Disruptive solution of medical endoscopy mu kuzuula n’okujjanjaba ebizimba okugatta

1、 Tekinologiya ow’okumenyawo okuzuula ebizimba amangu

(1) Okukebera ebifaananyi mu molekyu (Molecular Imaging Endoscopy).

Okutaataaganyizibwa mu tekinologiya:

Ebipima ebitunuuliddwa ebitangaaza, nga obubonero bwa EGFR antibody Cy5.5, mu ngeri ey’enjawulo bisiba ku kookolo w’olubuto nga bukyali (sensitivity 92% vs white light endoscopy 58%).

Confocal Laser Microendoscopy (pCLE): Okwetegereza mu kiseera ekituufu eky’obutoffaali obutali bulungi ku 1000x magnification, nga okuzuula obutuufu bwa 95% ku kookolo w’omumwa gwa Barrett.

Omusango gw’obujjanjabi:

Ekitongole kya National Cancer Center of Japan kyakozesa 5-ALA induced fluorescence okuzuula ebiwundu bya kookolo w’olubuto nga bukyali<1mm.

(2) Enkola y’okuzuula obulwadde eyambibwako AI mu kiseera ekituufu

Okussa mu nkola mu ngeri ey’ekikugu:

Enkola z’okuyiga okw’obuziba nga Cosmo AI ziwandiika mu ngeri ey’otoma ku polyps mu kiseera ky’okukebera colonoscopy, ekivaamu okweyongera kwa 27% mu adenoma detection rate (ADR).

Ultrasound endoscopy (EUS) nga egattibwa ne AI okwawula akabi akabi ak’ebizimba by’olubuto (AUC 0.93 vs expert 0.82).

2、 Revolutionary solution ku bujjanjabi obutuufu obutayingira mu mubiri

(1) Okulongoosa mu ngeri ey’amagezi enkola y’okusalako endoscopic submucosal dissection (ESD) .

Okukulaakulana mu tekinologiya:

3D optical topology imaging: Enkola ya Olympus EVIS X1 eraga enkola y’emisuwa egy’omunda mu kiseera ekituufu, ekendeeza ku kuvaamu omusaayi ebitundu 70%.

Nanoknife assisted ESD: Irreversible electroporation (IRE) obujjanjabi bw’ebiwundu ebiyingira mu binywa eby’omunda, okukuuma obulungi bw’enzimba obuzito.

Ebikwata ku bulungibwansi:

(2) Obujjanjabi obw’emirundi esatu obuyitibwa endoscopic ultrasound radiofrequency ablation (EUS-RFA).

Okugatta tekinologiya:

Radiofrequency electrode yayingizibwa mu 19G puncture needle, era kookolo w’olubuto n’aggyibwako wansi w’obulagirizi bwa EUS (the local control rate was 73% ≤ 3cm tumor).

Okugatta eddagala eritikkiddwa nano bubbles (nga paclitaxel perfluoropentane) okutuuka ku kugatta "observation treatment drug".

(3) Okusalako ennywanto z’omusaayi nga zilungamizibwa fluorescence

Ebifaananyi bya ICG ebiriraanye infrared:

Indocyanine green yafukibwa nga wabulayo essaawa 24 okulongoosebwa, era okukeberebwa mu endoscopic kwalaga nti sentinel lymph nodes mu kookolo w’olubuto (okuzuula omuwendo gwa 98%).

Ebiwandiiko okuva mu Yunivasite y’e Tokyo: Okusalako ennywanto ezitali za musingi kwakendeera ebitundu 40%, ate omuwendo gw’okuzimba omusaayi oluvannyuma lw’okulongoosebwa gwakendeera okuva ku bitundu 25% okutuuka ku bitundu 3%.

3、 Okulondoola oluvannyuma lw’okulongoosebwa n’okulabula okuddamu

(1) Okukebera omubiri mu mazzi (Liquid Biopsy Endoscopy).

Ebikulu mu by’ekikugu:

Kola okwekenneenya kwa ctDNA methylation ku sampuli za bbulawuzi eziyitibwa endoscopic brush (nga SEPT9 gene) okulagula obulabe bw’okuddamu (AUC 0.89).

Microfluidic chip integrated endoscopy: Okuzuula mu kiseera ekituufu obutoffaali bw’ekizimba obutambula (CTCs) mu mazzi ag’okunaaba mu lubuto.

(2) Enkola y’okussaako obubonero (absorbable marking clip system).

Obuyiiya mu tekinologiya:

Magnesium alloy clips zakozesebwa okulaga ku mabbali g’ebizimba (nga OTSC Pro), era okuvunda kwaliwo nga wayise emyezi 6 nga balongooseddwa. Okugoberera kwa CT kwalaga nti tewali bintu bikozesebwa.

Bw’ogeraageranya ne titanium clips: Okukwatagana kwa MRI kwalongooka ebitundu 100%.

4、 Enteekateeka y’okuyiiya ey’awamu ey’ebitongole ebitali bimu

(1) Okulongoosa mu ngeri ya endoscopic laparoscopic hybrid (Hybrid NOTES) .

Okugatta eby’ekikugu:

Okusalako ebizimba (nga kookolo w’omumwa gwa nnabaana) nga bayita mu nkola ey’obutonde ey’okukebera endoscopic, nga kugatta wamu n’okukebera omwalo gumu (single port laparoscopy) okusobola okusalako ennywanto z’omusaayi.

Ebiwandiiko okuva mu Peking University Cancer Center: Obudde bw’okulongoosebwa bwakendeera ebitundu 35%, omuwendo gw’okukuuma ennywanto gwalinnya okutuuka ku bitundu 92%.

(2) Obujjanjabi bwa pulotoni okutambulira mu endoscopic

Okussa mu nkola mu ngeri ey’ekikugu:

Okuteekebwa mu endoscopic kwa zaabu tags+CT/MRI fusion, okulondoola okutuufu okwa kookolo w’omumwa gwa nnabaana okusengulwa n’ekitangaala kya proton (ensobi<1mm).

5、 Endagiriro za tekinologiya mu biseera eby’omu maaso

(1) Endoscope ya DNA ya nanorobot:

"Origami robot" eyakolebwa Harvard University esobola okutwala thrombin okusiba obulungi emisuwa gy'omusaayi egy'ekizimba.

(2) Okwekenenya mu kiseera ekituufu mu metabolomics:

Endoscopic integrated Raman spectroscopy ekozesebwa okuzuula engalo ezikwata ku nkyukakyuka y’ebizimba (nga choline/creatine ratio) mu kiseera ky’okulongoosebwa.

(3) Okuteebereza okuddamu kw’obujjanjabi bw’abaserikale:

PD-L1 fluorescent nanoprobes (experimental stage) okulagula obulungi bw’obujjanjabi bwa kookolo w’olubuto obuziyiza endwadde.

Omulongooti gw’okugeraageranya emigaso gy’obujjanjabi

Ebiteeso by’ekkubo ly’okussa mu nkola

Ekifo ekikeberebwa kookolo nga bukyali: kirimu molecular fluorescence endoscopy n’enkola y’okuzuula kookolo eyambibwako AI.

Eddwaaliro ery’enjawulo erikwata ku bizimba: okuzimba ekisenge ekilongoosebwamu ekya EUS-RFA hybrid.

Okumenyawo okunoonyereza: Okukola ebikebera ebikwata ku bizimba (nga Claudin18.2 targeted fluorescence).

Tekinologiya ono avuga okuzuula n'okujjanjaba ebizimba mu mulembe gwa "precision closed-loop" okuyita mu kumenyawo okusatu okunene: okuzuula ku ddaala lya molekyu, okujjanjaba ku ddaala lya sub millimeter, n'okulondoola okw'amaanyi. Kisuubirwa nti omwaka 2030 we gunaatuukira, ebitundu 70% eby’obujjanjabi obw’omu kitundu ku bizimba ebigumu bujja kukulemberwa endoscopy.