Medical Robotics


Flexible endoscopy/colonoscopy



Colorectal cancer (CRC) is the 3rd deadliest cancer in the United States and world for both men and women. CRC develops from a growth on the colon wall called a polyp. When CRC is detected at the earliest (local) stage, there is a 90% survival rate, however, when detected at the latest stage (after metastization), the survival rate drops to 10%. Unfortunately, only 40% of CRC cases are detected at the earliest stage, partly due to low screening rates. The purpose of this research is to develop a less invasive, cheaper, and more accessible screening procedure for CRC.


Currently, the state-of-the art screening technology is a colonoscope, which is a flexible scope with a light source, camera, and port for tools/suction/irrigation. Although colonoscopes are the "gold standard" for CRC screening, looping (which causes patient discomfort, pain, and in severe cases perforation) can occur due to the "push" type motion required for advancing the scope.


Several research groups and companies have attempted to improve the standard colonoscope by implementing locomotion systems, usually resulting in a "front-wheel" drive scenario.



Robotic capsule colonoscope (RCC)



An alternative screening method for CRC is a capsule colonoscope, such as the PillCam Colon, however all commercially available capsules remain passive, and therefore can only perform visual screening procedures. A capsule colonoscope (or endoscope) is a pill-sized/shaped device which houses a camera, light source, (LED), battery, and wireless data transmission system. The capsule is swallowed by the patient, and it moves through the gastrointestinal tract passively. For colon screenings, the capsule remains in a low power "sleep" mode until the capsule reaches the colon.


In an attempt to improve current commercial capsule colonoscopes, several research groups have attempted to develop and implement locomotion systems using various techniques. Groups have used legs, micro-patterned polymer treads (my contribution), magnetics, propellers (stomach only), flaps, inch-worm motion, and vibration.



Capsule endoscopes for screening, diagnosis and therapy



In addition to implementing locomotion systems into capsule endoscopes, research is being conducted to develop therapeutic capsules. Of particular interest are drug delivery capsules, biopsy capsules, insufflation capsules, temperature/pressure sensing capsules, and 3D imaging capsules.



My contribution to robotic capsule colonoscopy



Our group (the Advanced Medical Technologies Laboratory at the University of Colorado Boulder) has been developing a robotic capsule colonoscope (RCC) that utilizes micro-patterned polydimethylsiloxane (PDMS) treads as a mobility method. The micro-patterned PDMS treads ,mimic insect feet and enhance friction on intestinal tissue.


The RCC consists of a housing with a centrally located and axially oriented DC motor. The motor drives a gear train, which simultaneously actuates 8 circumferentially located and axially oriented micro-patterned PDMS treads. Each tread is custom fabricated to have a micro-patterned external surface which interfaces with the tissue, and an internal surface that has timing teeth, which interfaces with the timing pulleys. The most successful prototype was able to travel in both an insufflated abdominal cavity and the collapsed colon near the cecum at a maximum speed of 3 mm/s.



Progression of the RCC design



The RCC design currently has a 7 year progression. The first prototypes were built and tested in vivo in 2008, but were not successful due to low friction coefficient between the mobility surface and the tissue, and a large RCC housing to mobility surface ratio.  A series of two-wheeled robots were used to verify the effectiveness of using micro-patterned PDMS for friction enhancement as well as study the effect of micro-pillar geometry (circular pillars perform best). Then, the design progressed to an omni-tread design, first with 8 treads, and then 4 tread to reduce size. The 4-tread  design was not as robust as the 8-tread design. More recently, we have moved towards wheeled designs (with micro-patterned PDMS for treads), which are easier to fabricate than treads.