Development of structured fabric-based endoscopic guiding sheath with tunable diameter and stiffness functions

Area of Science:

• Medical Devices
• Surgical Innovation
• Gastroenterology

Background:

• Flexible and continuum instruments offer advantages in Natural Orifice Transluminal Endoscopic Surgery (NOTES).
• Conventional endoscopic tools risk esophageal tissue damage, leading to complications in up to 15% of procedures like transgastric cholecystectomy.
• There is a need for improved endoscopic instruments to enhance safety and efficiency in NOTES.

Purpose of the Study:

• To develop and evaluate a novel structured fabric-based guiding sheath for NOTES.
• To create a device capable of dynamic diameter modulation and tunable stiffness.
• To assess the safety and efficacy of the guiding sheath in complex gastrointestinal navigation.

Main Methods:

• Development of a structured fabric construct for a guiding sheath.
• Implementation of pneumatic control systems for diameter and stiffness modulation.
• Phantom experiments to evaluate channel stability, radial expandability, and maneuverability.

Main Results:

• The guiding sheath provides a stable 15 mm internal working channel with radial expandability from 15 to 20 mm.
• Pneumatic control achieved a 7.3-fold increase in stiffness under negative pressure (0-80 kPa).
• Phantom studies confirmed consistent channel integrity and radial stability, securing instrument insertion.

Conclusions:

• The structured fabric-based guiding sheath significantly enhances endoscopic maneuverability and patient safety in NOTES.
• This innovative device has the potential to improve the safety and efficiency of procedures within the gastrointestinal tract.
• The tunable stiffness and dynamic diameter modulation address limitations of conventional endoscopic instruments.