Shape-shifting Capsule Robot for Endoscopy based on Eversion Navigation

下消化道（GI）的全面筛查对于发现和治疗早期致命疾病（如癌症）至关重要。在过去的二十年里，可摄入的内窥镜胶囊显示出了有希望的结果，为结肠镜筛查提供了一种侵入性更小、痛苦更少的替代方法。迄今为止，胶囊式内窥镜检查是小肠筛查的唯一可用选择。尽管如此，对胶囊运动的有限控制（其仅依赖于内窥镜）阻止了该技术实现与传统内窥镜等同的性能，传统内窥镜仍然被认为是下胃肠道筛查的黄金标准。 该项目提出了一种基于外翻导航的用于内窥镜检查的变形胶囊机器人的新设计：胶囊大小的系统通过一系列分布在其身体周围的连续外翻弹性轨道来推动自己通过胃肠道。轨道和胃肠道之间的持续接触是通过一系列可充气环形腔实现的，这些环形腔用于使其弹性结构变形以匹配导航部分的管腔。这种受控的变形使它们粘附在胃肠道的壁上，从而确保所需的牵引力来引导胃肠道，而不管局部管腔大小如何。拟定项目将研究用于下/上胃肠道筛查的拟定胶囊系统的（软）栓系和非栓系设计。 根据国际癌症研究机构（IARC）的数据，结直肠癌（CRC）是全球第三大最常见的恶性肿瘤，也是癌症相关死亡的第二大常见原因（2018年，估计）[1]。尽管CRC是最致命的病理之一，全球死亡人数超过880，000人（2018年估计），但在早期诊断时，CRC患者的存活率可高达90%[2]。然而，结肠镜检查引起的不适以及对疼痛的恐惧阻碍了患者进行定期筛查。内窥镜胶囊，如果在临床上像内窥镜一样可靠（甚至更可靠），将消除有效筛查计划道路上的这些障碍。 本研究的长期目标是开发一种完全不受约束的系统，用于从口腔到肛门的胃肠道导航，具有能够自主导航的胶囊大小的系统，从而能够可靠地筛查胃肠道难以到达的部分，例如传统内窥镜无法到达的小肠。这种系统对全球医疗保健的潜在影响可能是显著的，它可以为全面的筛查计划铺平道路，横向影响世界所有人口的生活。该项目的目的是开发拟议的系统，一种高达TRL 6的变形内窥镜胶囊。整个系统的研究和工程的具体科学目标是：1）以软系留2：1的比例设计和制造所提出的系统，嵌入所有最终系统组件，以在下胃肠道体模中进行导航测试。2)开发用于GI体模和体内动物试验的1：1比例栓系胶囊。3)为临床医生设计和实现控制界面，并了解如何通过直接让最终用户参与开发过程来优化用户体验。所提出的系统的主要新奇是使用一组可充气环形腔室，以使得能够调节系统的外径，同时使用弹性轨道，以确保它们与胃肠道壁的恒定接触。拟议的项目通过提出一种用于筛查和手术干预的胃肠道导航新方法，与EPSRC物理干预前沿的重大挑战保持一致。

Comprehensive screening of the lower gastrointestinal (GI) tract is essential to detect and treat the early stages of deadly diseases, such as cancer. Ingestible endoscopic capsules have shown promising results in the past two decades, offering a less invasive and painful alternative to colonoscopic screening. To date capsule endoscopy is the only available option for the screening of the small bowel. Nonetheless, limited control over capsules' motion, which relies solely on peristalsis, prevents this technology from achieving equivalent performance to conventional endoscopes, which are still regarded as the golden standard for screening of the lower GI tract. This project proposes a novel design for a Shape-shifting Capsule Robot for Endoscopy based on Eversion Navigation: a capsule-sized system that propels itself through the GI tract by means of a series of continuously everting elastic tracks distributed all around its body. Constant contact between the tracks and the GI tract is enabled by a series of inflatable toroidal chambers used to deform their elastic structure to match the lumen of the navigated section. This controlled deformation causes them to adhere to the walls of the GI tract, thus ensuring the needed traction to navigate it, regardless of the local lumen size. The proposed project will investigate both (soft) tethered and untethered designs of the proposed capsule system for the screening of the lower-/upper- GI tract. According to the International Agency for Research on Cancer (IARC), colorectal cancer (CRC) is the third most commonly diagnosed malignancy and the second most common cause of cancer-related deaths worldwide (2018, estimated) [1]. Despite being one of the deadliest pathologies with more than 880,000 deaths worldwide (2018, estimated), the survival rate of CRC patients can be as high as 90% when diagnosed at an early stage [2]. However, discomfort as well as fear of pain caused by colonoscopy discourages patients from undertaking regular screening. Endoscopic capsules, if made as clinically reliable as endoscopes (or even more), will remove both these obstacles on the pathway to an effective screening programme. The long-term goal of this research is to develop the system in a completely untethered version for the navigation of the GI tract from the mouth to the anus with a capsule-size system capable of autonomous navigation, thus enabling reliable screening of hard-to-reach portions of the GI tract e.g. the small intestine, which is not accessible with traditional endoscopes. The potential impact of such system on healthcare worldwide can be significant and it can pave the way for a comprehensive screening program transversally affecting the lives of all the world population. The aim of the project is to develop the proposed system, a shape-shifting endoscopic capsule up to TRL 6. The specific scientific objectives for research and engineering of the full system are: 1) Design and fabricate the proposed system in a soft tethered 2:1 scale, embedding all final system components, to undergo navigation tests in lower-GI tract phantoms. 2) Develop a tethered 1:1 scale capsule for GI phantom and in vivo animal testing. 3) Design and implement a control interface for the clinician and to understand how to optimize the UX by directly involving end-users in the development process. The main novelty of the proposed system is the use of a set of inflatable toroidal chambers to enable the adjustment of the outer diameter of the system together with the use of elastic tracks, to ensure their constant contact with the walls of the GI tract. The proposed project well aligns with the EPSRC grand challenge of the Frontiers of Physical Intervention by proposing a novel approach to GI tract navigation for screening and surgical interventions.