Kazuhiko Shinohara, MD PhD. School of Health Science, Tokyo University of Technology
Background and Objective:Colonoscopy requires a high level of dexterity and spatial cognitive ability. Although training programs for surgical colonoscopy are available, not a few complications such as injury to and perforation of the colon still occur during colonoscope insertion. Patient discomfort and mucosal injury during the insertion can be attributed to a lack of driving force at the head of the colonoscope and the large caliber shaft of the endoscope. While certain aspects of the colonoscopic examination can be substituted by CT colonography and capsule endoscopy, retrograde insertion of a conventional colonoscope via the rectum is still required for definitive diagnosis and endoscopic treatment of colorectal disease. As a solution to these problems, a prototype of a hydraulic-driven capsule-shaped colonoscope was developed and a feasibility study of the hydraulic insertion of such colonoscope performed.
Material and Methods:Three types of capsule module (25 mm length, 15 mm diameter) with different weights (3 g, 4.5 g, and 7 g) were fabricated. The 3 g module is compatible with commercially available capsule endoscopes. The center of each capsule module contains a channel for the guidewire and therapeutic devices, and the module is driven by water manually injected using a 10 ml syringe. The module and syringe are connected with a vinyl tube (3 mm diameter). The direction of movement of the capsule is controlled by the guidewire. All experiments were performed on a metal tray and then in porcine intestine.
Results :Driving experiments in both experimental environments demonstrated that each type of capsule module could be driven smoothly. In the porcine intestine, each capsule could be moved a distance of 5-7 cm by a 10 ml injection of water.
Conclusion:The feasibility of using a hydraulic-driven capsule colonoscope was demonstrated. Work is now ongoing to create an advanced prototype with installation of a light guide, CMOS-camera and integrated channel for the guidewire and water intake.
Program Number: P207