The Bellowscope Platform

An ultra-low-cost option for gastric cancer screening in rural areas of low-income countries

Combining novel soft and continuum robotic approaches to deliver a cost-effective gastroscope for cancer screening.

Stomach cancer is the 5th most common cancer globally, with an incidence rate accounting for approximately 7% of new cancer cases each year. Disease prevalence is highly dependent on geographic location, with over 50% of cases occurring in East Asia. To screen for stomach cancer, a visual inspection of the stomach cavity is performed by passing a flexible endoscope into the stomach via the mouth or nose. With the implementation of adequate screening programs, a significant reduction in mortality rates has been demonstrated through early detection of disease. However, screening programmes in many low-to-middle income countries are non-existent or ineffective due to economic and logistical limitations in providing the sedation, monitoring and reprocessing equipment associated with traditional endoscopy. 

 


Through a radical re-thinking of the way traditional endoscopes work, are manufactured and operated, we have developed the BellowScope – a solution that is a fraction of the cost of traditional devices, single-use, more intuitive to operate, and has the potential to reduce patient discomfort. Our innovative combination of a multi-backbone ‘snake-like’ handle and soft pneumatically driven camera tip presents a step change in endoscope design, and may enable screening programs be implemented at lower cost and in locations previously unserved. 

Operational Video

Relevant Publications

J. Chandler, M. Chauhan, N. Garbin, K. Obstein and P. Valdastri, “Parallel Helix Actuators for Soft Robotic Applications”Frontiers In Robotics And AI 7 (2020).

JH Chandler, M Chauhan, S Caló, N Aruparayil, N Garbin, F Campisano, KL Obstein, P Valdastri. “Tu1964 Usability of a Novel Disposable Endoscope for Gastric Cancer Screening in Low-Resource Settings: Results from Rural India“. Gastroenterology vol. 158 no. 6, S-1235, 2020

Garbin, AP Mamunes, D Sohn, RW Hawkins, P Valdastri, KL Obstein, “Evaluation of a novel low-cost disposable endoscope for visual assessment of the esophagus and stomach in an ex-vivo phantom model”, Endoscopy international open, vol. 7 no. 09, E1175-E1183, 2019. 

Garbin, L Wang, JH Chandler, KL Obstein, N Simaan, P Valdastri, “Dual-continuum design approach for intuitive and low-cost upper gastrointestinal endoscopy” IEEE Transactions on Biomedical Engineering, vol. 66 no. 07, 1963-1974, 2018. 

Garbin, L Wang, JH Chandler, KL Obstein, N Simaan, P Valdastri, “A disposable continuum endoscope using piston-driven parallel bellow actuator”, 2018 International Symposium on Medical Robotics (ISMR), 1-6, 2018. 

N. Garbin, S. Sarker, D. C. Sohn, P. R. Slawinski, P. Valdastri, and K. L. Obstein, “Evaluation of a novel disposable upper endoscope for unsedated bedside (non-endoscopy unit based) assessment of the upper gastrointestinal (ugi) tract,” Gastrointestinal Endoscopy, vol. 85, no. 5, Supplement, p. AB304, 2017.

Research Goals

Size Reduction

To reduce the size of BellowScope, to minimise patient discomfort and allow screening with only local anaesthetic.

Lower Cost

To develop low cost, ergonomic, mechanical control systems for steering the camera, thereby reducing procedural complexity and the associated time and discomfort for the patient.

Clinical Assessment

To assess the efficacy of the BellowScope platform under clinical conditions.

Automation

To automated the screening process using mechatronic control systems coupled with machine vision to allow the system to be deployed with minimal training.

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