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After 60 Years, Finally Redesigning the Endoscope for Low-Income Countries

April 17, 2019 By Tierney King

An endoscope that would originally cost over $90,000 to manufacture, could essentially cost $45 with a new, prototype endoscope.

The redesign of this critical healthcare tool has the potential to impact cancer screening in low to middle income countries. Normally, the cost of cancer screening equipment is so high, low income places can’t afford to utilize these tools.

An endoscope’s job consists of visualizing the inside of the upper part of the digestive tract for signs of oesophageal or stomach cancer. The prototype endoscope could transfer between patients without needing to be sterilized between each patient. This is because the part that is inserted into the gut is tossed after each procedure.

The engineers who created the device say the disposable component will cost approximately $2 per patient.

Lead engineer of the prototype is Pietro Valdastri, Professor of Robotics and Autonomous Systems at the University of Leeds. Valdastri says endoscopes have essentially remained unchanged for almost 60 years. Now, instead of a complex system, the prototype is pneumatically operated.

The device consists of a hand-held control column and the disposable section, which is a narrow silicon tube and a tiny capsule that houses the camera. Called the pill camera because of its size, the engineers hope to eventually reduce its size to 8 mm. When the procedure is finished, the silicon tubing and camera housing are disposed.

“Cancer of the stomach and oesophagus have the highest global mortality rates,” says Valdastri. “Screening programs in many low-to-middle income countries are non-existent or ineffective because endoscope facilities are few-and-far between. Conventional endoscopes require cleaning between patients and that requires a dedicated sterilization suite adding to the costs of the procedure. The new device is designed for use in locations where healthcare facilities are more basic, perhaps outside of a hospital setting.”

In the next steps, the engineers will test the low-cost device’s effectiveness and compare it to conventional endoscopes.

Overall, Valdastri says this could significantly impact China, where in 2015 more than one million people were diagnosed with gastric and oesophageal cancer. China struggles with a shortage of doctors which could correlate with the lack of screening programs implemented.

“Screening is effective at picking up the early signs of these cancers and there is an urgent need to develop technology which opens up these crucial checks to poorer populations,” Valdastri says.

Although the prototype cannot take biopsies like other, more expensive endoscopes, the prototype is smaller so patients don’t often need to be sedated. Additionally, the material of which it’s made from, silicone, is less likely to cause damage to tissues in the upper digestive tract. Valdastri hopes this device will come to fruition within the next four years.

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