platform provides real-time measurements of the capsule position, velocity, and acceleration.The platform was assessed with benchtop trials within a workspace that extends 15 cm from each side of the external permanent magnet, showing average error in estimating the force and the position of less than 0.1 N and 10 mm, respectively. The platform was also able to estimate the dynamic behavior of a known resistant force with an error of 5.45%. Finally, an in vivo experiment on a porcine colon model validated the feasibility of measuring the resistant force in opposition to magnetic propulsion of a wireless capsule.

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“…One possible robotic approach would be to employ a robotic magnetic navigation system in the form of a robot manipulator carrying the magnetic source which externally navigates the target device in the body. Another one is a commercial magnetic navigation system [33], which carries a magnetic source to steer cardiovascular interventional devices [33,34,35], or gastrointestinal (GI) devices such as endoscopic capsules within the body [36,65]. The commercial magnetic navigation system equipped with a fluoroscopic detector provides x-ray images and feedback data to the surgeon to update the location of the medical device within the body for any medical purpose such as screening, diagnostic or therapeutic purposes.…”

Section: Robotic Drug Delivery Systemsmentioning

confidence: 99%

Towards soft robotic devices for site-specific drug delivery

Alici

2015

Expert Review of Medical Devices

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Considerable research efforts have recently been dedicated to the establishment of various drug delivery systems (DDS) that are mechanical/physical, chemical and biological/molecular DDS. In this paper, we report on the recent advances in site-specific drug delivery (site-specific, controlled, targeted or smart drug delivery are terms used interchangeably in the literature, to mean to transport a drug or a therapeutic agent to a desired location within the body and release it as desired with negligibly small toxicity and side effect compared to classical drug administration means such as peroral, parenteral, transmucosal, topical and inhalation) based on mechanical/physical systems consisting of implantable and robotic drug delivery systems. While we specifically focus on the robotic or autonomous DDS, which can be reprogrammable and provide multiple doses of a drug at a required time and rate, we briefly cover the implanted DDS, which are well-developed relative to the robotic DDS, to highlight the design and performance requirements, and investigate issues associated with the robotic DDS. Critical research issues associated with both DDSs are presented to describe the research challenges ahead of us in order to establish soft robotic devices for clinical and biomedical applications. Towards soft robotic devices for site-specific drug delivery Abstract Considerable research efforts have recently been dedicated to the establishment of various drug delivery systems (DDS) which are mechanical / physical, chemical and biological/molecular DDS. In this paper, we report on recent advances in site-specific drug delivery 1 based on mechanical / physical systems consisting of implantable and robotic drug delivery systems. While we specifically focus on the robotic or autonomous DDS, which can be reprogrammable and provide multiple doses of a drug at a required time and rate, we briefly cover the implanted DDS, which are well-developed relative to the robotic DDS, to highlight the design and performance requirements, and investigate issues associated with the robotic DDS. Critical research issues associated with both DDSs are presented to describe the research challenges ahead of us in order to establish really soft robotic devices for clinical and biomedical applications.

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Robotic magnetic steering and locomotion of capsule endoscope for diagnostic and surgical endoluminal procedures

Cited by 260 publications

References 19 publications

Magnetic air capsule robotic system: proof of concept of a novel approach for painless colonoscopy

Magnetic air capsule robotic system: proof of concept of a novel approach for painless colonoscopy

A wireless platform forin vivomeasurement of resistance properties of the gastrointestinal tract

Towards soft robotic devices for site-specific drug delivery

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