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

胃肠道疾病是第三种最常见的死亡原因，是癌症死亡的主要原因，也是最常见的住院原因。在英国，胃肠道疾病给患者、国家医疗服务体系(NHS)和经济带来了沉重的负担。内窥镜在胃肠道疾病的诊断中起着至关重要的作用，胃肠道内窥镜的需求在过去5年中翻了一番，NHS(英国癌症研究中心，2015)预测每年将以6.5%的持续增长。自从15年前引入临床实践以来，胶囊内窥镜已经成为检查小肠表面衬里的主要手段，而这是以前被认为是临床医生无法接触到的解剖部位。然而，它对蠕动通过肠道的依赖导致了显著的限制，特别是由于不可预测和可变的运动速度。由于间歇性高传输速度导致肠道表面显示不完全，可能会漏掉显著的异常。此外，每个病例产生多达100,000张静止图像，从中生成视频片段，临床医生需要30到90分钟来进行完整的检查。因此，在胃肠道内窥镜的实践中，迫切需要安全、无痛、准确、可靠和一次性的新方法，并且需要对从业者进行最低限度的培训。本项目试图找到将振动冲击自行式技术应用于胶囊内窥镜的方法，并探索下一代内窥镜技术创新的可行性：自行式胶囊内窥镜。杨柳博士是一位具有应用动力学和控制研究背景的早期研究员，他专注于为不同的工程系统开发这种自我推进技术。他的应用研究的性质促使他将任何研究成果转化为实际应用，而胶囊内窥镜检查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化为医疗保健领域。因此，拟议的学科跳跃的目标是：(1)拓宽他的医疗技术的专业知识和临床经验，(2)将他的研究嵌入到医疗技术中，(3)启动自行式胶囊内窥镜的开发工作，以及(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，后来在世界各地。刘博士实现这一雄心勃勃的目标的途径是：1)在皇家德文和埃克塞特NHS基金会信托基金的内窥镜部门进行为期6个月的学科跳跃，学习、观察和接受培训；2)提炼研究问题并开发潜在的解决方案；3)充分了解在医疗行业实施该技术的开发周期，包括翻译开发、临床评估和法规批准、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.