Gastrointestinal (GI) disease is the third most common cause of death, the leading cause of cancer death, and the most common cause of hospital admission. The burden of GI disease in the UK is heavy for patients, the National Health Service (NHS), and the economy. Endoscopy plays a vital role in the diagnosis of GI disorders, and the demand for GI endoscopy has doubled in the past 5 years, with on-going growth of 6.5% per annum predicted by the NHS (Scoping the Future, Cancer Research UK, 2015).
Since its introduction into clinical practice 15 years ago, capsule endoscopy has become established as the primary modality for examining the surface lining of the small intestine, an anatomical site previously considered to be inaccessible to clinicians. However, its reliance on peristalsis for passage through the intestine leads to significant limitations, in particular due to the unpredictable and variable locomotion velocity. Significant abnormalities may be missed, due to intermittent high transit speeds that lead to incomplete visualisation of the intestinal surface. Furthermore, each case produces up to 100,000 still images, from which video footage is generated, taking between 30 and 90 minutes for the clinician to examine in its entirety. The procedure is therefore considered both time-consuming and burdensome for clinicians.
There is, therefore, in GI endoscopic practice a desperate need for new modalities that are safe, painless, accurate, reliable and disposable, and which require minimal training for practitioners. This project attempts to find the way to adapt the vibro-impact self-propulsion technique into capsule endoscopy, and to explore the feasibility of innovation for the next generation of endoscopy: the self-propelled capsule endoscopy.
Dr Yang Liu is an early-career researcher with a research background in applied dynamics and control, who has focused on developing this self-propulsion technique for different engineering systems. The nature of his applied research urges him to transfer any research findings into practical applications, and capsule endoscopy is one of the core deliverable areas for which the technique can make a revolutionary breakthrough. This requires to equip Dr Liu with the necessary clinical experience and knowledge to transfer his engineering research technologies into the healthcare domain. Therefore, the aims of the proposed discipline hop are: (1) to widen his healthcare technologies' expertise and clinic experience, (2) to embed his research into healthcare technologies, (3) to initiate the development work of the self-propelled capsule endoscopy, and (4) to build a long-lasting working relationship with clinicians, initially in the local NHS hospital, and later worldwide.
The approach for Dr Liu to realize this ambitious goal is: 1) to undertake a 6 month discipline hop, learning, observing and being trained in the Endoscopy Department at the Royal Devon & Exeter NHS Foundation Trust; 2) to refine research questions and develop potential solutions; and 3) to fully understand the development cycle of implementing such technique in healthcare sector, including the key activities at the stages of Translational Development, Clinical Evaluation and Regulatory Approval, and Adoption and Diffusion.
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