Devices and methods transmit mechanical motion to guidewires and endoscopic tools for controlled access through challenging anatomies, addressing entry challenges and reducing trauma.
Unmet Need
Medical professionals face challenges in smoothly advancing guidewires and endoscopic accessory tools through challenging patient anatomies due to difficult angles, small openings, and tortuous paths, leading to increased trauma and complications. For example, Endoscopic Retrograde Cholangiopancreatography (ERCP) provides access to the luminal structures of the pancreatic and biliary ducts to treat a variety of hepatobiliary indications. Selective cannulation refers to the act of passing a guidewire through the papilla and then into either the main pancreatic duct (PD) or common bile duct (CBD). This step is notoriously difficult because physicians are attempting to pass an endoscopic accessory into a blind tunnel on the other side. The failure rate for the procedure is 5- 20% depending on the institution, and the most dreaded complication of the procedure, post ERCP pancreatitis (PEP) occurs in almost 4% of cases overall. This typically occurs when many attempts to cannulate the CBD are unsuccessful and result in perturbation of the PD. The American Society for Gastrointestinal Endoscopy suggests that a biliary cannulation rate of > 85% should be the goal for all endoscopists engaged in ERCP.
Devices and methods that transmit mechanical motion to the distal end of endoscopic accessory tools and guidewires, enable controlled manipulation and reduced friction. This device uses actuators and vibrational energy to enhance access, and in this example, reduce the difficulty of selective cannulation in ERCP procedures.
Technology Overview
Johns Hopkins researchers in coordination with colleagues at JHU’s Applied Physics Laboratory and Boston Scientific have developed a technology that will facilitate enhanced access through patient-specific pathologies (e.g. tortuous anatomies, benign/malignant strictures) that may otherwise inhibit the physical movement of an endoscopic accessory. This invention will facilitate atraumatic entry of guidewires and endoscopic accessory tools into luminal structures - reducing complications and increasing successful outcomes.
Publications
U.S. Patent 11,478,131
