New 3D Microendoscope- Analysis of How It Differs and Its Potential

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Thanks to medgadget for reporting on Massachusetts General Hospital investigators development of a three-dimensional miniature endoscope.  This is a topic near and dear to my heart since the first medical device development I did was on microendoscopes back in 1994.  This new scope is fundementally different from traditional scopes. 

As the press release reports:

Standard miniature endoscopic devices – which give physicians access to hard-to-reach internal organs and structures – utilize bundles of optical fibers to supply light to and transmit images from the areas of interest. Larger endoscopes that use image sensors to produce high-quality, two-dimensional images can be a centimeter or more in diameter. Existing miniature endoscopes using smaller fiber bundles may be more flexible but have difficulty producing high-quality images.

The new device developed at MGH-Wellman uses a technology called spectrally encoded endoscopy (SEE). Multicolored light from a single optical fiber – introduced through a probe about the size of a human hair – is broken into its component colors and projected onto tissue, with each color illuminating a different part of the tissue surface. The light reflected back is recorded, and the intensity of the various colors decoded by a spectrometer, which analyzes the wavelengths of light. Another device called an interferometer, which calculates structural information based on the interaction between two waves of light, provides the data required to create three-dimensional images.

Types of Scopes I Use and a Brief History of Microendoscopes:

As a fertility specialist, my surgical practice is almost entirely endoscopic.  Traditional endoscopes are simple telescopes with either a series of lenses or rod-lens combinations.  They require a large amount of light and are commonly in the 5 to 10 mm size range.  My work initially focused on the development of “microendoscopes” which I defined as those sub-5mm.  Standard lens scopes can be effectively made down to 3mm as surgical tools but become very fragile in this size and break easily.  The next innovation was the development of “fiberscopes”.  These telescopes consisted of a series of fiberoptic image and light carrying bundles with proximal and diatal lenses.  In some cases the distal lens was not convex but of the GRIN type.  I saw the scopes progressively improve from 1500 fibers to 15,000 to 30,000 then to 50,000.  Each successive generation yieded better resolution.  To a real extent these fibers where like pixels.  As the number of fibers went down the image became more pixelated and had poorer resolution and light throughput. 

One of the most exciting projects I worked on was the development of the “falloposcope” which was a 0.55 scope that could pass down the inside of the human fallopian tube and see fine scars that werte otherwise missed in women with infertility

My Use of Microendoscopes for Awake Surgery:

At this point, I began to use these scopes for office-based surgery under local or no anesthesia.  My idea was to reduce costs and speed recovery by using tiny telescopes to diagnose disease.  The concept caught on and I became the Director of the Yale Office Laparoscopy .  I was teaching twice monthly courses to doctors from around the world who eagerly adopted the technology.  I used a 2mm laparoscope which is still used today and then helped develop a 2mm hysteroscope to look inside the uterus.  These instruments were so small that the patients could be awake and watch my view of their insides as I operated! Our motto was “where the patient is a part of the surgical team”.  Here is a review of a new procedure I developed called “conscious pain mapping”. 

Fast Forward to Today:

I am very excited about recent reports of tiny scopes to look inside the breast or into the spine or into the brain.  I belive microendoscopes will continue to evolve. This report is impoin that this is a new type of endoscope that uses a different mechanism for providing the image.  The system allows radically smaller scopes and potentially provides a 3D image.  THis opens up the potential for remote imaging and for computer modification of the images- the two topics I belive define the future of endoscopic surgery.   

Check back on monday for major breaking news from docinthemachine of a new type of endoscope that makes invisible disease visible…..

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