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Endosc Int Open 2016; 04(04): E466-E471
DOI: 10.1055/s-0042-104115
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Evaluation of the tip-bending response in clinically used endoscopes

Esther D. Rozeboom
1   Department of Robotics and Mechatronics, University of Twente, Enschede, the Netherlands
,
Rob Reilink
2   DEMCON Advanced Mechatronics, Enschede, the Netherlands
,
Matthijs P. Schwartz
3   Department of Gastroenterology and Hepatology, Meander Medical Center, Amersfoort, the Netherlands
,
Paul Fockens
4   Department of Gastroenterology and Hepatology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
,
Ivo A. M. J. Broeders
1   Department of Robotics and Mechatronics, University of Twente, Enschede, the Netherlands
5   Department of Surgery, Meander Medical Center, Amersfoort, the Netherlands
› Author Affiliations
Further Information

Publication History

submitted 17 January 2016

accepted after revision 12 February 2016

Publication Date:
30 March 2016 (online)

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Background and study aims: Endoscopic interventions require accurate and precise control of the endoscope tip. The endoscope tip response depends on a cable pulling system, which is known to deliver a significantly nonlinear response that eventually reduces control. It is unknown whether the current technique of endoscope tip control is adequate for a future of high precision procedures, steerable accessories, and add-on robotics. The aim of this study was to determine the status of the tip response of endoscopes used in clinical practice.

Materials and methods: We evaluated 20 flexible colonoscopes and five gastroscopes, used in the endoscopy departments of a Dutch university hospital and two Dutch teaching hospitals, in a bench top setup. First, maximal tip bending was determined manually. Next, the endoscope navigation wheels were rotated individually in a motor setup. Tip angulation was recorded with a USB camera. Cable slackness was derived from the resulting hysteresis plot.

Results: Only two of the 20 colonoscopes (10 %) and none of the five gastroscopes reached the maximal tip angulation specified by the manufacturer. Four colonoscopes (20 %) and none of the gastroscopes demonstrated the recommended cable tension. Eight colonoscopes (40 %) had undergone a maintenance check 1 month before the measurements were made. The tip responses of these eight colonoscopies did not differ significantly from the tip responses of the other colonoscopes.

Conclusion: This study suggests that the majority of clinically used endoscopes are not optimally tuned to reach maximal bending angles and demonstrate adequate tip responses. We suggest a brief check before procedures to predict difficulties with bending angles and tip responses.

 

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