Abstract
When detected early, colorectal cancer can be treated with minimally invasive flexible endoscopy. However, since only specialized experts can delineate margins and perform endoscopic resections of lesions, patients still often undergo colon resections. To better assist in the performance of surgical tasks, a robotized flexible interventional endoscope was previously developed, having two additional side channels for surgical instrument. We propose to enhance the imaging capabilities of this device by combining it with optical coherence tomography (OCT). For this purpose, we have developed a new steerable OCT instrument with an outer diameter of 3.5 mm. The steerable instrument is terminated with a 2 cm long transparent sheath to allow three-dimensional OCT imaging using a side-focusing optical probe with two external scanning actuators. The instrument is connected to an OCT imaging system built around the OCT Axsun engine, with a 1310 nm center wavelength swept source laser and 100 kHz A-line rate. Once inserted in one of the side channels of the robotized endoscope, bending, rotation and translation of the steerable OCT instrument can be controlled by a physician using a joystick. Ex vivo and in vivo tests show that the novel, steerable and teleoperated OCT device enhances dexterity, allowing for inspection of the surgical field without the need for changing the position of the main endoscope.
Highlights
Colorectal cancer is the third most common cancer in the world in terms of incidence, and takes the second place in mortality worldwide [1]
Following insertion of the interventional endoscope in the colon, the optical coherence tomography (OCT) probe was advanced in the side instrument channel until visible in the white light endoscopic camera (Fig. 8)
We have presented a novel steerable and robotized endoscopic OCT for real-time assistance during teleoperated endoscopic treatment of colorectal cancer
Summary
Colorectal cancer is the third most common cancer in the world in terms of incidence, and takes the second place in mortality worldwide [1]. The most common treatment approach for colorectal cancer is based on resection of the diseased section of the organ during open or laparoscopic surgery [2]. Early detection allows for minimally invasive treatment options In this case, early stage cancerous lesions are removed using flexible endoscopy procedures, including endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) [3,4]. Early stage cancerous lesions are removed using flexible endoscopy procedures, including endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) [3,4] These minimally invasive endoscopic treatment options are not commonly performed due to their complicated nature, requiring highly experienced clinicians to localize lesions while simultaneously manipulating the endoscope and other surgical tools [5]. An example of a solution addressing these challenges is the development of flexible interventional endoscopes with two insertable therapeutic instruments [6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
