Transparent antifouling material for improved operative field visibility in endoscopy.
Camera-guided instruments, such as endoscopes, have become an essential component of contemporary medicine. The 15-20 million endoscopies performed every year in the United States alone demonstrate the tremendous impact of this technology. However, doctors heavily rely on the visual feedback provided by the endoscope camera, which is routinely compromised when body fluids and fogging occlude the lens, requiring lengthy cleaning procedures that include irrigation, tissue rubbing, suction, and even temporary removal of the endoscope for external cleaning. Bronchoscopies are especially affected because they are performed on delicate tissue, in high-humidity environments with exposure to extremely adhesive biological fluids such as mucus and blood. Here, we present a repellent, liquid-infused coating on an endoscope lens capable of preventing vision loss after repeated submersions in blood and mucus. The material properties of the coating, including conformability, mechanical adhesion, transparency, oil type, and biocompatibility, were optimized in comprehensive in vitro and ex vivo studies. Extensive bronchoscopy procedures performed in vivo on porcine lungs showed significantly reduced fouling, resulting in either unnecessary or ∼10-15 times shorter and less intensive lens clearing procedures compared with an untreated endoscope. We believe that the material developed in this study opens up opportunities in the design of next-generation endoscopes that will improve visual field, display unprecedented antibacterial and antifouling properties, reduce the duration of the procedure, and enable visualization of currently unreachable parts of the body, thus offering enormous potential for disease diagnosis and treatment.
John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138.
Steffi
S
Sunny
Interventional Pulmonology, Beth Israel Deaconess Medical Centre, Boston, MA 02215.
George
G
Cheng
John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138.
Daniel
D
Daniel
Interventional Pulmonology, Beth Israel Deaconess Medical Centre, Boston, MA 02215.
Peter
P
Lo
Interventional Pulmonology, Beth Israel Deaconess Medical Centre, Boston, MA 02215.
Sebastian
S
Ochoa
John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138; Department of Chemical and Biological Engineering, University of Maine, Orono, ME 04469; Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA 02138.
Caitlin
C
Howell
Institute of Particle Technology and Interdisciplinary Center for Functional Particle Systems, Friedrich-Alexander University Erlangen-Nürnberg, 91058 Erlangen, Germany.
Nicolas
N
Vogel
Interventional Pulmonology, Beth Israel Deaconess Medical Centre, Boston, MA 02215.
Adnan
A
Majid
John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138; Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA 02138; Department of Chemistry and Chemical Biology, Harvard University, Cambridge, MA 02138; Kavli Institute for Bionano Science and Technology, Harvard University, Cambridge, MA 02138 jaiz@seas.harvard.edu.
Joanna
J
Aizenberg
D001999:Bronchoscopy / Q000295:instrumentation / Q000379:methods / Q000592:standards; D020099:Coated Materials, Biocompatible / Q000032:analysis / Q000737:chemistry; D019723:Endoscopes / Q000592:standards; D004724:Endoscopy / Q000295:instrumentation* / Q000379:methods / Q000592:standards*; D004867:Equipment Design; D006801:Humans; D014794:Visual Fields
D020099:Coated Materials, Biocompatible
antifouling materials; biopsy; endoscopy; surface wetting
Biomed Res Int. 2014;2014:502143
25013785
J Clin Invest. 2014 Jul;124(7):3047-60
24892808
Surg Endosc. 2007 Feb;21(2):333-8
17219293
Nature. 2011 Sep 21;477(7365):443-7
21938066
Nano Lett. 2013 Apr 10;13(4):1793-9
23464578
Nat Mater. 2009 Jun;8(6):512-8
19377464
J Thorac Dis. 2016 Mar;8(Suppl 2):S130-9
26981263
ACS Appl Mater Interfaces. 2013 Jul 24;5(14):6704-11
23777668
Proc Natl Acad Sci U S A. 2012 Aug 14;109(33):13182-7
22847405
Nat Commun. 2013;4:2167
23900310
Nat Mater. 2002 Sep;1(1):59-63
12618851
Arch Intern Med. 2010 Oct 25;170(19):1752-7
20975024
Eur Respir J. 1999 Jun;13(6):1455-76
10445627
Nat Commun. 2015 Oct 20;6:8649
26482559
ACS Appl Mater Interfaces. 2014 Aug 13;6(15):13299-307
25006681
ACS Appl Mater Interfaces. 2015 Sep 2;7(34):19466-73
26268298
Am J Physiol Lung Cell Mol Physiol. 2008 Aug;295(2):L240-63
18487356
Proc Natl Acad Sci U S A. 2013 Apr 2;110(14):5624-9
23509269
J Endourol. 2010 Jun;24(6):905-13
20370436
Nat Biotechnol. 2014 Nov;32(11):1134-40
25306244
J Bronchology Interv Pulmonol. 2010 Apr;17(2):122-5
23168726
Nat Mater. 2015 Aug;14(8):790-5
26099112
N Engl J Med. 2006 Jan 19;354(3):241-50
16421365
ACS Appl Mater Interfaces. 2015 Mar 4;7(8):4763-71
25646977
ACS Biomater Sci Eng. 2015 Jan 12;1(1):43-51
33435082
Chem Soc Rev. 2007 Aug;36(8):1350-68
17619692