Leung Billy H K, Poon Carmen C Y, Zhang Ruikai, Zheng Yali, Chan Cecilia K W, Chiu Philip W Y, Lau James Y W, Sung Joseph J Y
IEEE Trans Biomed Eng. 2017 May;64(5):1106-1114. doi: 10.1109/TBME.2016.2591060. Epub 2016 Jul 13.
Wireless capsule endoscope (WCE) is a revolutionary approach to diagnose small bowel pathologies. Currently available WCEs are mostly passive devices with image capturing function only, while on-going efforts have been placed on robotizing WCEs or to enhance them with therapeutic functions. In this paper, the authors present a novel inflatable WCE for haemostasis in the gastrointestinal (GI) tracts by balloon tamponade effect.
The proposed wireless capsule consists of a balloon that can be inflated using the endothermic reaction of acid and base. When the balloon reached a precalculated pressure level, it is able to stop at a bleeding site in the bowel, and achieve haemostasis by tamponade effect. The prototype is 14 mm in diameter, with three sections of 13, 35, and 12 mm in length, respectively. The three sections are linked together with flexible joints and enclosed in a silicone balloon. The prototypes were tested in ex vivo porcine intestine models.
In the ten ex vivo trials conducted, the inflatable wireless capsule achieved average balloon pressure of 46.0 mmHg and withstood average maximum longitudinal pulling force at 1.46 N. An in vivo study was carried out as a proof-of-concept for treating bleeding in a porcine model. The proposed inflatable WCE succeeded in the animal test by controlling haemostasis within 5 min. No rebleeding was observed in the next 20 min.
The results suggested that the inflatable capsule with a real-time bleeding detection algorithm can be implemented. Moreover, the proposed inflatable WCE prototype can achieve haemorrhage control in the lower GI.
To our best knowledge, this is the first study that demonstrated the potential to treat GI haemorrhage by an inflatable WCE. The proposed capsule enables the development of a closed-loop system based on a body sensor network to provide early treatment of GI bleeding for p-medicine.
无线胶囊内镜（WCE）是诊断小肠疾病的一种革命性方法。目前可用的WCE大多是仅具有图像捕捉功能的被动设备，而目前正在努力使WCE机器人化或赋予其治疗功能。在本文中，作者提出了一种新型的可充气WCE，通过球囊压迫效应实现胃肠道（GI）止血。
所提出的无线胶囊由一个可利用酸碱吸热反应充气的球囊组成。当球囊达到预先计算的压力水平时，它能够停留在肠道的出血部位，并通过压迫效应实现止血。该原型直径为14毫米，分别有三段长度为13、35和12毫米。这三段通过柔性接头连接在一起，并封装在一个硅胶球囊中。该原型在离体猪肠模型中进行了测试。
在进行的十次离体试验中，可充气无线胶囊的平均球囊压力达到46.0 mmHg，平均承受的最大纵向拉力为1.46 N。作为在猪模型中治疗出血的概念验证进行了一项体内研究。所提出的可充气WCE在动物试验中成功地在5分钟内控制了出血。在接下来的20分钟内未观察到再次出血。
结果表明可以实现具有实时出血检测算法的可充气胶囊。此外，所提出的可充气WCE原型能够在胃肠道下部实现出血控制。
据我们所知，这是第一项证明可充气WCE治疗胃肠道出血潜力的研究。所提出的胶囊能够基于身体传感器网络开发一个闭环系统，为精准医疗提供胃肠道出血的早期治疗。
