Robotic Colonoscope Research Articles

The Robotic Colonoscope E-Worm, a New Device to Perform Colonoscopy: Preliminary Report

Colorectal tumor is the second cause of neoplastic mortality in males after lung cancer, and ranks the same in female after breast cancer. Among screening procedures conventional colonoscopy is considered the best available method, however it is invasive, it's associated with procedural risks, usually needs conscious sedation or even deep sedation. The E-Worm is a new medical device for the diagnostic colonoscopy, it is the result of an italian academic research in the field of robotic biomimetics, it moves like a worm using two specific clampers for adhesion with intestinal mucosa. The light sources (LEDS) and the videocamera are inserted in the head of the E-Worm. This allows a live vision on the screen of the workstation like a normal colonoscope. The unique locomotion system with outstanding flexibility, able to follow every type of tree-dimensional shape, gives a new opportunity for a painless colonoscopy procedure. The flexibility together with the low force required to move the probe reduces the risk of any perforation. The Authors present their fist experience in performing colonoscopies using this new colonoscope. From December 2007 to November 2008 we performed 37 colonoscopies with the E-Worm. Patients were prepared with PEG as conventional colonoscopy. Cecal intubation was possible in 15 cases (40%), ileal exploration was performed in 1 patient with crohn's disease (2%). The right colon was reached in other 7 patients (19%). No patients needed sedation. No complications occurred. Pathologies were found in 19 pts (51%). Evaluating the first 20 pts with the last 17 we saw an increase of cecal intubation rate from 35% to 48%. In spite of a lower definition resolution of endoscopic picture, the diagnostic yield was good, comparable to conventional colonoscopy. Our preliminary experience demonstrates that this new colonoscope allows good diagnostic procedures without any need of sedation. In our opinion the low cecal intubation rate could be related to the learning curve.

내시경용 로봇을 위한 공압구동기의 운동특성 해석

A novel locomotion using the pneumatic impulsive actuator was proposed for robotic colonoscope. This locomotion showed good moving performance in the environment of rigid pipe, however, the displacement per one impact(step displacement) is greatly reduced due to the low stiffness and high damping characteristics of the colon. Therefore, the modeling technique based on spring and damping system is studied to predict the step displacement and some parametric studies are carried out to investigate main parameters that influence the step displacement of locomotion. Based on simulation result, a new locomotion to control the resistance force is suggested and fabricated. Through the experiment on the colon, the usefulness of modeling technique is confirmed and successful improvement of moving characteristics is achieved.

DEVELOPMENT OF A ROBOTIC COLONOSCOPE

Background: Colonoscopy is a common procedure for the diagnosis of various colon pathologies such as cancer of the colon. Due to the working characteristics of conventional colonoscopes, the present colonoscopy procedure is unpleasant for the patient and is technically demanding for the endoscopist.Methods: A robotic colonoscope named EndoCrawler is proposed for inspection and surgical procedures. Supported by the colonic walls, it can propel itself into the human colon using its rubber bellow actuators to push against the colonic walls. The bellow actuators are distributed circumferentially and longitudinally in order to derive sufficient propelling forces.Results: Promising results from in vitro and in vivo experiments (on pigs) suggested that the EndoCrawler was a viable alternative to the conventional colonoscope. It was observed to be able to move at a speed of 150 mm/min in a live pig colon. It achieved a distance of 30 cm before being stopped by feces.Conclusion: It was demonstrated experimentally on pigs that the plurality of bellow actuators was a viable concept. Efforts are now being dedicated towards reducing the diametral space, improving the ability of the robot to negotiate bends, and improving the crawling speed of the robotic scope.