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具有成本效益的基于智能手机的可弯曲内窥镜系统在发展中国家的应用:器械验证研究。

Cost-Effective Smartphone-Based Articulable Endoscope Systems for Developing Countries: Instrument Validation Study.

机构信息

Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea.

Department of Convergence Medicine, College of Medicine, University of Ulsan, Seoul, Republic of Korea.

出版信息

JMIR Mhealth Uhealth. 2020 Sep 10;8(9):e17057. doi: 10.2196/17057.

Abstract

BACKGROUND

Endoscopes are widely used for visualizing the respiratory tract, urinary tract, uterus, and gastrointestinal tracts. Despite high demand, people in underdeveloped and developing countries cannot obtain proper access to endoscopy. Moreover, commercially available endoscopes are mostly nonarticulable as well as not actively controlled, limiting their use. Articulating endoscopes are required for some diagnosis procedures, due to their ability to image wide areas of internal organs. Furthermore, actively controlled articulating endoscopes are less likely to harm the lumen than rigid endoscopes because they can avoid contact with endothelial tissues.

OBJECTIVE

The study aimed to demonstrate the feasibility and acceptability of smartphone-based wide-field articulable endoscope system for minimally invasive clinical applications in developing and less developed countries.

METHODS

A thin articulable endoscope system that can be attached to and actively controlled by a smartphone was designed and constructed. The system consists of a flexible endoscopic probe with a continuum mechanism, 4 motor modules for articulation, a microprocessor for controlling the motor with a smartphone, and a homebuilt app for streaming, capturing, adjusting images and video, and controlling the motor module with a joystick-like user interface. The smartphone and motor module are connected via an integrated C-type On-The-Go (OTG) USB hub.

RESULTS

We tested the device in several human-organ phantoms to evaluate the usability and utility of the smartphone-based articulating endoscope system. The resolution (960 × 720 pixels) of the device was found to be acceptable for medical diagnosis. The maximum bending angle of 110° was designed. The distance from the base of the articulating module to the tip of the endoscope was 45 mm. The angle of the virtual arc was 40.0°, for a curvature of 0.013. The finest articulation resolution was 8.9°. The articulating module succeeded in imaging all 8 octants of a spherical target, as well as all 4 quadrants of the indices marked in human phantoms.

CONCLUSIONS

The portable wide-field endoscope was successfully controlled using a smartphone, yielding clear images with a resolution of 960 × 720 pixels at realistic focal distances. Actively and precisely controlled articulating movements have resulted in minimally invasive monitoring in the narrow space of internal organs providing a wide-area view. We found our smartphone-based active articulated endoscope to be suitable for point-of-care applications in developing and less developed countries.

摘要

背景

内窥镜被广泛用于观察呼吸道、泌尿道、子宫和胃肠道。尽管需求很高,但发展中国家和不发达国家的人们无法获得适当的内窥镜检查。此外,商业上可用的内窥镜大多不可弯曲,也无法主动控制,限制了它们的使用。由于能够对内部器官的大面积进行成像,因此需要使用可弯曲的内窥镜进行一些诊断程序。此外,主动控制的可弯曲内窥镜比刚性内窥镜更不容易损伤管腔,因为它们可以避免与内皮组织接触。

目的

本研究旨在展示基于智能手机的宽视场可弯曲内窥镜系统在发展中国家和欠发达国家的微创临床应用中的可行性和可接受性。

方法

设计并构建了一种可附着在智能手机上并可主动控制的薄型可弯曲内窥镜系统。该系统由带有连续机构的柔性内窥镜探头、4 个用于弯曲的电机模块、一个用于通过智能手机控制电机的微处理器、以及一个用于流式传输、捕获、调整图像和视频以及通过类似于操纵杆的用户界面控制电机模块的自制应用程序组成。智能手机和电机模块通过集成的 C 型即插即用 (OTG) USB 集线器连接。

结果

我们在几个人体器官模型中测试了该设备,以评估基于智能手机的可弯曲内窥镜系统的可用性和实用性。该设备的分辨率(960×720 像素)被认为可用于医疗诊断。设计的最大弯曲角度为 110°。从可弯曲模块的底部到内窥镜尖端的距离为 45mm。虚拟弧形的角度为 40.0°,曲率为 0.013。最精细的弯曲分辨率为 8.9°。可弯曲模块成功地对球形目标的 8 个八分位以及人体模型中标记的 4 个象限进行了成像。

结论

该便携式宽视场内窥镜成功地通过智能手机进行了控制,在实际焦距下获得了 960×720 像素的清晰图像。主动且精确的弯曲运动实现了在内部器官的狭窄空间内进行微创监测,提供了大面积的视野。我们发现,我们的基于智能手机的主动弯曲内窥镜适用于发展中国家和欠发达国家的即时护理应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/effe/7516686/d4a9148af419/mhealth_v8i9e17057_fig1.jpg

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