Page 55 - Flexible Robotics in Medicine

CHAPTER 3

Cable-driven flexible endoscope utilizing

diamond-shaped perforations: FlexDiamond

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Bok Seng Yeow , Yan Bing Soh , Hui-Min Chua , Jun Hao Edmund Ong ,
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Jing Chun Teo , Wei Yang Un , Chwee Ming Lim and Hongliang Ren 1
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Department of Biomedical Engineering, National University of Singapore, Singapore,
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Singapore General Hospital, Bukit Merah, Singapore
Nasopharyngeal carcinoma (NPC) is a type of cancer that originates in the
nasopharynx, the area that is in the upper part of the throat. Surveillance of NPC is
traditionally physician-operated, and our aim is an automatic NPC surveillance
prototype capable of inserting a camera via the nasopharyngeal airway. A flexible
manipulator is used to generate bending, which allows access to the target region. We
adopted diamond-shaped perforations on the manipulator to improve the bending
function. This chapter will firstly focus on analyzing the existing endoscopes to review
their strengths and weaknesses. FlexDiamond aims to provide an infection-free and
automatic method of detecting NPC. We report the key performance indicators, the
step-by-step procedures for the operation of the prototype, and the comparison with
these existing prototypes.

3.1 Clinical background of nasopharyngeal carcinoma

The nasopharynx is the region behind the nose and above the pharynx (throat).
Malignant cancer cells forming in the tissues of the nasopharynx are known as
nasopharyngeal cancer nasopharyngeal carcinoma (NPC) [1]. There are three types of
NPC—nonkeratinizing differentiated carcinoma, keratinizing squamous cell carcinoma,
and undifferentiated carcinoma [2]. Signs of nasopharyngeal cancer include having a
lump in the neck or nose, nosebleeds, headaches, sore throat, and trouble speaking,
breathing, and hearing. The cancer is commonly found in victims residing in Asian
countries. Generally, having a Chinese or Asian ancestry increases the risk of contracting
the disease. NPC is more commonly seen in East Asia, especially southern China [3,4].
Males are more likely to suffer from NPC. Diet rich in salt-cured meat and fish is
suspected to be a possible cause of this cancer [5]. NPC also ranked eighth in the most

Flexible Robotics in Medicine.
DOI: https://doi.org/10.1016/B978-0-12-817595-8.00003-1 39
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