Endoscopic Mucosal Resection Device with Deployable Cutting Arms
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Solution Overview
Problem
Existing endoscopic mucosal resection (EMR) techniques face challenges in completely removing suspect tissue from the gastrointestinal tract without penetrating the muscularis layer, due to difficulties in removing the entire suspect region and the risk of muscularis penetration during cutting.
Innovation Solution
An improved EMR device with deployable cutting elements on moveable arms, allowing for precise incision and resection between the mucosa and submucosa layers without penetrating the muscularis, using a scissor-like action for blunt dissection and controlled deployment of cutting elements to cut through the mucosa away from the muscularis.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Device complexity
If traditional snare and forceps EMR technique is used to grasp and lift the lesion, then the procedure can be performed with simple equipment, but complete removal of the suspect region becomes difficult and the risk of penetrating the muscularis increases
Solution Approach 1:
The EMR device divides the cutting function into multiple deployable cutting elements positioned on moveable arms, allowing the suspect tissue to be resected in controlled segments rather than requiring a single complex snare maneuver. This segmentation enables complete removal while maintaining equipment simplicity.
Solution Approach 2:
The moveable arms with deployable cutting elements serve as intermediaries between the endoscope and the suspect tissue, providing precise control over the resection process. These intermediaries allow the cutting elements to be positioned and deployed exactly where needed, ensuring complete removal without penetrating the muscularis.
2Device complexity
If traditional snare and forceps EMR technique is used to grasp and lift the lesion, then the procedure can be performed with simple equipment, but the risk of penetrating the muscularis during cutting increases
Solution Approach 1:
The EMR device performs preliminary positioning of multiple cutting elements on moveable arms before making the actual cut. This preliminary action allows the physician to plan the resection path in advance, ensuring that the cutting elements will cut through the mucosa and submucosa without penetrating the muscularis, while still using relatively simple equipment.
Solution Approach 2:
The device provides visual feedback through the endoscope to show the position of the cutting elements relative to the tissue layers. This feedback mechanism allows the physician to monitor the cutting process in real-time and adjust the deployment of cutting elements to avoid penetrating the muscularis, maintaining equipment simplicity while reducing risk.
3Reliability
If deployable cutting elements on moveable arms are used for precise incision, then complete removal of suspect tissue is achieved, but the device complexity increases
Solution Approach 1:
The moveable arms with cutting elements are nested within the endoscope shaft, allowing the complex resection mechanism to be contained within a relatively simple endoscope structure. The cutting elements can be deployed from the nested configuration to perform the resection, then retracted back into the shaft, maintaining a compact overall device structure.
Solution Approach 2:
The moveable arms provide dynamic positioning capability, allowing the cutting elements to be deployed and repositioned as needed during the procedure. This dynamic capability enables complete removal of irregularly shaped suspect tissue while keeping the base device structure relatively simple, as the complexity is confined to the moveable components.
4Object-affected harmful factors
If deployable cutting elements on moveable arms are used for controlled cutting, then the risk of muscularis penetration is reduced, but the device complexity increases
Solution Approach 1:
The cutting elements are designed with local quality variations, having different geometries and deployment characteristics suited for specific positions and tissue depths. This local optimization allows controlled cutting at the mucosa-submucosa interface without penetrating the muscularis, while the overall device structure remains relatively simple due to the modular nature of the cutting elements.
Data Source
AI summary
A method for resecting tissue from an organ of a patient, the organ being comprised of at least a first layer, a second layer and a third layer, the method including the steps of providing an EMR device with access to the organ, the EMR device including at least one deployable cutting element disposed on at least one moveable arm, identifying a target tissue area for resection, forming an incision through the first and second layers without penetrating the third layer, positioning the EMR device through the incision such that the device is positioned between the first third layers, advancing the moveable arm between the first and third layers, deploying the cutting element such that the cutting element is advanced in the direction of the first layer and away from the third layer and, while the EMR device is positioned between the first and third layers, cutting through the first layer.