外磁场驱动无线胶囊式内窥镜的动力学模型

目的：建立外磁场驱动无线胶囊式内窥镜驱动力的动力学模型,并对模型进行仿真与实验。方法：磁场随线圈组中电流大小以及方向的改变而改变,利用磁场的改变控制无线胶囊式内窥镜的运动。结果：开发了OV7930外围电路PCB,并按设计组装成磁控无线胶囊式内窥镜胶囊。结论：实验中采集到清晰的图像,证明了该模型设计的可行性。     

英研制出胶囊式内窥镜

英国皇家伦敦医院的专家研制出一种胶囊式内窥镜 ,它长３０ｍｍ、直径１１ｍｍ ,内件包括微型摄像机、光源和信号发送器。这样患者在接受肠胃检查时 ,可能不必痛苦地吞下带导管的内窥镜了 ,只需像吃药丸一样吞下一粒胶囊 ,其中的微型摄像机就能忠实地记录肠胃内的状况 ,供医生诊断。患者需要检查时 ,不需要上医院 ,只需吞下胶囊。由于胶囊体积很小 ,吞咽时不会感到痛苦 ,吞下后也不会觉得不舒服 ,胶囊中的微型摄像机在拍得肠胃内部清晰影像后 ,会通过信号发送器把图像发送到别在患者腰间的特殊录像装置上。一粒胶囊可以拍摄长达６ｈ的影像。…     

无线胶囊式小肠内窥镜技术进展

本文简介了无线胶囊式内窥镜系统中的关键技术及进展,并着重介绍了M2A无线胶囊式内窥镜和NORIKA无线胶囊式内窥镜的技术构成.     

基于极低功耗数模混合集成电路芯片的智能型胶囊式内窥镜检查系统的研制

目的：研制开发基于极低功耗数模混合集成电路芯片的新型智能胶囊式内窥镜检查系统,并对整个系统进行详细分析。方法：系统采用自行设计的极低功耗数模混合集成电路芯片,使捕获图像的最大分辨率和最高图像传输速率大幅提升。结果：该系统进一步缩小了胶囊式内窥镜的体积,延长了工作时间;其捕获图像的最大分辨率达到480×480像素,最高图像传输速率可达12帧/s。结论：新型智能胶囊式内窥镜检查系统实现了更小体积、更长工作时间、更高分辨率以及更快传输速率等设计目标,且安全性高,依从性好,应用前景广阔。     

新型无线内镜用于临床

新型无线内镜也称第二型胶囊内镜。经过多年的临床实践，无线内镜与传统内窥镜相比，它更有优越性。它可以无线传输拍摄图像，克服了传统推进式内窥镜的不足之处，通过口服智能胶囊完成胃肠道影像检查。，由于无线内镜体积小、重量轻、检查方便、无创伤、无痛苦、无交叉感染，不影响受检者的正常工作和生活，安全可靠，阳性检出率高。     

新产品介绍

日立制作所近日推出了内窥镜手术辅助机器人“MTLT-1”。该产品是第一款通过日本厚生劳动省的医疗用具认证的产品。其特点是可通过嵌入手术钳 内的开关进行控制,使内窥镜直接指向执刀医生指定的方向。原来进行内窥镜手术时,通常由助手操作内窥镜的视野,因此难以即时显示执刀医生希望确认的患者部位的图像。而使用MTLT-1时,由于执刀医生可以自行调整内窥镜的手术视野。因而可以节省时间。另外由于在进行内脏器官手术时,该机器人可以控制内窥镜在垂直方向移     

基于STC12LE2052AD控制芯片的内窥镜无线采集系统设计与应用

目的:设计内窥镜无线采集系统,用于内窥镜检查的图像采集。方法:内窥镜无线采集系统的发射端和接收端均采用单片机STC12LE2052AD为主控制芯片,nRF24L01为无线传输模块,采集图像时按下发射模块的按键,霍尔传感器接通后发射模块输出无线信号,接收模块收到信号后三极管接通,通过采集软件功能完成图像的采集,对300例患者分别进行电子胃镜检查(100例)、喉镜检查(100例)和腹腔镜检查(100例),并进行图像采集测试。结果:设计的内窥镜无线采集系统,经临床对患者的电子胃镜、喉镜和腹腔镜检查各100例的图像采集测试,系统能够采集到各内窥镜检查的清晰图像,实现内窥镜无线图像采集时操作简单、故障率低和系统性能稳定,可满足临床科室的使用。结论:内窥镜无线采集系统适用于内窥镜检查的图像采集,提高内窥镜检查系统采集图像的自由度,降低内窥镜采集系统的故障和医疗风险。     

一种超声检查床的制作

目的介绍一种超声检查床,可根据具体检查部位随意移动病人位置,并在任意位置固定。方法采用两层床面,分别受控横向移动装置和纵向移动装置。利用齿轮与锥尖的分开和接触来控制床面的移动和固定。结论本制作采用纯机械传动,避免漏电对患者的潜在危险。横向和纵向自由移动床面,并在任意位置固定,极大地减轻操作人员的工作强度,具有较高的实用价值。     

无线胶囊内窥镜的研究进展和讨论

本文介绍了无线胶囊内窥镜的国内外研究进展,详细分析了无线胶囊内窥镜的组成结构和工作原理,深入探讨了目前无线胶囊内窥镜研发和应用过程中存在的多种问题,并针对问题提出了相应的解决办法和思路。     

无线内窥镜系统的图像工作站的数据库研究

无线内窥镜克服了传统电子内窥镜只能检测胃部及部分肠道的缺陷，通过吞咽微型摄像胶囊，使之进入肠道，对食道、胃、小肠和大肠进行特定和非特定位置的图像拍摄，从而可以对整个消化道系统进行检测。这种对病人进行检查的方式是无创、无痛苦的，符合现今倡导的无创和微创的发展趋势。本文设计的图像信息管理部分是以SQL Server2000作为后台数据库，前端采用ADO数据库访问技术，实现对基本信息管理模块、图像信息管理模块和病历信息模块3个模块进行管理，并且完成其信息地查询、修改、更新等功能。它可以使医生能够在计算机屏幕上查看清晰的图像，而且还能方便地对患者信息、病历信息和图像信息进行管理，有利于实现医院规范化管理。     

Screening and surveillance for hereditary polyposis and non-polyposis syndromes with capsule endoscopy

The hereditary polyposis syndromes and non-polyposis colorectal carcinoma have been considered as scarcely occurring but inheritable dominant autosomal syndromes. The increasing risk of small bowel carcinoma and prevention of obstruction and intussusception have been making frequent and acute surgical interventions unavoidably led to the necessity of screening and surveillance the patients. Earlier the diagnosis of these symptoms was difficult to establish because traditional radiological methods have a low yield for small polyps. Furthermore, small bowel is only partially accessible with traditional endoscopic techniques such as upper endoscopy, colonoscopy and push-enteroscopy. The "wireless" capsule endoscopy has opened the way then for the non-invasive and painless test of the entire small intestine. - Test results have been cumulated to justify the efficiency and safety of capsule endoscopy concerning the syndromes above. This method can be applied safely even consequently to repeatedly performed surgical interventions by low risk of capsule retention. As the results compared of the diagnosed familial adenomatous polyposis and of Peutz-Jeghers syndrome reflect on capsule endoscopy, its diagnostic sensitiveness is stated as significantly higher than the Barium-contrast X-Ray and MR-enterography. Nevertheless, determination of size and location of polyps has become more problematic when evaluating the test results.     

New applications of capsule endoscopy: PILLCAMTM ESO

Capsule endoscopy has opened a new era in small bowel examination. Its indications are now well-defined and currently, wireless capsule endoscopy is considered as the first-line imaging tool for the diagnosis of small bowel diseases. ECE has been shown to be feasible, safe and a good alternative technique in patients refusing conventional endoscopy. Although results reported in both GERD and cirrhotic patients are encouraging, great differences in terms of accuracy (particularly in GERD patients) have been found in published studies. These differences have been attributed to study designs, the lack of adequate experience and inconvenience of ingestion protocols. In summary, more large-scale studies evaluating the new 14-fps capsule, adequate ECE-experience and new modified ingestion protocols are still needed.     

Multiple angiodysplasias diagnosed by capsule endoscopy

Angiodysplasias are the most frequent vascular lesions of the gastrointestinal tract and sources of significant mortality from bleeding. Small bowel angiodysplasias account for approximately 40% of cases of gastrointestinal bleeding with obscure origin and represent the single most common cause for hemorrhage in this subset of patients. Their cause is unknown but most are probably acquired and the result of a degenerative process associated with aging. The difficulty of their diagnosis stems from their multiple appearance and small size. Examinations that have been performed so far support that the sensitivity of capsule endoscopy (CE) performed during active bleeding was higher than in case of previous overt bleeding and occult bleeding. Case report: A 61-year-old female patient, who has received anticoagulant therapy for 13 years, presented with recurrent gastrointestinal bleeding of obscure origin underwent wireless capsule endoscopy after negative upper endoscopy and colonoscopy. CE showed non-bleeding typical angiodysplasia in the antrum of the stomach and active bleeding in the first third of jejunum without a visible bleeding source. As the next diagnostic step we performed selective mesenteric angiography to clarify the diagnosis and at the same time we also applied radiological intervention. Conclusion: Capsule endoscopy changed in practice guidelines for obscure bleeding and became the first-line method for evaluation of patient after upper endoscopy and colonoscopy have been shown to be negative. If the examination is performed early, CE could shorten considerably the time to diagnosis, lead to definitive treatment and numerous examinations with low yield could be avoided. The therapy of small bowel angiodysplasias is questionable. Radiological intervention poses the least load for the patient.     

Identification of a Meckel's diverticulum bleeding by urgent capsule endoscopy

A 10 year-old patient was admitted to our hospital due to severe gastrointestinal bleeding. His symptoms included hematochezia and fainting. Neither emergency upper endoscopy nor colonoscopy had identified the site of bleeding. During the colonoscopy they noticed that fresh blood entered the cecum from the ileum. An urgent capsule endoscopy was performed 8 hours after the patient admission. They placed the capsule with specific endoscopic technique into the proximal duodenum under general anesthesia. During 3,5 hours by the small bowel passage the capsule moved to the ileum and a focal bleeding lesion was detected at this site, suggesting the typical picture of bleeding Meckel's diverticulum. The patient was transfused by 1 unit of blood, with a minimum haemoglobin level 95 g/l. By surgery the ulcerated Meckel's diverticulum was identified and resected. Histopathology showed ectopic gastric mucosa. Surgical resection of the diverticulum resulted complete healing of this patient. The capsule endoscopy diagnosis was prompt, precise, and the all examinations were carried out within 24 hours. Involving urgent small bowel capsule endoscopy into the diagnostic workup of the obscure bleeding patient could considerably shorten the time to achieve a correct diagnosis and allowed the early institution of definitive treatment. By this one could spare a great number of costly alternative investigations with low diagnostic yield.     

Evaluation of diagnostic yield and clinical impact of capsule endoscopy in patients with obscure gastrointestinal bleeding

BACKGROUND AND AIMS: The major indication of small bowel capsule endoscopy is the diagnostics of obscure gastrointestinal bleeding. The present retrospective study was aimed to analyze the diagnostic yield, positive and negative predictive values and clinical impact of capsule endoscopy in patients with obscure gastrointestinal bleeding. PATIENTS AND METHODS: During a 36 month period at two workplaces 66 capsule endoscopy studies were performed in 62 patients with gastrointestinal bleeding who had undergone non-diagnostic upper endoscopy and colonoscopy. Capsule video recordings were evaluated by two investigators at both workplaces. Capsule endoscopy findings were divided into 3 groups according to the bleeding source: definitive bleeding source (48 patients), uncertain bleeding potential (5 patients), and negative finding (8 patient). Patients after capsule endoscopy were followed-up until a mean of 20 (1-41) months. RESULTS: A definitive small bowel bleeding source was detected in 78.7% of the cases studied by capsule endoscopy. Definitive bleeding sources included angiodysplasia (28 cases), small bowel Crohn's disease (5 cases), small bowel tumor (5 cases), small bowel stenosis (2 cases), NSAID therapy related ulcer (1 case), non-specific inflammation (1 case) and helminthiasis (1 case) respectively. The positive and negative predictive values of capsule endoscopy studies were 95.8% and 84.6% respectively. In cases with definitive bleeding sources 72% of patients received therapy in accordance with capsule endoscopy findings (surgery in 18 patients, medical treatment modification in 16 patients, chemoembolisation in 1 patient). During the follow-up period 17.7% of the patients had rebleeding. CONCLUSIONS: Capsule endoscopy is a useful and effective diagnostic method in cases with obscure gastrointestinal bleeding. Effective therapy may be introduced in accordance with the majority of positive capsule endoscopy results.     

Wireless capsule endoscopy and its role in gastroenterology: our results and a review of the literature

INTRODUCTION: Since its recent introduction, capsule endoscopy has revolutionized the diagnostics of diseases of the small bowel. The number of studies on the use of this method is constantly increasing. Along with this, our knowledge about the usability and diagnostic power of capsule endoscopy is growing and the indications for this technique are getting progressively more accurate. AIMS: To study the usability of capsule endoscopy in suspected Crohn's disease, in gastrointestinal bleeding of small bowel origin, and in undetermined abdominal complains. METHOD: Capsule endoscopy was performed in 20, previously examined, carefully selected patients. RESULTS: Positive findings were recorded in all patients with gastrointestinal bleeding and in 3/4 of patients with suspected Crohn's disease. However, in patients with indeterminate abdominal complains, the capsule endoscopy proved to be inefficient. CONCLUSION: In the study below, based on their own experience, the authors try to provide an overall picture of capsule endoscopy by reviewing contemporary medical literature. The usability of the capsule endoscopy in suspected Crohn's disease and gastrointestinal bleeding of small bowel origin is suggested by the results of the study.     

Small-Bowel Adaptation: A Case of Morphological Changes Induced by Teduglutide in Short-Bowel Syndrome With Intestinal Failure

Teduglutide (TED) reduces the need for parenteral support (PS) in patients with short-bowel syndrome with intestinal failure (SBS-IF). It is a glucagon-like peptide-2 analog that improves absorption, induces the expansion of the absorptive epithelium in the small intestine, and may be used in patients with SBS-IF after a 6- to 12-month adaptation period, if PS is always necessary. We described the functional and morphological effect of TED in a 40-year-old female patient with SBS-IF due to Crohn's disease who underwent terminal jejunostomy after 12 months of drug exposition. Marked hypertrophy of the villi was detected by endoscopic capsule and confirmed by histological measurements. This is the first publication demonstrating an increase in intestinal absorption in an SBS-IF patient treated with TED because of a morphological adaptation of the small bowel, with hyperplasia confirmed by capsule endoscopy and histology. The capsule endoscopy, a noninvasive exploration of the gut, could be evaluated to monitor the real efficacy of treatments with growth factors in SBS patients.     

Small bowel stromal tumors diagnosed by capsule endoscopy

Small intestinal stromal tumors account for approximately 35% of all gastrointestinal stromal tumors. Gastrointestinal bleeding is considered as one of the main clinical symptoms for SISTs. Capsule endoscopy has brought revolution in small bowel diagnostics, as it is considered the best method of visualisation of the entire small intestine. Besides, it is well tolerated by patients and is accompanied by a low number of complications. It is also indicated as the first diagnostic method in gastrointestinal bleeding of obscure origin, following negative upper endoscopy and colonoscopy. CASE REPORT: 2 patients (a male and a female, aged 58 and 69, respectively) presented with obscure gastrointestinal bleeding have been examined by capsule endoscopy after negative upper endoscopy and colonoscopy. Videorecords have been assessed in both cases by two independent experts. The capsule reached the Bauchin-valve in both cases during the 8 hours of the testing time and the entire small bowel was clearly visible. - Based on the capsule endoscopic images, for one of the two cases a tumor has been reported as the background of the small intestinal bleeding. In the other case we could mark the location of the bleeding, while we were unable to ascertain the type of the actively bleeding lesion during the test. In order to determine the accurate bleeding source double-balloon enteroscopy was performed in the second case. After surgery the histological and immunohistochemical tests have justified the presence of spindle cell GISTs. Taking into consideration the Fletcher-classification, for the tumor size and the mitotic index, both cases can be classified as a GIST of low malignant potential. CONCLUSIONS: An early diagnosis and application of a definitive therapy become possible by using capsule endoscopy, therefore the chance of survival of the patients might be increased.