Boğaziçi University Department of Mechanical Engineering and Institute of Biomedical Engineering started a project aimed to develop a medical device that will cut down the time needed for a colonoscopy by half and minimize the pain a patient may experience after the procedure. With the robotic colonoscopy device to be developed as a first in Turkey, the project is expected to alter the commonly used method of colonoscopy. The project is supported by TUBITAK (The Scientific and Technological Research Council of Turkey).
An important contribution to medicine from Turkey
There are nearly one million people diagnosed with colon or colorectal cancer (CRC) worldwide each year and 500,000 deaths. According to data collected in 12 cities in 2007-2008 by the Active Cancer Registration System of the Turkish Ministry of Health (http://kanser.gov.tr/Dosya/Bilgi-Dokumanlari/raporlar/kolorektal.pdf), CRC is the third most common cancer observed in women, representing 7.8% of all cancer cases in women, and fourth in men with 7.5% of all cancer cases. With the innovative device being developed at Boğaziçi University, robotic technology will be used for the first time in colonoscopy, a procedure commonly used for the detection and treatment of colon and colorectal cancer.
People aged 50 and over are recommended to have a colonoscopy every 10 years. At present, a thin, long, flexible tube with a small video camera on the end is used to inspect the whole colon and the lower part of the small intestine and take pictures or a video of the colon. The patient is anesthetized during the procedure. If cancerous cells are detected, the same device can also collect tissue samples for a biopsy. The procedure that lasts between 30 minutes to one hour is difficult for the doctor and painful for the patient. During the procedure the doctor has to watch the screen where the camera images are reflected and maintain hand-eye coordination. Moreover, there may be some complications during colonoscopy; for example the scope may perforate or tear the lining of the colon, which causes pain. Colonoscopy, therefore, is a procedure for which most people have reservations.
Diagnosis of cancer will be faster
With the new device, Boğaziçi University will bring a new approach to colonoscopy. Assistant Professor Evren Samur of Boğaziçi University Department of Mechanical Engineering and his team are aiming to develop a robotic colonoscopy device that will make the procedure faster and pain free. Samur summarizes the disadvantages of the classic colonoscopy procedure: “It is a routine procedure. The Ministry of Health recommends the procedure to be performed routinely; therefore, the number of patients is quite high. On the other hand, the procedure lasts long; a doctor can perform 8 to 10 procedures a day, so the demand cannot be met. However, if the procedure time is reduced by half, more patients can be served in one day and the cancer will be detected earlier.”
In the new project, a balloon replaces the thin, long, flexible tube. As the balloon fills with air, it adopts the shape of the intestine and advances along the colon. The new device will eliminate the discomfort experienced by the patient. Moreover, it has been designed as a robotic system. The doctor will no longer have to stand by the patient but sit at a more comfortable place and remotely control the device. As such, it will be the first robotic device in the world to be used in the field of colonoscopy.
Pain free and fast colonoscopy
Samur described how the project started: “The demand came from doctors,” he explained. “The procedure lasted long, and hand-eye coordination was difficult. I was a student in the PhD program when we received a request to develop a robotic colonoscopy device. At present there are several groups doing research on robotic colonoscopy but there is no colonoscopy robot that has been clinically tested and turned into a product yet.” About two years ago Samur and one of his students began thinking and developing ideas on the issue. When the balloon system took shape, he conducted an experiment on a small prototype in the lab, taking the first steps in the project. The experiment was successful; currently the necessary planning has been completed and the patent application has been filed under PCT, the internationally accepted Patent Corporation Treaty. Since June 2016, the project has been supported by TUBİTAK 1003 program, with funding of 2 million TL. The work is expected to be completed in three years.
All the research within the framework of this project is being carried out at BU, using the infrastructure of the Department of Mechanical Engineering and the Center for Life Sciences and Technologies. Acıbadem University is the medical advisor and also carries the responsibility for the tests to be run during the last year of the project. A company named Simeks Medical has been providing support in the production of the balloon system.
During the last year of the project, the final prototypes will be trialed first on plastic mannequins and then on pigs. The experiments have been approved by the Ethics Committee. If the experiments to be conducted by Acıbadem University prove to be successful, the project will move on to the next stage after getting the necessary international licensing. Samur and his team aim to turn the robotic colonoscopy device they have designed into a manufacturable product.
The following persons participate in the project led by Boğaziçi University:
- Asst. Prof. Evren Samur, Department of Mechanical Engineering (Project Director)
- Asst. Prof. Özgür Kocatürk, Institute of Biomedical Engineering (Researcher)
- Prof. Cengizhan Öztürk, Institute of Biomedical Engineering (Advisor)
- Cem Tutcu ve Onur Mert Erkan (PhD Degree students)
- Prof. Nurdan Tözün, School of Medicine, Head of Internal Medicine Department (Sub project Director)
- Asst. Prof. Emin Aksoy, Department of Medical Engineering (Researcher)
- Dr. Dilek Kitapçıoğlu, Acıbadem CASE (Researcher)
- Dr. Pelin Çelikbilek Erkasap, Acıbadem CASE (Researcher)
Simeks Medical Products:
- Özgür Karadeniz, Production and R&D Director (Sub project Director)
- Yalın Dermanlı, R&D Engineer (Researcher)
- Eda Yılmaz, R&D Engineer (Researcher)