Centre for Biomaterials and Tissue Engineering (CBIT), Universitat Politècnica de València, Valencia, Spain.
Digestive Endoscopy Unit, Digestive Diseases Department, La Fe Polytechnic University Hospital, Valencia, Spain.
Proc Inst Mech Eng H. 2020 May;234(5):468-477. doi: 10.1177/0954411920901414. Epub 2020 Jan 25.
Access to the small bowel by means of an enteroscope is difficult, even using current devices such as single-balloon or double-balloon enteroscopes. Exploration time and patient discomfort are the main drawbacks. The prototype 'Endoworm' analysed in this paper is based on a pneumatic translation system that, gripping the bowel, enables the endoscope to move forward while the bowel slides back over its most proximal part. The grip capacity is related to the pressure inside the balloon, which depends on the insufflate volume of air. Different materials were used as in vitro and ex vivo models: rigid polymethyl methacrylate, flexible silicone, polyester urethane and ex vivo pig small bowel. On measuring the pressure-volume relationship, we found that it depended on the elastic properties of the lumen and that the frictional force depended on the air pressure inside the balloons and the lumen's elastic properties. In the presence of a lubricant, the grip on the simulated intestinal lumens was drastically reduced, as was the influence of the lumen's properties. This paper focuses on the Endoworm's ability to grip the bowel, which is crucial to achieving effective endoscope forward advance and bowel folding.
经内镜小肠检查的通道建立较为困难，即使使用目前的单气囊或双气囊小肠镜等设备也难以实现。操作时间长和患者不适是主要的缺点。本文分析的“Endoworm”原型基于气动传输系统，该系统通过抓取肠管，在肠管沿其最靠近探头的部分向后滑动的同时，使内镜向前移动。抓握能力与气囊内的压力有关，而气囊内的压力取决于空气的注入量。我们使用不同的材料分别在体外和体内模型上进行了实验：刚性聚甲基丙烯酸甲酯、柔性硅树脂、聚酯氨酯和猪的离体小肠。通过测量压力-容积关系，我们发现它取决于管腔的弹性特性，摩擦力取决于气囊内的气压和管腔的弹性特性。在存在润滑剂的情况下，对模拟肠腔的抓握能力明显降低，同时管腔特性的影响也降低。本文重点介绍了“Endoworm”抓取肠管的能力，这对实现有效的内镜前进和肠管折叠至关重要。
