COVID Driving Demand for Single-Use Endoscopes

Conquering the Final Frontier won’t be easy.

Space is not the kindest environment for human biology: It deflates muscles, decalcifies bones, damages eyes, stresses the heart, changes immunity, and disrupts the genome.
  
Simply put, the cosmos shortens homo sapiens’ overall life expectancy.
 
The kidneys are particularly vulnerable to the universe’s harsh conditions because they can collect all the lost calcium from bones. Such an inclination can be dangerous for rocketeers—more than 30 astronauts have developed kidney stones within two years of their space flights, leaving them vulnerable during future trips to Mars or the moon (the average ETA to the Red Planet is seven months).
 
Consequently, NASA is interested in technology being tested at the University of Washington Medical Center that would enable patients with small kidney stones to “push” the tiny rocks from their bodies, thereby avoiding surgery. The technology uses ultrasound waves to dislodge and move small kidney stone fragments remaining after surgery so the body can naturally expel them. A clinical trial currently is being conducted; researchers hope to finalize results and submit data to the U.S. Food and Drug Administration next year.
 
The same idea is under development at UCI Health, where four urologists are tweaking designs for a new ureteroscope that can remove all kidney stone fragments during surgery. The ureteroscope will include features intended to improve kidney stone removal efficiency and efficacy such as multiple laser channels and multidirectional deflection.
 
“The ureteroscope, which is only one-eighth of an inch in diameter, allows the surgeon to move across the urethra, bladder, and ureter and enter the kidney, all through normal passageways,” said Ralph V. Clayman, M.D., a UCI Health urologist, a distinguished professor of urology and dean emeritus of the UCI School of Medicine. “The ureteroscope is commonly passed through an outer sheath that protects the ureter during stone extraction and facilitates passage of the ureteroscope into the kidney. Stones are then fragmented using a laser fiber that is the size of three human hairs.”
 
Demand for minimally invasive surgical techniques and the rising prevalence of chronic diseases are expected to fuel growth of the global endoscope market over the next seven years. Grand View Research Inc. data predicts the worldwide market to swell 9.2 percent annually through 2028, with the disposable endoscopes segment growing the fastest during the forecast period.
 
MPO’s feature “Widening Scope” explores the trends and challenges impacting the global endoscope market, as well as the promising future for these devices. Arthur Roti, general manager for Instrument Technology Inc., was among the experts interviewed for the story. His full input is provided in the following Q&A:
 
Michael Barbella: What challenges are currently facing the market? How is your company working to overcome these challenges?
Arthur Roti: There are some supply chain issues developing as a result of the pandemic. Materials are becoming harder to purchase and the lead times have grown quite dramatically in some cases.
 
Barbella: How has medical device/component miniaturization impacted endoscope design? Is there a growing interest in/effort to develop capsule endoscopic devices as a result?
Roti: One of the big challenges with miniaturization is heat dissipation for the LED lighting on the tip of many endoscopes. 
 
Barbella: What safeguards are endoscope developers/manufacturers incorporating into designs to reduce hospital-acquired and medical scope-transmitted infections?
Roti: As I stated [previously], there is a rapidly growing market for single use endoscopes as sterilization of narrow insertion tubes can be very challenging. The COVID-19 pandemic has played a role in driving the demand for disposable scopes.
 
Barbella: How is AI and robotics being incorporated into endoscope design and technology?
Roti: We focus on design, development, and manufacturing of the complete insertion tube with articulation and electronics installed. Many of our customers then attach these to servos that connect to joysticks, which control the articulation and also the movement of any instruments that are inserted through the tube. We also design and manufacture the mechanical control pods when the customer needs them.
 
Barbella: What is the future growth potential for the endoscope market? Is there any sub-sector within the market that is especially primed for growth?
Roti: We have seen a lot of interest in endoscopes used for urology and gastro-intestinal procedures. These are two areas where there have been many advances in treatments for cancers and other diseases.