LoCoMoTE: Low Cost Morphable Teleoperated Endoscope for Gastric Intestinal Tract Screening

Existing technologies are unable to meet China's endoscopic gastrointestinal (GI) screening needs, due to its large, aging population, insufficient infrastructure and high incidence of GI cancers. To address this challenge, we propose a novel and low cost soft endoscope, together with high-speed wireless communications to create a way to perform regular endoscopic screening programs in China.
The soft endoscope will be able propel itself inside torturous, compliant environments, such as the human gastrointestinal tract, and dramatically reduce the pain associated with conventional endoscopes. Because of the self-propelling feature and the inherent safety of using soft material, the new endoscope can be operated by non-specialist staff with minimal training and be supervised or even controlled remotely by specialist clinicians with wireless communication. The endoscope will be operated by clinicians via a custom made haptic interface. The endoscope itself will be made to be low cost and disposable. Therefore, this will enable rural medical clinics to run regular endoscopic screening programs with the system, as it will require no additional sterilisation facilities and will be easy to learn to use.
To facilitate adoption and to provide support for rural clinicians, the endoscope will be connected to a high-speed 5G wireless that will enable haptic tele-operation. Through this, expert clinicians in large hospitals all over the country will be able to monitor and directly control screening procedures from any location. Experts will therefore be able to train rural clinicians in techniques by physically demonstrating them, support rural clinics to ensure accurate diagnosis and allow experts to perform more complex procedures remotely. Aligning well with China's strategy of starting 5G commercial applications in 2020, this approach is timely and takes advantage of the wide-spread availability of wireless internet in China and deals directly with the challenges faced by efforts to create large-scale endoscopic screening programs in the country.

The global market for flexible endoscopes for performing GI screenings and surgeries is substantial and continues to grow. In 2013, over 10 million diagnostic GI endoscopies were performed with flexible endoscopes worldwide, including gastroscopies and colonoscopies. In the same year, the global endoscopy market produced a total revenue of 26 billion USD, 7 billion of which was from flexible endoscopy alone.
This new soft endoscope offers several key advantages not only over traditional endoscopes, but also over other robotic endoscopy products. The main advantages include effective self-propulsion and safe interaction, and simple design, addressing the unmet challenges in colonoscopy, and dramatically improving the efficiency and comfort of the procedure.
The real beauty of the teleoperation system is in how it creates an internet of skills, connecting large numbers of clinicians together and allowing them to share their skills and knowledge. Even in a large city hospital, there are only so many experts that are on hand to provide assistance when needed. With this teleoperation system, clinicians will have access to experts from potentially thousands of hospitals, instantly. This will dramatically increase the efficiency of endoscopic clinics and simultaneously disseminate skills and knowledge. Thus, it will not only allow patients to have better access to quality endoscopic screenings, but it will create more skilled clinicians to perform those screenings over time. This, therefore, has the potential to solve both the problem of availability of endoscopic screening and the skill shortage.
This proposal has demonstrated the necessity, vision and ambition of this project. The impact of this project has the potential to change the lives of millions of Chinese people for the better, engender development of crucial medical skills and advance the fields of robotic medicine considerably. This will not require unrealistic leaps in technological innovation; this will not require immense resources. This is possible due to a confluence of circumstances in China and technological development that has created an opportunity. This proposal seeks to seize this opportunity and, in so doing, improve the welfare of the Chinese people and push the frontiers of robotic medicine to a new and exciting level.