Magnetically Controllable Gastrointestinal Steering of Video Capsules
Magnetically Controllable Gastrointestinal Steering of Video Capsules
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DOI：
10.1109/tbme.2010.2087332
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发表时间：
2011-02-01
影响因子：
4.6
通讯作者：
Pappone, Carlo
中科院分区：
文献类型：
--
作者：
Carpi, Federico;Kastelein, Nathan;Pappone, Carlo
无线胶囊内窥镜(WCE)允许舒适的胃肠道(GI)视频探查，特别适用于小肠。在探查胃镜和结肠镜检查也可到达的其他胃肠道节段，WCE的诊断效果仍然较差。它的主要缺点是不能控制由蠕动和重力随机驱动的胶囊运动。为解决这一问题，磁机动技术已成为近年来的研究热点。在这里，我们报告了在家猪模型中，最常见的视频胶囊(PillCam，给定成像有限公司，以色列)的磁致能样本在活体胃肠道的每个主要区域(食道、胃、小肠和结肠)内的精确机器人转向和非侵入性3-D定位的首次演示。此外，我们还展示了如何使用已经用于心血管临床程序的机器人磁性导航系统(Niobe，Stereoaxis，Inc，USA)轻松实现这一点。胶囊可以自由安全地移动，全方位转向精度为1度，并通过透视成像进行实时跟踪，从而实现误差为1 mm的三维定位。立体定向系统所提供的转向和定位的准确性以及其在世界范围内的临床可获得性可能允许在这一新的应用中立即和广泛地使用。这预计，可磁控的WCE将成为近期的现实。该仪器应该与下一代视频胶囊一起使用，这种胶囊具有内在的磁性，能够实时光学图像可视化，预计很快就会进入市场。
Wireless capsule endoscopy (WCE) allows for comfortable video explorations of the gastrointestinal (GI) tract, with special indication for the small bowel. In the other segments of the GI tract also accessible to probe gastroscopy and colonscopy, WCE still exhibits poorer diagnostic efficacy. Its main drawback is the impossibility of controlling the capsule movement, which is randomly driven by peristalsis and gravity. To solve this problem, magnetic maneuvering has recently become a thrust research area. Here, we report the first demonstration of accurate robotic steering and noninvasive 3-D localization of a magnetically enabled sample of the most common video capsule (PillCam, Given Imaging Ltd, Israel) within each of the main regions of the GI tract (esophagus, stomach, small bowel, and colon) in vivo, in a domestic pig model. Moreover, we demonstrate how this is readily achievable with a robotic magnetic navigation system (Niobe, Stereotaxis, Inc, USA) already used for cardiovascular clinical procedures. The capsule was freely and safely moved with omnidirectional steering accuracy of 1 degrees, and was tracked in real time through fluoroscopic imaging, which also allowed for 3-D localization with an error of 1 mm. The accuracy of steering and localization enabled by the Stereotaxis system and its clinical accessibility world wide may allow for immediate and broad usage in this new application. This anticipates magnetically steerable WCE as a near-term reality. The instrumentation should be used with the next generations of video capsules, intrinsically magnetic and capable of real-time optical-image visualization, which are expected to reach the market soon.