Utilising the Vibro-Impact Self-Propulsion Technique for Gastrointestinal Endoscopy

胃肠道疾病是第三大最常见的死亡原因，是癌症死亡的主要原因，也是最常见的住院原因。在英国，胃肠道疾病对患者、国民健康服务体系（NHS）和经济来说都是沉重的负担。内窥镜检查在胃肠道疾病的诊断中起着至关重要的作用，在过去的5年里，对胃肠道内窥镜检查的需求翻了一番，NHS预测每年将持续增长6.5% （Scoping the Future, Cancer Research UK, 2015）。自从15年前被引入临床实践以来，胶囊内窥镜已经成为检查小肠表面衬里的主要方式，这是一个以前被认为是临床医生无法进入的解剖部位。然而，它依靠蠕动通过肠道导致了显著的局限性，特别是由于不可预测和可变的运动速度。由于间歇性的高传输速度导致肠表面的不完全可见，可能会遗漏重大异常。此外，每个病例产生多达10万张静止图像，从中生成视频片段，临床医生需要30到90分钟的时间来全面检查。因此，对于临床医生来说，该程序被认为既耗时又繁重。因此，在胃肠道内镜实践中，迫切需要安全、无痛、准确、可靠和一次性的新模式，并且对从业人员的培训要求最低。本项目试图寻找将振动冲击自推进技术应用于胶囊内窥镜的方法，并探索创新下一代内窥镜的可行性：自推进胶囊内窥镜。刘洋博士是一名具有应用动力学和控制研究背景的早期研究人员，他专注于为不同的工程系统开发这种自推进技术。应用研究的性质促使他将任何研究成果转化为实际应用，胶囊内窥镜是该技术可以取得革命性突破的核心可交付领域之一。这需要刘博士具备必要的临床经验和知识，将他的工程研究技术转移到医疗保健领域。因此，拟议的学科hop的目标是：(1)扩大他的医疗技术专业知识和临床经验，(2)将他的研究融入医疗技术，(3)启动自行胶囊内窥镜的开发工作，(4)与临床医生建立长期的工作关系，最初是在当地的NHS医院，后来是在世界范围内。刘医生实现这一雄心勃勃的目标的方法是：1)在皇家德文郡和埃克塞特NHS基金会信托的内窥镜部门进行为期6个月的学科跳跃，学习，观察和培训；2)细化研究问题并制定潜在的解决方案；3)充分了解该技术在医疗行业实施的发展周期，包括转化开发、临床评估和监管审批、采用和推广阶段的关键活动。

Gastrointestinal (GI) disease is the third most common cause of death, the leading cause of cancer death, and the most common cause of hospital admission. The burden of GI disease in the UK is heavy for patients, the National Health Service (NHS), and the economy. Endoscopy plays a vital role in the diagnosis of GI disorders, and the demand for GI endoscopy has doubled in the past 5 years, with on-going growth of 6.5% per annum predicted by the NHS (Scoping the Future, Cancer Research UK, 2015).Since its introduction into clinical practice 15 years ago, capsule endoscopy has become established as the primary modality for examining the surface lining of the small intestine, an anatomical site previously considered to be inaccessible to clinicians. However, its reliance on peristalsis for passage through the intestine leads to significant limitations, in particular due to the unpredictable and variable locomotion velocity. Significant abnormalities may be missed, due to intermittent high transit speeds that lead to incomplete visualisation of the intestinal surface. Furthermore, each case produces up to 100,000 still images, from which video footage is generated, taking between 30 and 90 minutes for the clinician to examine in its entirety. The procedure is therefore considered both time-consuming and burdensome for clinicians.There is, therefore, in GI endoscopic practice a desperate need for new modalities that are safe, painless, accurate, reliable and disposable, and which require minimal training for practitioners. This project attempts to find the way to adapt the vibro-impact self-propulsion technique into capsule endoscopy, and to explore the feasibility of innovation for the next generation of endoscopy: the self-propelled capsule endoscopy. Dr Yang Liu is an early-career researcher with a research background in applied dynamics and control, who has focused on developing this self-propulsion technique for different engineering systems. The nature of his applied research urges him to transfer any research findings into practical applications, and capsule endoscopy is one of the core deliverable areas for which the technique can make a revolutionary breakthrough. This requires to equip Dr Liu with the necessary clinical experience and knowledge to transfer his engineering research technologies into the healthcare domain. Therefore, the aims of the proposed discipline hop are: (1) to widen his healthcare technologies' expertise and clinic experience, (2) to embed his research into healthcare technologies, (3) to initiate the development work of the self-propelled capsule endoscopy, and (4) to build a long-lasting working relationship with clinicians, initially in the local NHS hospital, and later worldwide.The approach for Dr Liu to realize this ambitious goal is: 1) to undertake a 6 month discipline hop, learning, observing and being trained in the Endoscopy Department at the Royal Devon & Exeter NHS Foundation Trust; 2) to refine research questions and develop potential solutions; and 3) to fully understand the development cycle of implementing such technique in healthcare sector, including the key activities at the stages of Translational Development, Clinical Evaluation and Regulatory Approval, and Adoption and Diffusion.