Bariatric reduction system - BARS: device, technique and first clinical experience.

Background: Roux-en-Y gastric by-pass (RYGB) is one of the most effective bariatric procedures, but the rate of weight regain (WR) can reach 63% after the second year. Enlargement of the gastrojejunal anastomosis is one of the reported causes. A newly CE-marked flexible endoscopic system, Bariatric Anastomotic Reduction System (BARS) (Ovesco Endoscopy, Tuebingen, Germany), derivative of the well-established endoscopic over-the-scope-clip (OTSC) clipping system, has been recently developed.

Predictive Tilt Compensation for Robot Assisted Magnetic Capsule Endoscope.

Wireless capsule endoscopes provide a painless and non-invasive alternative to the flexible endoscope in various applications of the gastrointestinal tract diagnosis. Operating a wireless capsule endoscope in the colon may benefit from an active position control as the large colon diameter can lead to uncontrollable and unpredictable capsule trajectory. Robot assisted magnetic steering is an attractive technique that is being explored by researchers worldwide.

Ontology-based specification and generation of search queries for post-market surveillance.

Background: The vigilant observation of medical devices during post-market surveillance (PMS) for identifying safety-relevant incidents is a non-trivial task. A wide range of sources has to be monitored in order to integrate all accessible data about the safety and performance of a medical device. PMS needs to be supported by an efficient search strategy and the possibility to create complex search queries by domain experts.

Pre-clinical study on a telemetric gastric sensor for recognition of acute upper gastrointestinal bleeding: the "HemoPill monitor".

Background: Acute upper gastrointestinal bleeding is a life-threatening medical condition with a relevant risk of re-bleeding even after initial endoscopic hemostasis. The implantable HemoPill monitor contains a novel telemetric sensor to optically detect blood in the stomach allowing the surveillance of high-risk patients for re-bleedings.

Methods: In this pre-clinical porcine study, bleeding has been simulated by injecting porcine blood into the stomach of a pig through an implanted catheter using a syringe pump.

Efficacy of the OTSC System in the treatment of GI bleeding and wall defects: a PMCF meta-analysis.

Since its market launch in 2007, the endoscopic OTSC clipping system has been the object of intensive clinical research. These data were systematically collected for post-market clinical follow-up (PMCF). The aim of the study was the systematic review of the efficacy and safety of the OTSC System.

Preclinical evaluation of a novel thermally sensitive co-polymer (LiftUp) for endoscopic resection.

Endoscopic resection techniques can successfully resect large lesions either in "en bloc" fashion or in "piece-meal" technique by using a submucosal injection solution. The aim of this study was to evaluate the safety of a novel injectable, containing thermally sensitive co-polymer from ethylenoxide and propylenoxide (LiftUp) used as submucosal injection solution. We conducted an animal trial in the porcine model to evaluate the LiftUp gel in a preclinical setting and to study the effectiveness of mucosal lifting and the safety of the new injectable.

Efficacy and safety of the remOVE System for OTSC and FTRD clip removal: data from a PMCF analysis.

Introduction: The remOVE System (Ovesco Endoscopy AG, Tuebingen, Germany) is a medical device for the endoscopic removal of OTSC or FTRD clips (Ovesco Endoscopy AG, Tuebingen, Germany). The aim of this paper is to assess the efficacy and safety of this system.

Material And Methods: A total of 74 patients underwent clip extraction.

Future of robotic surgery in urology.

Objectives: To provide a comprehensive overview of the current status of the field of robotic systems for urological surgery and discuss future perspectives.

Materials And Methods: A non-systematic literature review was performed using PubMed/Medline search electronic engines. Existing patents for robotic devices were researched using the Google search engine.

Telemetric real-time sensor for the detection of acute upper gastrointestinal bleeding.

Acute upper gastrointestinal bleedings from ulcers or esophago-gastric varices are life threatening medical conditions which require immediate endoscopic therapy. Despite successful endoscopic hemostasis, there is a significant risk of rebleeding often requiring close surveillance of these patients in the intensive care unit (ICU). Any time delay to recognize bleeding may lead to a high blood loss and increases the risk of death.

Laparoscopic gastro-jejunal anastomosis using novel r2 deflectable instruments in an ex vivo model.

Objective: A novel 5 mm steerable instrument system (r2-DRIVE) was developed with active tip deflection and tip and shaft rotation. The feasibility and training effect of the r2 instruments were determined in a phantom model.

Material And Methods: Experienced laparoscopic surgeons and untrained novices performed laparoscopic gastro-jejunal anastomoses using porcine tissue and r2 DRIVE-instruments.

Design and Performance of a Low-Cost Telemetric Laparoscopic Tactile Grasper.

Tactile feedback is completely lost in laparoscopic surgery, which would provide information about tissue compliance, texture, structural features, and foreign bodies. We developed a system with artificial tactile feedback for laparoscopic surgery that consists of a telemetric tactile laparoscopic grasper, a remote PC with customized software, and a commercial video-mixer. A standard, nonsensorized laparoscopic grasper was customized to allow the integration of a tactile sensor and its electronics.

Porcine survival model to simulate acute upper gastrointestinal bleedings.

The existing animal models used for the simulation of acute gastrointestinal bleedings are usually non-survival models. We developed and evaluated a new porcine model (domestic pig, German Landrace) in which the animal remains alive and survives the artificial bleeding without any cardiovascular impairment. This consists of a bleeding catheter which is implanted into the stomach, then subcutaneously tunnelled from the abdomen to the neck where it is exteriorized and fixed with sutures.

A miniaturized robotic platform for natural orifice transluminal endoscopic surgery: in vivo validation.

Background: Natural orifice transluminal endoscopic surgery (NOTES) involves accessing the abdominal cavity via one of the body natural orifices for enabling minimally invasive surgical procedures. However, the constraints imposed by the access modality and the limited available technology make NOTES very challenging for surgeons. Tools redesign and introduction of novel surgical instruments are imperative in order to make NOTES operative in a real surgical scenario, reproducible and reliable.

Single-port live donor nephrectomy using a novel Curved Radius r2 Surgical System in an in vivo model.

Objective: Single-port laparoscopic donor nephrectomy provides low morbidity and satisfactory cosmetic results for patients. The aim of this animal study was to establish a surgical technique of single-site (LESS) living donor nephrectomy using novel curved r2 CURVE manipulators specially designed for single-port access.

Material And Methods: A total of six LESS nephrectomies were performed in three female pigs.

Endoscopic full-thickness resection and clip defect closure in the colon with the new FTRD system: experimental study.

Background: The benefit of endoscopic full-thickness resection is the improved diagnostic work-up with an integral wall specimen which allows a precise determination of the tumor or its precursor and its infiltration depth into the wall.

Materials And Methods: A new endoscopic full-thickness resection device (FTRD), which is a combination of a modified over-the-scope-clip (OTSC) system with an electrocautery snare, has been tested in an experimental setting. In eleven pigs, divided into three groups, endoscopic full-thickness resection was performed in the colon at one or two sites, respectively.

25 years of SMIT: the past, the present, and the future of minimally invasive therapy.

A quarter of a century has passed since the Society of Minimally Invasive Therapy (SMIT) was founded in 1989 with the aim to provide a platform to promote the development of minimally invasive therapy and the new instruments and devices needed to carry out the new surgical techniques. Both the founder of the society, British urologist John EA Wickham, and the German surgeon Gerhard F Buess, who was one of the leading members from the beginning, conceived SMIT as an interdisciplinary forum to promote the cooperation between physicians from various surgical specialties, but also medical engineers, resp. medical device manufacturers, whose expertise was needed to build the instruments that had to be developed to carry out the new concept of surgery.

European research on wireless endoscopy--the VECTOR project.

Within the European VECTOR project, various technologies to enhance the current field of capsule endoscopy towards screening of colorectal cancers and its precursors, and enhanced diagnostic and therapeutic functionalities have been developed. Among others, this includes technologies for active locomotion, wireless therapy and detection of gastrointestinal bleeding. The VECTOR project has contributed to the trend to develop novel procedures for improved diagnosis and treatment of gastrointestinal diseases.