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Flexible endoscopic instrument for diagnosis and treatment of early gastric cancer

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Abstract

Gastric cancer is a common cancer endangering human life and health worldwide. Early detection and diagnosis of gastric cancer that is normally performed by flexible endoscope can significantly improve the survival rate of patients. However, current endoscopic instruments have some problems, such as limitation of degrees of freedom (DOFs) and lack of surgical triangulation. Meanwhile, the lack of an intraoperative technique for the real-time evaluation of early gastric cancer is also a serious problem. To solve these problems, we have developed a dual-bending flexible endoscopic instrument for the diagnosis and treatment of early gastric cancer. This instrument has a compact structure with a maximum outer diameter of 3 mm and an insertion length of 1220 mm. It has 5 DOFs with a dual-bending function, which can form a surgical operation triangulation to easily perform the endoscopic procedure. Apart from the surgical forceps, the end of the instrument can be equipped with different endoscopic devices to meet the needs of diagnosis and treatment, such as endomicroscopic probes, electrosurgical knives, and laser ablation optical fibers. It is verified that the instrument can carry these devices to complete corresponding tasks, demonstrating the great potential of this instrument in clinical applications.

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References

  1. Sung H et al (2021) 2020 Global cancer statistics GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer J Clin 71(3):209–249

    Google Scholar 

  2. Sugano K (2015) Screening of gastric cancer in Asia. Best Pract Res Clin Gastroenterol 29(6):895–905

    Article  PubMed  Google Scholar 

  3. Ono H et al (2001) Endoscopic mucosal resection for treatment of early gastric cancer. Gut 48(2):225–229

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Zuo S, Iijima K, Tokumiya T, Masamune K (2014) Variable stiffness outer sheath with “Dragon skin” structure and negative pneumatic shape-locking mechanism. Int J Comput Assist Radiol Surg 9:857–865

    Article  PubMed  Google Scholar 

  5. Schmitz A, Shen T, Berthet-Rayne P, Yang GZ (n.d.) A rolling-tip flexible instrument for minimally invasive surgery. Int Conf Robot Autom 2019:379–385

  6. Yuan X, Da L, Gong M (2014) Design and research on a shape memory alloy-Actuated single-port laparoscopic surgical robot. IEEE Int Confer Mechatron Auto 2014:1654–1658

    Google Scholar 

  7. Ping Z, Zhang T, Zhang C, Liu J, Zuo S (2021) Design of contact-aided compliant flexure hinge mechanism using superelastic nitinol. J Mech Design 143(11):114501

  8. Jani JM, Leary M, Subic A, Gibson MA (2014) A review of shape memory alloy research, applications and opportunities. Mater Des 1980–2015(56):1078–1113

    Article  Google Scholar 

  9. Fischer H, Vogel B, Pfleging W (1999) Flexible distal tip made of nitinol (NiTi) for a steerable endoscopic camera system. Mater Sci Eng A 273:780–783

    Article  Google Scholar 

  10. von Recum AF (1998) Handbook of biomaterials evaluation: scientific, technical and clinical testing of implant materials. CRC Press

    Google Scholar 

  11. Chitalia YC, Jeong S, Deaton N, Chern JJ, Desai JP (2020) Design and kinematics analysis of a robotic pediatric neuroendoscope tool body. IEEE/ASME Trans Mechatronics PP(99):1–1

    Google Scholar 

  12. Pettersen KY (2017) Snake robots. Annu Rev Control 44:19–44

    Article  Google Scholar 

  13. Greer JD, Morimoto TK, Okamura AM, Hawkes EW (2017) Series pneumatic artificial muscles (sPAMs) and application to a soft continuum robot. IEEE Int Conf Robot Autom 2017:5503–5510

    PubMed  PubMed Central  Google Scholar 

  14. Burgner-Kahrs J, Rucker DC, Choset H (2015) Continuum robots for medical applications: a survey. IEEE Trans Rob 31(6):1261–1280

    Article  Google Scholar 

  15. Kato T, Okumura I, Song S-E, Golby AJ, Hata N (2014) Tendon-driven continuum robot for endoscopic surgery: preclinical development and validation of a tension propagation model. IEEE/ASME Trans Mechatron 20(5):2252–2263

    Article  Google Scholar 

  16. Du Z, Yang W, Dong W (2015) Kinematics modeling of a notched continuum manipulator. Robot 7(4):041017

    Google Scholar 

  17. York PA, Swaney PJ, Gilbert HB, Webster RJ (2015) A wrist for needle-sized surgical robots. IEEE Int Conf Robot Autom 2015:1776–1781

    PubMed  PubMed Central  Google Scholar 

  18. Alambeigi F et al (2019) On the use of a continuum manipulator and a bendable medical screw for minimally invasive interventions in orthopedic surgery. IEEE Trans Med Robot Bionics 1(1):14–21

    Article  PubMed  PubMed Central  Google Scholar 

  19. Tan YK, Fielding JW (2006) Early diagnosis of early gastric cancer. Eur J Gastroenterol Hepatol 18(8):821–829

    Article  PubMed  Google Scholar 

  20. Wallace MB, Fockens P (2009) Probe-based confocal laser endomicroscopy. Gastroenterology 136(5):1509–1513

    Article  PubMed  Google Scholar 

  21. Pohl H et al (2008) Miniprobe confocal laser microscopy for the detection of invisible neoplasia in patients with Barrett’s oesophagus. Gut 57(12):1648–1653

    Article  CAS  PubMed  Google Scholar 

  22. Newton RC, Kemp SV, Yang G-Z, Elson DS, Darzi A, Shah PL (2012) Imaging parenchymal lung diseases with confocal endomicroscopy. Respir Med 106(1):127–137

    Article  PubMed  Google Scholar 

  23. Newton RC et al (2011) Progress toward optical biopsy: bringing the microscope to the patient. Lung 189(2):111–119

    Article  PubMed  Google Scholar 

  24. Wang H, Wang S, Li J, Zuo S (2018) Robotic scanning device for intraoperative thyroid gland endomicroscopy. Ann Biomed Eng 46:543–554

    Article  PubMed  Google Scholar 

  25. Corke PI (2007) A simple and systematic approach to assigning Denavit-Hartenberg parameters. IEEE Trans Rob 23(3):590–594

    Article  Google Scholar 

  26. Saini S, Orlando MF, Pathak PM (2022) Intelligent control of master-slave based robotic surgical system. J Intell Rob Syst 105(4):1–20

    Article  Google Scholar 

  27. Yang Y et al (2020) Safety control method of robot-assisted cataract surgery with virtual fixture and virtual force feedback. J Intell Rob Syst 97(1):17–32

    Article  Google Scholar 

  28. Osawa K et al (2022) Stress dispersion design in continuum compliant structure toward multi-dof endoluminal forceps. Appl Sci 12(5):2480

    Article  CAS  Google Scholar 

  29. Wang H, Wang X, Yang W, Du Z (2020) Design and kinematic modeling of a notch continuum manipulator for laryngeal surgery. Int J Control Autom Syst 18(11):2966–2973

    Article  Google Scholar 

  30. Wang Z, Bao S, Wang D, Qian S, Zhang J, Hai M (2023) Design of a novel flexible robotic laparoscope using a two degrees-of-freedom cable-driven continuum mechanism with major arc notches. J Mech Robot 15(6):064502

    Article  Google Scholar 

  31. Mao Y et al (2013) Endoscopic holmium: YAG laser ablation of early gastrointestinal intramucosal cancer. Lasers Med Sci 28(6):1505–1509

    Article  PubMed  Google Scholar 

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Funding

This work was supported by the National Natural Science Foundation of China under Grant 62133010 and in part by the National Key R&D Program of China under Grant 2019YFB1311501.

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Authors and Affiliations

  1. Key Laboratory of Mechanism Theory and Equipment Design of Ministry of Education, Tianjin University, Tianjin, 300072, China

    Chi Zhang, Weihao Huang, Xingfeng Xu & Siyang Zuo

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  1. Chi Zhang
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  2. Weihao Huang
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  3. Xingfeng Xu
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  4. Siyang Zuo
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Correspondence to Siyang Zuo.

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Zhang, C., Huang, W., Xu, X. et al. Flexible endoscopic instrument for diagnosis and treatment of early gastric cancer. Med Biol Eng Comput 61, 2815–2828 (2023). https://doi.org/10.1007/s11517-023-02911-1

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