Design of a high-sensor count fibre optic manometry catheter for in-vivo colonic diagnostics

Arkwright, John W.; Underhill, Ian D.; Maunder, Simon A.; Blenman, Neil G.; Szczesniak, Michal; Wiklendt, Lukasz; Cook, Ian J.; Lubowski, David Z.; Dinning, Phil G.

doi:10.1364/oe.17.022423

Cited by 99 publications

(86 citation statements)

References 24 publications

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“…The plastic rod was inserted through the length of the ileal segment. The design of the fiberoptic catheter meant that adjacent sensors on the catheter faced in opposite directions (i.e., alternating between 12 o'clock and 6 o'clock) (2). Thus every second sensor faced away from the rod toward the gut wall.…”

Section: Methodsmentioning

confidence: 99%

Neurally mediated propagating discrete clustered contractions superimposed on myogenic ripples in ex vivo segments of human ileum

Kuizenga

Sia

Dodds

et al. 2015

American Journal of Physiology-Gastrointestinal and Liver Physi

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Kuizenga MH, Sia TC, Dodds KN, Wiklendt L, Arkwright JW, Thomas A, Brookes SJ, Spencer NJ, Wattchow DA, Dinning PG, Costa M. Neurally mediated propagating discrete clustered contractions superimposed on myogenic ripples in ex vivo segments of human ileum. Am J Physiol Gastrointest Liver Physiol 308: G1-G11, 2015. First published November 13, 2014; doi:10.1152/ajpgi.00230.2014.-Narrow muscle strips have been extensively used to study intestinal contractility. Larger specimens from laboratory animals have provided detailed understanding of mechanisms that underlie patterned intestinal motility. Despite progress in animal tissue, investigations of motor patterns in large, intact specimens of human gut ex vivo have been sparse. In this study, we tested whether neurally dependent motor patterns could be detected in isolated specimens of intact human ileum. Specimens (n ϭ 14; 7-30 cm long) of terminal ileum were obtained with prior informed consent from patients undergoing colonic surgery for removal of carcinomas. Preparations were set up in an organ bath with an array of force transducers, a fiberoptic manometry catheter, and a video camera. Spontaneous and distension-evoked motor activity was recorded, and the effects of lidocaine, which inhibits neural activity, were studied. Myogenic contractions (ripples) occurred in all preparations (6.17 Ϯ 0.36/min). They were of low amplitude and formed complex patterns by colliding and propagating in both directions along the specimen at anterograde velocities of 4.1 Ϯ 0.3 mm/s and retrogradely at 4.9 Ϯ 0.6 mm/s. In five specimens, larger amplitude clusters of contractions were seen (discrete clustered contractions), which propagated aborally at 1.05 Ϯ 0.13 mm/s and orally at 1.07 Ϯ 0.09 mm/s. These consisted of two to eight phasic contractions that aligned with ripples. These motor patterns were abolished by addition of lidocaine (0.3 mM). The ripples continued unchanged in the presence of this neural blocking agent. These results demonstrate that both myogenic and neurogenic motor patterns can be studied in isolated specimens of human small intestine. small intestine; motor patterns; enteric nervous system; myogenic; neurogenic PROPULSION AND MIXING OF INTESTINAL CONTENTS along the digestive tract are essential for normal digestion. The motor patterns underlying these functions are due to the coordinated contractions and relaxations of the smooth muscle layers of the intestine. The internal circular smooth muscle layer and the external longitudinal smooth muscle layer are controlled by two main mechanisms. Myogenic activity is driven by the nonneural pacemaker cells, the interstitial cells of Cajal. Neurogenic control is mediated by circuits in the enteric nervous system. These two types of activity combine to generate the motor patterns that mix and propel luminal content (14,29). Most of our understanding of these mechanisms has been derived from animal studies. Although the basic functions of the gastrointestinal tract are similar between human and animals, there are si...

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Section: Methodsmentioning

confidence: 99%

Neurally mediated propagating discrete clustered contractions superimposed on myogenic ripples in ex vivo segments of human ileum

Kuizenga

Sia

Dodds

et al. 2015

American Journal of Physiology-Gastrointestinal and Liver Physi

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“…Data attained through in vivo high-resolution colonic manometry [26] suggest that colonic contractions occur over 2-4 cm. For the base case of the model, we have chosen a length of 4 cm as a starting point.…”

Section: /37mentioning

confidence: 99%

“…The length of the real contractions is not known and state-of-the-art manometric sensor data is limited to coarse spatial sampling (~ 1 cm steps) along the full colonic length [26]. Understanding how the pressure field is influenced by the size of the contraction will help differentiate between single coherent propagation waves and possible multiple short-length waves moving in different directions.…”

Section: Length Of Peristaltic Wavementioning

confidence: 99%

Investigating the relationships between peristaltic contraction and fluid transport in the human colon using Smoothed Particle Hydrodynamics

Sinnott¹,

Cleary²,

Arkwright³

et al. 2012

Computers in Biology and Medicine

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The gastrointestinal tract comprises of several distinct organs in sequence, extending over 7 meters in the human abdomen. Controlled propulsion and mixing of content along the digestive tract is essential for a normal life. This is achieved by a rich assortment of motor patterns that ensure that movements and propulsion are appropriate for the breakdown of food, absorption of nutrients and excretion of waste. These movements (motility) are due to coordinated contractions and relaxations of circular and longitudinal smooth muscle layers. For oesophageal FGIDs the combined technical advances in recording abnormal contractility, via oesophageal manometry, and relating these abnormalities to impaired flow [2] has seen a dramatic improvement in our understanding of the problem and therefore our ability to treat the patient.However, this is not the case for FGIDs in regions below the stomach. The small and large intestines are relatively inaccessible and obtaining detailed manometric recordings and visualizing the movement of digesta is difficult. As a result our understanding of normal pressure/flow relationships is still relatively simplistic [3]. Therefore while abnormal contractility is implicated in , how these abnormalities relate to impaired flow remains largely unknown.Computational modeling of gastrointestinal systems has the potential to help understand these complex relationships. Many mathematical models of peristaltic pumping in flexible tubes have been developed over the last decades and the reader is referred to [7,8] for comprehensive reviews of 3/37 this research. The vast majority of these models do not take into account the solid wall mechanics of the flexible tube in predicting the transient wall deformation. Instead the wall shape is fully prescribed. Some exceptions to this include Carew and Pedley [9] who developed a model of peristaltic flow in the ureter with an active contracting wall coupled to the internal resistance from the intra-luminal pressures in an infinitely long tube. Such models are based on lubrication theory and are therefore limited to simple geometry systems with low inertial flows and long waves. They are well suited to studying the dynamics of the ureter. However, the development of intestinal flow models for studying the effect of single and multiple wave trains on transport requires an active wall model that can accommodate more realistic geometry and non-linear wall mechanics.More recently detailed computational models of oesophageal motility [10,11] have helped to define relationships between motility and flow. In addition CFD models have started to consider the effect of peristaltic motor patterns in the small intestine [12] and the stomach [13,14]. While these studies in the stomach and small bowel have sourced anatomically accurate wall geometries from MRI, they have not attempted a 2-way coupling of the motor activity in the wall with the fluid content.Instead motor patterns are prescribed as a sequence of fixed geometric changes to the boundary.Physiologically real...

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“…Both single point [9] and distributed pressure sensing have been demonstrated in-vitro [10,11] and in-vivo [12,13]. Distributed temperature sensing for the monitoring of hyperthermal therapies have been reported by Smith et al [14].…”

Section: Biophotonicsmentioning

confidence: 99%

A fibre optic catheter for simultaneous measurement of longitudinal and circumferential muscular activity in the gastrointestinal tract

Arkwright

Blenman

Underhill

et al. 2011

Journal of Biophotonics

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Diagnostic catheters based on fibre Bragg gratings (FBG's) are proving to be highly effective for measurement of the muscular activity associated with motility in the human gut. While the primary muscular contractions that generate peristalsis are circumferential in nature, it has long been known that there is also a component of longitudinal contractility present, acting in harmony with the circumferential component to improve the overall efficiency of material movement. We report the detection of longitudinal motion in mammalian intestine using an FBG technique that should be viable for similar detection in humans. The longitudinal sensors have been combined with our previously reported FBG pressure sensing elements to form a composite catheter that allows the relative phase between the two components to be detected. The catheter output has been validated using video mapping in an ex-vivo rabbit ileum preparation.

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Design of a high-sensor count fibre optic manometry catheter for in-vivo colonic diagnostics

Cited by 99 publications

References 24 publications

Neurally mediated propagating discrete clustered contractions superimposed on myogenic ripples in ex vivo segments of human ileum

Neurally mediated propagating discrete clustered contractions superimposed on myogenic ripples in ex vivo segments of human ileum

Investigating the relationships between peristaltic contraction and fluid transport in the human colon using Smoothed Particle Hydrodynamics

A fibre optic catheter for simultaneous measurement of longitudinal and circumferential muscular activity in the gastrointestinal tract

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