Page 392 - Flexible Robotics in Medicine

Robotic transluminal Pan-and-Tilt Scope 385

solution that allows for subjects to self-administer, together with the increased viewing
angle compared to an existing rigid endoscope. This will ensure the early detection
of NPC.

The current state of the art for the surveillance of NPC involves the use of
nasopharyngoscope operated by clinicians for monitoring and assessing the
nasopharyngeal region. Most clinicians use flexible endoscopes such as the Optim
ENTity NasoView because they cause less discomfort to subjects compared to rigid
endoscopes. However, for P.A.T.S, the material selected for the sheath of the tube was
made using a softer material (TangoBlack). The material chosen shall bend slightly
through atube on thenoseplate andbeableto maintain straight in the nasal cavity.
Hence, as the material used is softer compared to the metallic, rigid endoscope tube, it
reduces the discomfort to the subjects and is still able to serve its purpose of
maintaining straight.

16.6.2 The envisioned procedure of using Pan-and-Tilt Scope

• Prior to the first use, subjects must undergo a training session by the clinician. The
clinician will teach the subject how to operate the device safely and how to capture
images, rotate, and tilt the camera using the four buttons; how to insert and remove the
device safely; and how to clean the device after use.
• Prior to using the device, subjects will have first to spray a numbing nasal spray
such as topical decongestant and anesthetics, which will reduce the swelling, widen
the path for the endoscope, and numbs the nose, which helps to decrease the chance
of sneezing.
• The device should be cleaned and sterilized before and after each use.
• Next, the subject will put on the nose plate and adjust until it is tight to the subject’s
nose. Then, the device is carefully inserted into the nose through the tube on the nose
plate. The device should enter the nose straight like that of the rigid tube and will not
contact the inner wall of the nasal cavity.
• The insertion of the tube will stop once the predetermined length of the tube is inserted
into the nose. This length will be determined by the clinician during the first visit
through images of the subject’s anatomy. The length should be long enough to reach
the nasopharyngeal region for surveillance.

16.6.3 Failure mode analysis

A risk table is done to analyze the possible failure mode of the device. The risks
and adverse effects can be mitigated and controlled by following the proposed
measures.