Complications of upper gastrointestinal endoscopy

O'Loughlin, Colm; Shaker, Reza

doi:10.1002/9781118662915.ch8

Cited by 4 publications

(3 citation statements)

References 47 publications

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“…For example, in transgastric cholecystectomy, the rate of complication is 15%, which includes esophageal laceration, esophageal perforation, abdominal sepsis and wound infection [8]. In upper gastrointestinal endoscopy, perforation occurs more frequently in the esophagus than the stomach with a relatively high mortality rate between approximately 2% to 25% [9], due to the sites of pathology (e.g. Zenker's diverticulum, esophageal stricture or esophageal malignancy) [10].…”

Section: Introductionmentioning

confidence: 99%

A Variable-Dimension Overtube for Natural Orifice Transluminal Endoscopic Surgery

Sun

Liu²,

Wang

et al. 2020

IEEE Access

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In natural orifice transluminal endoscopic surgery, the insertion of surgical instruments can cause patient discomfort, even bleeding and perforation. This paper proposes a design of an overtube which can vary its radial dimension. It can be inserted through the natural orifice in a small diameter configuration and then enlarge its size and form a hollow and rigid channel to allow passing instruments, while to reduce the friction between the instruments and the surrounding tissue. A Bricard linkage is used as the basic unit of the overtube and a mechanism is designed to drive multiple Bricard units to fold or unfold. Optimization of the design parameters has been studied and comparison experiments have been completed to verify the feasibility of the design on reducing the shear forces and normal forces exerted during surgical instrument insertion. The ex vivo experiment is also completed to prove the protection of the overtube on the esophagus during the insertion. INDEX TERMS Deployable structure, forces exerted on the esophagus, mechanical design, protective device, transesophageal surgery.

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Section: Introductionmentioning

confidence: 99%

A Variable-Dimension Overtube for Natural Orifice Transluminal Endoscopic Surgery

Sun

Liu²,

Wang

et al. 2020

IEEE Access

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“…Since the first traditional endoscope, built in 1983 by American company Welch Allyn, it has become a very mature technology. Though endoscopes with high resolution can observe the fine structure of the intestinal mucosa and find tiny lesions, it brings pain to patients and even complications, which are potentially harmful [ 4 ]. More importantly, for the insertion endoscope, most parts of the small intestine are still blind spots [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

The Modelling, Analysis, and Experimental Validation of a Novel Micro-Robot for Diagnosis of Intestinal Diseases

et al. 2020

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Intestinal-related diseases all around the world are increasing nowadays, and gradually become stubborn diseases threatening human health, and even lives. Diagnosis methods have attracted more and more attention. This article concerns a non-invasive way, a novel micro-robot, to diagnose intestinal diseases. This proposed micro-robot is a swallowable device, 14 mm in diameter, like a capsule. In order to make it possible for the micro-robot to move forward, backward, or anchor itself at a suspicious lesion point in the intestine with different lumen diameter sections, two key mechanisms have been proposed. One is an expanding mechanism with two-layer folded legs for anchoring. The designed expanding mechanism could realize a large variable diameter ratio, upwards of 3.43. In addition, a pair of specific annular gears instead of a traditional pinion drive is devised not only saving limited space, but also reducing energy loss. The other mechanism is a telescoping mechanism, possessing a self-locking lead screw nut system, which is used to obtain axial motion of the micro-robot. Then, the kinematics and dynamics of the micro-robot are analyzed. After that, the following experiments, including force tests and locomotion tests, are constructed. A good match is found between the theoretical results and the experimental data. Finally, in vitro experiments are performed with a prototype to verify the safety and reliability of the proposed micro-robot in porcine intestine.

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“…Capsule endoscopy can only rely on the passive movement of intestinal peristalsis and cannot carry out fixed-point detection of the gastrointestinal tract. It also does not have the function of expanding the intestinal tract and cannot be examined at the intestinal fold [3]. Therefore, the research focused on the gastrointestinal microrobot which can move autonomically and expand the intestinal tract is important [4,5,6,7,8].…”

Section: Introductionmentioning

confidence: 99%

A Novel Expanding Mechanism of Gastrointestinal Microrobot: Design, Analysis and Optimization

et al. 2019

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In order to make the gastrointestinal microrobot (GMR) expand and anchor in the gastrointestinal tract reliably, a novel expanding mechanism of the GMR is proposed in this paper. The overlapping expanding arm is designed to be used to increase the variable diameter ratio (ratio of fully expanded diameter to fully folded diameter) to 3.3, which makes the robot more adaptable to the intestinal tract of different sections of the human body. The double-layer structure of the expanding arm increases the contact area with the intestine, reducing the risk of intestinal damage. The kinematics and mechanical model of the expanding arm are established, and the rigid velocity, rigid acceleration, and expanding force of the expanding arm are analyzed. The elastodynamics model of the expanding arm is established. Through the finite element analysis (FEA), the velocity, acceleration, and the value and distribution of the stress of the expanding arm under elastic deformation are obtained. Based on the elastodynamics analysis, the structure of the expanding arm is optimized. By the structure optimization, the thickness of the expanding mechanism is reduced by 0.4mm, the weight is reduced by 31%, and the stress distribution is more uniform. Through the mechanical test, the minimum expanding force of the expanding mechanism is 1.3 N and the maximum expanding force is 6.5 N. Finally, the robot is tested in the rigid pipeline and the isolated intestine to verify the reliability and safety of the expanding mechanism.

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Complications of upper gastrointestinal endoscopy

Cited by 4 publications

References 47 publications

A Variable-Dimension Overtube for Natural Orifice Transluminal Endoscopic Surgery

A Variable-Dimension Overtube for Natural Orifice Transluminal Endoscopic Surgery

The Modelling, Analysis, and Experimental Validation of a Novel Micro-Robot for Diagnosis of Intestinal Diseases

A Novel Expanding Mechanism of Gastrointestinal Microrobot: Design, Analysis and Optimization

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