8 WORLD GASTROENTEROLOGY NEWS NOVEMBER 2016 Editorial | Expert Point of View | Gastro 2016: EGHS-WGO | WDHD News | WGO & WGOF News | WGO Global Guidelines | Calendar of Events Endoscopy: The Future is Wireless, Indeed Advances in wireless technology of-fer innovative solutions for diagnostic and –potentially- therapeutic endos-copy. The development of capsule endoscopy allows the investigation of the gastrointestinal tract overcoming the limits of traditional instruments, more comfortably and less stressfully for the patient. Nowadays, a variety of wireless en-doscopes are available for the exami-nation of the small and large bowel, of the lower esophagus, and (if magneti-cally guided) even of the stomach. However, we have not reached yet the ultimate targets of this technology: mini-robots for pan-endoscopy and interventional endoscopy. The major obstacles to achieving these goals are limited battery power, lack of capsule control and guidance through the digestive tract, accurate localization of the ingested device, enhancement of image quality, and development of biopsy and drug delivery systems. Energy, energy, energy: the prereq-uisite to achieve the aforementioned goals. Today, the deliverable power supply to the capsules is about 25mW and it is estimated that future mini-robots will require more than 550mW to fulfill our expectations. Therefore, we must either increase power sup-ply or develop new technology that requires minimum energy to perform the required tasks. Many innovative solutions are un-der investigation ex-vivo to overcome the limited battery life of the com-mercially available capsules. Among them, the wireless power transmission technology that transfers power from a transmitter (outside of the body) to a receiver (within the capsule) in the form of electromagnetic waves based on inductive coupling is the most promising solution for the delivery of safe, stable, and sufficient energy. 1 While a portable transmitter has re-cently been developed, 2 issues such as misalignment between the transmit-ter and receiver magnetic fields and efficient power transmission through biological tissues need to be solved and successful testing in humans is pending. On the other hand, taking advantage of nanotechnology medi-cine, new miniature devices incorpo-rated in capsules and new technolo-gies like the field programmable gate array (FPGA) and the application-specific circuit (ASCI) are expected to consume less energy. Indeed, an ASCI based prototype micro-robot has been shown to consume less energy than the commercially available capsules. 3 The mobility, localization, and orientation of wireless capsules in the digestive tract are unpredictable and largely undetectable (the latter two), so far. The active locomotion sys-tems under development are divided in those with internal (within the capsule), external, and mixed actua-tors. 4 Within the first group, friction force based mechanisms (worm-like, paddle/legged, crawler mobility) predominate; however, high energy requirements, “hostile” shape for the intestine, and capture of the majority of the endoscope space make their use questionable. The future of the active locomo-tion of the wireless robot seems to be the magnet. External locomo-tion actuators take advantage of an Konstantinos Triantafyllou, MD, PhD, FEBGH Assistant Professor of Gastroenterology Chrysoula Malli, MD Consultant Gastroenterologist Hepatogastroenterology Unit, Second Department of Internal Medicine – Propaedeutic Research Institute and Diabetes Center, Medical School, National and Kapodistrian University of Athens, ‘‘Attikon” Univer-sity General Hospital Athens, Greece NOW ONLINE - E-WGN EXPERT POINT OF VIEW ARTICLES COLLECTION! Did you enjoy this expert point of view article? We invite you to check out the entire collection of Scientific and Ex-pert Point of View articles from e-WGN from the past five years on the new WGO website. You can view this article and more at www.worldgastroenterology.org/publications/e-wgn/e-wgn-expert-point-of-view-articles-collection.
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