Hydroflotation magnetic-aided endolumenal navigation-preliminary platform in ex-vivo setting for the next paradigm in minimally invasive urologic surgery.

BACKGROUND AND PURPOSE: Navigation of endolumenal devices, such as image rendering capsules, have been described for diagnostic purposes in the animal, and more recently, human models. In urology, the ureter is a prime lumenal structure that often needs to be explored for diagnostic and therapeutic purposes. A novel device using a flotation mechanism in a water-filled environment was developed and its navigation achieved with magnetic-aided guidance. The device was tested for propulsion and real-time control in the ex-vivo setting.

MATERIALS AND METHODS: An endolumenal bionic worm (EBW) with a magnetic core was developed and introduced into synthetic lumens (SL) and supermarket chicken lumenal structures. The latter involved the gastrointestinal lumenal tissue of supermarket chickens; ie, the ex-vivo equivalent of a ureteral substitute lumen (USL). Navigation was graded by achievement of the EBW in propulsion to premarked sites, ability to remain static when necessary, and trauma to the USL. The structures were observed under the microscope for breech after the exercises. Navigation was observed in 10 SLs and 10 USLs.

RESULTS: The EBW was successfully steered using the magnetic guidance system with hydroflotation. Observation of endolumenal surfaces did not reveal evidence of trauma in either model.

CONCLUSION: Hydroflotation magnetic-aided endolumenal navigation (HMAEN) of a microdevice was achieved endolumenally with targeted real-time control and with no observed trauma to the structures. HMAEN could potentially be used to guide devices like the EBW to permit diagnostic and therapeutic ureteroscopy including biopsy of ureteral and renal pelvis lesions, thus ushering in the platform for the next paradigm in endolumenal urologic procedures.