Evaluation of a novel, ultrathin, tip-bending endoscope in a synthetic force-sensing pancreas with comparison to medical guide wires

John E Chandler1, Cameron M Lee1, Alexander P Babchanik1, C David Melville1, Michael D Saunders2, Eric J Seibel11Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA, USA; 2Digestive Disease Center, University of Washington Medical Center, Seattle,...

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Autores principales:	Chandler JE, Lee CM, Babchanik AP, Melville CD, Saunders MD, Seibel EJ
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2011
Materias:	Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/e3d9e754948c4a7596dbe5b57b90c0de
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spelling	oai:doaj.org-article:e3d9e754948c4a7596dbe5b57b90c0de2021-12-02T00:17:46ZEvaluation of a novel, ultrathin, tip-bending endoscope in a synthetic force-sensing pancreas with comparison to medical guide wires1179-1470https://doaj.org/article/e3d9e754948c4a7596dbe5b57b90c0de2011-12-01T00:00:00Zhttp://www.dovepress.com/evaluation-of-a-novel-ultrathin-tip-bending-endoscope-in-a-synthetic-f-a8950https://doaj.org/toc/1179-1470John E Chandler1, Cameron M Lee1, Alexander P Babchanik1, C David Melville1, Michael D Saunders2, Eric J Seibel11Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA, USA; 2Digestive Disease Center, University of Washington Medical Center, Seattle, WA, USAPurpose: Direct visualization of pancreatic ductal tissue is critical for early diagnosis of pancreatic diseases and for guiding therapeutic interventions. A novel, ultrathin (5 Fr) scanning fiber endoscope (SFE) with tip-bending capability has been developed specifically to achieve high resolution imaging as a pancreatoscope during endoscopic retrograde cholangiopancreatography (ERCP). This device has potential to dramatically improve both diagnostic and therapeutic capabilities during ERCP by providing direct video feedback and tool guidance to clinicians.Methods: Invasiveness of the new tip-bending SFE was evaluated by a performance comparison to ERCP guide wires, which are routinely inserted into the pancreatic duct during ERCP. An in vitro test model with four force sensors embedded in a synthetic pancreas was designed to detect and compare the insertion forces for 0.89 mm and 0.53 mm diameter guide wires as well as the 1.7 mm diameter SFE. Insertions were performed through the working channel of a therapeutic duodenoscope for the two types of guide wires and using a statistically similar direct insertion method for comparison to the SFE.Results: Analysis of the forces detected by the sensors showed the smaller diameter 0.53 mm wire produced significantly less average and maximum forces during insertion than the larger diameter 0.89 mm wire. With the use of tip-bending and optical visualization, the 1.7 mm diameter SFE produced significantly less average force during insertion than the 0.89 mm wire at every sensor, despite its larger size. It was further shown that the use of tip-bending with the SFE significantly reduced the forces at all sensors, compared to insertions when tip-bending was not used.Conclusion: Combining high quality video imaging with two-axis tip-bending allows a larger diameter guide wire-style device to be inserted into the pancreatic duct during ERCP with improved capacity to perform diagnostics and therapy.Keywords: endoscopic retrograde cholangiopancreatography (ERCP), scanning fiber endoscope (SFE), pancreatic cancer, minimally invasive therapyChandler JELee CMBabchanik APMelville CDSaunders MDSeibel EJDove Medical PressarticleMedical technologyR855-855.5ENMedical Devices: Evidence and Research, Vol 2012, Iss default, Pp 1-12 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medical technology R855-855.5
spellingShingle	Medical technology R855-855.5 Chandler JE Lee CM Babchanik AP Melville CD Saunders MD Seibel EJ Evaluation of a novel, ultrathin, tip-bending endoscope in a synthetic force-sensing pancreas with comparison to medical guide wires
description	John E Chandler1, Cameron M Lee1, Alexander P Babchanik1, C David Melville1, Michael D Saunders2, Eric J Seibel11Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA, USA; 2Digestive Disease Center, University of Washington Medical Center, Seattle, WA, USAPurpose: Direct visualization of pancreatic ductal tissue is critical for early diagnosis of pancreatic diseases and for guiding therapeutic interventions. A novel, ultrathin (5 Fr) scanning fiber endoscope (SFE) with tip-bending capability has been developed specifically to achieve high resolution imaging as a pancreatoscope during endoscopic retrograde cholangiopancreatography (ERCP). This device has potential to dramatically improve both diagnostic and therapeutic capabilities during ERCP by providing direct video feedback and tool guidance to clinicians.Methods: Invasiveness of the new tip-bending SFE was evaluated by a performance comparison to ERCP guide wires, which are routinely inserted into the pancreatic duct during ERCP. An in vitro test model with four force sensors embedded in a synthetic pancreas was designed to detect and compare the insertion forces for 0.89 mm and 0.53 mm diameter guide wires as well as the 1.7 mm diameter SFE. Insertions were performed through the working channel of a therapeutic duodenoscope for the two types of guide wires and using a statistically similar direct insertion method for comparison to the SFE.Results: Analysis of the forces detected by the sensors showed the smaller diameter 0.53 mm wire produced significantly less average and maximum forces during insertion than the larger diameter 0.89 mm wire. With the use of tip-bending and optical visualization, the 1.7 mm diameter SFE produced significantly less average force during insertion than the 0.89 mm wire at every sensor, despite its larger size. It was further shown that the use of tip-bending with the SFE significantly reduced the forces at all sensors, compared to insertions when tip-bending was not used.Conclusion: Combining high quality video imaging with two-axis tip-bending allows a larger diameter guide wire-style device to be inserted into the pancreatic duct during ERCP with improved capacity to perform diagnostics and therapy.Keywords: endoscopic retrograde cholangiopancreatography (ERCP), scanning fiber endoscope (SFE), pancreatic cancer, minimally invasive therapy
format	article
author	Chandler JE Lee CM Babchanik AP Melville CD Saunders MD Seibel EJ
author_facet	Chandler JE Lee CM Babchanik AP Melville CD Saunders MD Seibel EJ
author_sort	Chandler JE
title	Evaluation of a novel, ultrathin, tip-bending endoscope in a synthetic force-sensing pancreas with comparison to medical guide wires
title_short	Evaluation of a novel, ultrathin, tip-bending endoscope in a synthetic force-sensing pancreas with comparison to medical guide wires
title_full	Evaluation of a novel, ultrathin, tip-bending endoscope in a synthetic force-sensing pancreas with comparison to medical guide wires
title_fullStr	Evaluation of a novel, ultrathin, tip-bending endoscope in a synthetic force-sensing pancreas with comparison to medical guide wires
title_full_unstemmed	Evaluation of a novel, ultrathin, tip-bending endoscope in a synthetic force-sensing pancreas with comparison to medical guide wires
title_sort	evaluation of a novel, ultrathin, tip-bending endoscope in a synthetic force-sensing pancreas with comparison to medical guide wires
publisher	Dove Medical Press
publishDate	2011
url	https://doaj.org/article/e3d9e754948c4a7596dbe5b57b90c0de
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Evaluation of a novel, ultrathin, tip-bending endoscope in a synthetic force-sensing pancreas with comparison to medical guide wires

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