Disruptive Solution of Medical Endoscopy in Pediatric Specialized Diagnosis and Treatment

1、 Special program for newborns and infants (0-1 years old)

(1) Ultra fine transnasal endoscopic system

Technological breakthrough:

1.8mm diameter gastroscope (such as Olympus XP-190): Inspect esophageal atresia through the nasal cavity of premature infants (≥ 2.4mm).

CO ₂ constant pressure infusion: maintain pressure<8mmHg to avoid gastric rupture (neonatal gastric wall thickness is only 1-2mm).

Clinical value:

Alternative X-ray imaging diagnosis of congenital esophageal atresia with radiation dose reset to zero.

The success rate of direct visualization enema for meconium intestinal obstruction has increased from 60% to 92%.

(2) Bronchoscopic bronchoalveolar lavage (BAL)

Micro bronchoscope:

Complete pathogen sampling of severe pneumonia using a 2.2mm working channel (such as Storz 27005K).

Comparison of blind testing: The detection rate of pathogens has increased from 40% to 85% (J Pediatr 2023).

2、 Innovative diagnosis and treatment for young children (1-3 years old)

(1) Magnetic controlled capsule endoscope

Technological innovation:

8mm swallowable capsules (such as CapsoCam Pediatric): controlled by an external magnetic field to redirect within the small intestine.

AI automatically identifies bleeding points in Meckel's diverticulum with a sensitivity of 94%.

Advantages:

Replace traditional colonoscopy and avoid general anesthesia.

(2) Painless cystourethroscope

Hydrogel lubrication technology:

The thermosensitive hydrogel containing lidocaine reduced the insertion pain (pain score decreased from 7 to 2).

The accuracy rate of diagnosing posterior urethral valve is 100%.

3、 Minimally invasive treatment for school-age children (3-12 years old)

(1) Modified version of transoral endoscopic myomectomy (POEM)

Pediatric adaptation:

A 1.9mm micro electric knife (such as Olympus KD-655) is used to treat achalasia.

The surgery time has been reduced from 90 minutes in the adult version to 35 minutes.

Therapeutic effect:

Eating resumed 48 hours after surgery, which is 5 days faster than traditional Heller surgery.

(2) Arthroscopic epiphyseal regulation

Technical highlights:

2.7mm arthroscopy (such as Arthrex NanoScope) guides the implantation of an 8-shaped steel plate.

The correction accuracy for treating knee valgus is 0.5 ° (traditional osteotomy has an error of about 3 °).

4、 Functional Preservation Program for Adolescents (12-18 Years Old)

(1) Endoscopic release of scoliosis

Technological breakthrough:

3mm single hole endoscope is used to cut the concave ligament (such as Joimax iLESSYS).

Combine magnetic growth rods (MAGEC) to reduce one open adjustment surgery per year.

(2) Endoscopic treatment of adolescent breast development

Fat dissolution technology:

1.6mm endoscopic assisted injection of phosphatidylcholine resulted in a 91% regression rate of male breast development.

5、 Intelligent and Comfortable Technology

(1) VR Distraction System

Technical implementation:

Wearing Meta Quest 3 during the examination showed interactive gaming, and the pain tolerance time was extended by three times.

(2) AI sedation depth monitoring

Pediatric Sedation Assistant：

Automatic adjustment of propofol dosage based on facial expression analysis resulted in a 70% reduction in respiratory depression events.

(3) Robot assisted bronchoscopy

Monarch Miniature Version:

The 3mm robotic arm reached the 10th level bronchus, and the success rate of foreign body removal was 99%.

6、 Future technological directions

Degradable airway stent:

The polycaprolactone material stent is absorbed for 6 months to treat tracheal softening.

Nano endoscopic sensor:

Real time monitoring of intestinal lactase activity to diagnose intolerance.

Organ chip simulation:

Preoperative microfluidic chip testing of the surgical plan for congenital biliary atresia.

Clinical Benefit Comparison Table

Implementation strategy suggestions

NICU: equipped with a 1.8mm bronchoscope and CO ₂ perfusion system.

Children's Digestive Center: Construction of Magnetron Capsule AI Analysis Platform.

Research focus: Developing growth adaptive endoscopic implants (such as expandable esophageal stents).

These technologies are reshaping the paradigm of pediatric diagnosis and treatment through three major breakthroughs: millimeter level approaches, zero psychological trauma, and growth friendly treatments. It is expected that by 2028, 90% of invasive pediatric examinations will be needle free and painless.