A balloon endomicroscopy scanning device for diagnosing barrett's oesophagus

摘要

Confocal endomicroscopy can be used for identification of early mucosal dysplasia in various gastrointestinal conditions, and has particular potential in the monitoring of Barrett's oesophagus and the early stages of oesophageal cancer. However, it can be difficult to systematically scan a significant area of the oesophagus because of the small field-of-view and limited flexibility of the probe. Tissue deformation and inconsistent probe-tissue contact also make it difficult to form large mosaics. A mechanical scanning device is therefore desirable for controlled, large area surface scanning and mosaicing of the oesophagus. This paper proposes a robotic catheter encapsulated in an inflatable balloon, providing stable scanning over the oesophageal surface. It has an outer diameter of 3 mm, making it suitable for deployment through an endoscope working channel, and uses a custom endomicroscopy probe based on a leached flexible fibre bundle and an external confocal laser scanning system. Detailed mechanical performance and image quality evaluations were performed to assess the clinical potential of the device. In ex vivo studies using swine oesophagus, long helical scans were obtained, demonstrating that the device is able to scan the lumen stably and maintain good probe-tissue contact. The experimental results demonstrate the potential of the robotic catheter for systematic high-resolution imaging of the oesophageal mucosa, potentially reducing or even eliminating the need for physical biopsy.