Tactile Pressure Sensors Make Esophageal Manometry More Palatable

For patients suffering from esophageal disorders and searching for answers, the lack of information gleaned from procedures such as manometry used to be tough to swallow.  Advancements in high-resolution tactile pressure sensing technology, however, have led to the development of the ManoScan 360 motility visualization system, which provides clinicians with greater detail, accuracy, and data to aid in diagnosis of esophageal problems.

Entailing the insertion of a sensor-equipped catheter through the nose and down through the esophagus and into the stomach, esophageal manometry is performed to assess function of the organ as it moves food down into the stomach through a process called peristalsis.

“The test measures how well the circular bands of muscle (sphincters) at the top and bottom of your esophagus open and close, as well as the pressure, strength, and pattern of the wave of esophageal muscle contractions that moves food along,” according to The Mayo Clinic.

And while esophageal manometry had, for years, enabled the diagnosis of such conditions as dysphagia, achalasia, gastric reflux, and scleroderma, for example, its usefulness had been somewhat limited. Conventional motility catheters typically featured just four to six pressure sensors, and the information they relayed was not particularly precise or easy to interpret. As a result, doctors were often reduced to simply saying whether or not the esophagus was performing normally.

Dissatisfied with this lack of data, Dr. Ray Clouse, who was a professor of medicine and psychiatry that specialized in gastroenterology at Washington University in St. Louis at the time, sought an alternative solution. Clouse believed that a motility catheter that yielded additional feedback on pressures occurring in the organ might lead to better diagnoses of esophageal disorders.

With this goal in mind, he developed a catheter system outfitted with a higher number of sensors. However, this system ultimately proved to be too cumbersome and, as it relied on a series of water pumps, difficult to maintain.

With the help of a motility catheter salesperson, Pressure Profile Systems (PPS) became involved with the project, driven by the realization that the application of tactile pressure sensor arrays could result in a workable solution. After two years—and with the assistance of a grant from the National Institutes of Health—PPS developed a custom motility catheter that incorporated 36 multiplexed circumferential pressure sensors.

Dubbed the ManoScan 360, the 36-element catheter system collects information about esophageal performance in much greater detail than was previously possible, and presents that information in a visual, easy-to-understand manner. In fact, the system provides a spatial resolution of nearly 10 times that of its predecessors.

Thanks to the incorporation of the numerous tactile pressure sensors, the system captures all relevant motor function measurements from the pharynx down to the stomach. Whereas physicians previously had to puzzle out a diagnosis from limited manometry readings, they now have an easy-to-understand view of how the esophagus is functioning from the inside. Isolating and diagnosing problems has become as simple as looking at a pressure map generated by the measurements taken from the complex capacitive tactile sensor arrays.

The driving concept of optimizing the product for the end-user is further exemplified in the product’s flexibility based on user preference. Rather than forcing this newer approach on healthcare providers, the manometry system was designed to accommodate those who were used to the status quo and might be resistant to change. To that end, the product’s software also includes the option to display pressure data in the conventional format that clinicians had been using for years.

The ManoScan 360 was ultimately introduced to the market in 2004 by a spinout company called Sierra Scientific Instruments (SSI). SSI was acquired by Given Imaging in 2010, which now markets the product as the ManoScan ESO.


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