How are Biomaterials Actually in Use?
chapter 1. Biomaterials
"Biomaterials play a vital role in modern medicine and healthcare."
But firstly, what are biomaterials?
Biomaterials are any substances that are designed to interact with biological systems, either as a part of a medical device or for therapeutic/ diagnostic purposes.
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Clinicians and surgeons regularly work with various biomaterials in their day-to-day practice, often without explicitly referring to them using the specific term. Indeed, medical devices used for diagnosis, treatment, and intervention are all made from materials that qualify as "biomaterials." The use of biomaterials in medical devices is frequent because it ensures the compatibility of medical instruments so that they perform intended functions effectively without causing adverse reactions or complications.
biocompatibility
Biocompatibility is an essential quality a material should possess to be considered a biomaterial.
Simply, it refers to the capability of a material to interact with living tissues or biological systems without causing harmful reactions or significant immune responses. Biocompatibility ensures that the biomaterial is safe and can coexist harmoniously with the body's cells, tissues, and organs when implemented in use.
introduction to jang sarang clinic
Jang Sarang Internal Medicine Clinic is a gastroenterology health facility with abundant experience in treating bowel diseases. Founded in 2008, Jang Sarang IM Clinic’s mission is to provide the highest standard of medical services with accurate diagnoses and a comfortable environment while ensuring thorough disinfection and hygiene management. As one of few gastroenterology clinics in Cheongju-si, North Chungcheong Buk-do, since its establishment, the Jang Sarang Clinic has served a critical role as a focal point to fulfill the medical roles within the community.
gastroenterology
Gastroenterology is a medical specialty that focuses on the study, diagnosis, and treatment of disorders and diseases related to the gastrointestinal (GI) tract. The GI tract starts from the mouth and includes the esophagus, stomach, small intestine, large intestine (colon), rectum, and anus, which are various organs involved in the absorption and digestion of food, as well as the elimination of waste products.
endoscopy
An endoscopy is a procedure used to visually examine internal organs. There are two main types of endoscopy: Upper Gastrointestinal Endoscopy and Colonoscopy. Upper Endoscopy focuses on the upper digestive system, while Colonoscopy examines the large intestine, including the colon, rectum, and anus.
The primary purpose of this procedure is to diagnose digestive system issues and identify diseases, but sometimes medical interventions are performed during the endoscopy to treat conditions. It is recommended for patients who experience symptoms such as dysphagia, unexplained weight loss, upper abdominal pain, intractable vomiting, or bleeding.
chapter 2. Biomaterials for Endoscopy
What Specific Medical Devices Are Used for Endoscopy?
1. endoscope
An endoscope is a medical device inserted through a natural opening to examine hollow organs of the body. It consists of three sections, namely, the control section, the insertion section, and the connector section. The camera at the tip of the endoscope transmits images to a monitor, allowing the medical team to visualize the internal organs or structures in detail.
Materials in Use
1. Stainless Steel: Stainless steel is extensively used as a biomaterial due to its excellent corrosion resistance and ease of processing. It is often used in combination with other materials to form the insertion tube and distal tip.
2. Polymers: Polymers are highly promising materials in biomedical applications due to their flexible chemical structure and resistance to heat and chemical attack. They are utilized in various aspects of endoscopy. Firstly, polymers are used for the insertion tube and the distal tip. Here, specific polymers, such as silicones, polyurethanes, polyesters, and others, are used either individually or as blends, composites, or multilayers. Additionally, polymers serve as the outer sheath, allowing the endoscope to bend and navigate smoothly through the body's internal passages, protective covers for delicate optical components and camera systems, and channel liners for inserting various instruments.
3. Optical Fibers: Optical fibers transmit light from the light source to the endoscope's tip, allowing the transmission of information as light pulses along a glass or plastic fiber. These fibers are typically made of materials like glass or synthetics known for their excellent light transmission properties.
Direct/ Indirect Contact with the Body
When part of the endoscope directly contacts with the body, it's not only exposed to the GI tract, but also to the atmosphere and liquid mediums during sterilization process. Therefore, these parts covering the external must display biocompatibility and resistant to chemical and heat attack. A small buckle or crack on the outside of the tube is extremely dangerous, that the endoscope must be repaired and go through the leakage test* before usage. This is why limited materials are employed in composing of the endoscope, because it's hard to find a material that's flexible enough, yet chemical and heat resistant for thorough sterilization process.
2. Polypectomy snare
Polypectomy snare is a medical wire loop inserted through the instrument channel of the endoscope to remove polyps found during the endoscopy
Polyps are abnormal growths that can occur in the colon, rectum, or other parts of the GI tract. While most polyps are benign, some have the potential to become cancerous over time. Removing polyps during a polypectomy is a preventive measure to reduce the risk of developing colorectal cancer.
Polypectomy procedure
During the polypectomy procedure, the endoscope is inserted into the patient's colon or rectum. Once the polyp is located and visualized, the snare is positioned around the base of the polyp. The snare is then tightened, using an electric current passed through the wire loop, to cut and remove the polyp from the surrounding tissue. The electric current simultaneously cauterizes the tissue to minimize bleeding.
After the polypectomy, the removed polyp is sent for further examination (histopathology) to determine if it is benign, pre-cancerous, or cancerous. The results of the histopathological analysis guide the patient's future management and follow-up care.
Materials in Use
Polypectomy snares are typically made of a thin, flexible wire with a specialized electrically conductive coating. The most common material used for the wire in polypectomy snares is stainless steel. It is chosen for its strength, flexibility, and resistance to corrosion, making it suitable for medical instruments like polypectomy snares that need to be durable and safe for repeated use.
The electrically conductive coating on the wire enables the snare to deliver an electric current when activated, which is crucial during the polypectomy procedure. The electric current allows the snare to cut and remove the polyp while simultaneously cauterizing the surrounding tissue to minimize bleeding.
Polypectomy snares come in various sizes and configurations to accommodate different polyp sizes and locations. They are designed to be efficient and safe, allowing for precise removal of polyps while minimizing the risk of complications.
3. biopsy forceps
Biopsy forceps are medical instruments used to obtain tissue samples (biopsies) from inside the body for diagnostic purposes. It comes in various sizes and configurations to accommodate different endoscopic procedures and target tissues. They are designed to be precise and safe, allowing for accurate sampling of tissues while minimizing patient discomfort and risk of complications.
During an endoscopy, the biopsy forceps are inserted through the endoscope's working channel and advanced to the target area where the tissue sample needs to be obtained. The jaws of the forceps are then opened to grasp and secure a small piece of tissue. Once the tissue is securely held by the forceps, it is cut or detached from the surrounding tissue using a sharp cutting edge or by applying gentle pressure to sever the tissue. The biopsy forceps are then withdrawn, bringing the tissue sample with them.
