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Robotic Endoscopy for Scarless Surgeries

A new flexible robot developed by researchers from Singapore’s Nanyang Technological University and National University Hospital has just been successfully used in performing three gastric tumor removal procedures in India.

Read more :
Robotic Endoscopy for Scarless Surgeries

ENDOSCOPE
ENDOSCOPY
Endoscopy means looking inside and typically refers to looking inside the human body for medical reasons using an instrument called an endoscope. Endoscopy can also refer to using a borescope in engineering and technical situations where direct line-of-sight observation is not feasible.

DETAILS
1.)Endoscopy is a minimally invasive diagnostic medical procedure used to assess the interior surfaces of an organ by inserting a tube into the body. The instrument may have a rigid or flexible tube and not only provide an image for visual inspection and photography, but also enable taking biopsies and retrieval of foreign objects. Endoscopy is the vehicle for minimally invasive surgery.

2.)Many endoscopic procedures are considered to be relatively painless and, at worst, associated with mild discomfort. Most patients tolerate the procedure with only topical anaesthesia of the oropharynx using lignocaine spray.Complications are rare (only 5% of all operations)but can include perforation of the organ under inspection with the endoscope or biopsy instrument. If that occurs open surgery may be required to repair the injury.


Components
An endoscope can consist of

1.) a rigid or flexible tube
2.) a light delivery system to illuminate the organ or object under inspection. The light source is normally outside the body and the light is typically directed via an optical fiber system
3.) a lens system transmitting the image to the viewer from the fiberscope
an additional channel to allow entry of medical instruments or manipulators

Uses
Endoscopy can involve

1.) The gastrointestinal tract (GI tract):
esophagus, stomach and duodenum (esophagogastroduodenoscopy)
2.) Small intestine
colon (colonoscopy,proctosigmoidoscopy)
3.) Bile duct
endoscopic retrograde cholangiopancreatography (ERCP), duodenoscope-assisted cholangiopancreatoscopy, intraoperative cholangioscopy
4.) The respiratory tract
The nose (rhinoscopy)
The lower respiratory tract (bronchoscopy)
5.) The urinary tract (cystoscopy)
6.) The female reproductive system
The cervix (colposcopy)
The uterus (hysteroscopy)
The Fallopian tubes (Falloscopy)
7.) Normally closed body cavities (through a small incision):
The abdominal or pelvic cavity (laparoscopy)
The interior of a joint (arthroscopy)
8.) Organs of the chest (thoracoscopy and mediastinoscopy)
9.) During pregnancy
The amnion (amnioscopy)
The fetus (fetoscopy)
10.)Plastic Surgery
11.)Panendoscopy (or triple endoscopy)
Combines laryngoscopy, esophagoscopy, and bronchoscopy
12.)Non-medical uses for endoscopy
The planning and architectural community have found the endoscope useful for pre-visualization of scale models of proposed buildings and cities (architectural endoscopy)
Internal inspection of complex technical systems (borescope)
Endoscopes are also a tool helpful in the examination of improvised explosive devices by bomb disposal personel
FBI uses endoscopes to shove under doors to spy on people.

Risks
1.)Infection
2.)Punctured organs
3.)Allergic reactions due to Contrast agents or dyes (such as those used in a CT scan)
4.)Over-sedation

After The Endoscopy
After the procedure the patient will be observed and monitored by a qualified individual in the endoscopy or a recovery area until a significant portion of the medication has worn off. Occasionally a patient is left with a mild sore throat, which promptly responds to saline gargles, or a feeling of distention from the insufflated air that was used during the procedure. Both problems are mild and fleeting. When fully recovered, the patient will be instructed when to resume his/her usual diet (probably within a few hours) and will be allowed to be taken home. Because of the use of sedation, most facilities mandate that the patient is taken home by another person and not to drive on his/her own or handle machinery for the remainder of the day.


Recent developments
With the application of robotic systems, telesurgery was introduced as the surgeon could operate from a site physically removed from the patient. The first transatlantic surgery has been called the Lindbergh Operation.

CAPSULE ENDOSCOPE



1.) Wireless capsule endoscopy, also known as the capsule camera or video pill or Miniature ingestible Capsule is a camera with the size and shape of pill used to visualize the gastrointestinal tract.

2.) This device is being promoted as an alternative to an endoscopy and has become a valuable tool to gastroenterologists all over the world with sales over 135 million dollars per year with over half million Capsules already sold. The camera assists in detecting cancer, ulcers and other types of internal medical ailments.

3.) Capsule Endoscopy is a revolutionary new technology that allows our physicians to see the middle part of your intestinal tract – the small intestine – where no scope can currently go. Our patients can now swallow a wireless video camera about the size of a large vitamin, and then go normally about their day while the capsule records images throughout the digestive tract. This new tool is especially helpful in finding the source of unexplained intestinal bleeding and for detecting Crohn’s Disease.


(Endoscopic capsule end-on, showing six LEDs and camera lens.)

4.) The Wireless Capsule endoscope can be safely ingested into human Gastrointestinal tracts and the camera using CCD or CMOS technology with long battery life takes picture and transmits them to an outside device for viewing. Battery life is key as the Capsule takes longer than 8 hours to reach Colon.

5.) At the present time, the capsule camera is primarily used to visualize the small intestine. Whereas the upper gastrointestinal tract (esophagus, stomach, and duodenum) and the colon (large intestine) can be very adequately visualized with scopes (cameras placed at the ends of thin flexible tubes), the small intestine is very long (average 20-25 feet) and very convoluted. The capsule camera travels through the length of the small intestine in about 4 hours, and wirelessly transmits two images every second to a receiver carried by the patient. The images are of very good quality, comparable to those from scopes. The test carries a high sensitivity and specificity for detecting lesions. The main uses today are for detecting the cause of gastrointestinal bleeding, and for inflammatory bowel disease, such as Crohn's disease.

5.) The Endoscopy Capsule is going to be used for many more active procedures and functions like the Current Endoscopes very soon .



RF SYSTEM LAB'S NEXT GENERATION ENDOSCOPE CAPSULE





The capsule creates the map of inner body,while rotating through the digestive canal. It rotates and records the 6 to 8 meters of digestive tract in extremely close up shots. The captured images are recorded as the long combined surface images and creates the flat map of internal body. The created map displays the flat picture of the pipe-shaped digestive tract as if the digestive canals are sliced open with scissors. It allows to measure the affected area and the dimension with calibration and records the passing time of Sayaka. It is also achievable to determine the cell hardness from the slight movement of peptic cells with highly magnified video.

PARTS INSIDE A PillCam SB ENDOSCOPIC CAPSULE



1.) The wireless capsule is 11 x 26 mm (about the size of a large vitamin) and has a super-smooth coating on it that makes it very easy to swallow. It contains a color video camera, 4 LED lights, batteries and a wireless transmitter. Images are transmitted to a data recorder worn by the patient.

2.) In eight hours, the M2A capsule generates about 57,000 images, at a speed of 2 frames per second. These images will be transferred to a computer and converted into a color digital movie which the doctor can then examine.

IMAGE OF NORMAL VILLI


IMAGE OF CROHN'S DISEASE


IMAGE OF ACTIVE BLEEDING JEJUNUM


REQUIREMENTS FOR PATIENT



1.) The patient will need to come to Hospital in the morning to swallow the capsule and sensors will be attached to patient's body. He/She wear a lightweight belt containing a data recorder about the size of a portable CD player that will receive information from the capsule throughout its journey. Then he/she can leave and go about his/her regular activities and return back to our office eight hours later so the doctor can remove the equipment and retrieve the data.



2.) The night before the test, the patient will need to fast for 10-12 hours, to ensure that his/her intestinal tract is empty and the camera will have a clear view of the walls of the small intestine. In the morning, he/she will come to the Hospital, where the staff will apply adhesive sensors to patient's abdomen, and help the patient put on a belt containing the data recorder (about the size of a portable CD player). After that, the patient can leave and go about his/her daily activities. The natural muscular contractions of the patient's intestines will move the capsule through his/her system. he/She can drink clear liquids after about two hours, and four hours after swallowing the capsule he/she can have a light meal. At the end of eight hours, he/she return to Hospital and the Hospital staff will remove the data recorder and sensors and download paient data into Hospital computers for further analysis. The disposable capsule will pass naturally through patient's system within 24 hours.


(IMAGE OF RECORDER WITH PC)