In the management of cholangiocarcinoma, effective biliary drainage and accurate diagnosis are vital to allow further treatment. Confirmation of tissue diagnosis and molecular characterization is also required to guide future treatment options including surgery and chemotherapy as well as the possible use of personalized treatments that target specific mutations present within individual tumours. Initial CT or MRI scans may be followed by endoscopic ultrasound (EUS) or endoscopic retrograde cholangiopancreatography (ERCP) to obtain tissue samples. However, these methods often fall short due to difficulty in accessing entire bile duct strictures. SpyGlass cholangioscopy can improve diagnosis, yet may fail to provide sufficient tissue for molecular characterization. Here we present a perspective on the development of snake-like agile robots with integrated optical imaging and Raman spectroscopy. These robots could improve the mapping of the biliary tree and the precision of biopsy collection and allow tissue analysis in situ, as well as facilitating stenting to restore the flow of bile. A multidisciplinary approach that brings together clinicians, pathologists, and engineers is required to develop these new robotic technologies and improve patient outcomes.
在胆管癌的治疗中，有效的胆道引流与精准诊断是实施后续治疗的关键。为明确手术、化疗等治疗方案，并针对个体肿瘤特异性突变开展个性化靶向治疗，必须通过组织病理学确诊及分子特征分析。临床通常先进行CT或MRI检查，再通过超声内镜（EUS）或内镜逆行胰胆管造影（ERCP）获取组织样本。然而，由于难以完整探查胆管狭窄区域，这些方法常存在局限。SpyGlass胆道镜虽能提升诊断效能，但所获组织量常不足以完成分子特征分析。本文提出一种集成光学成像与拉曼光谱技术的蛇形灵巧机器人发展前景：该技术可优化胆道树三维成像，提高活检精准度，实现原位组织分析，并辅助支架置入以恢复胆汁引流。开发此类新型机器人技术需要临床医师、病理学家与工程师的多学科协作，以最终改善患者预后。
肿瘤(癌症)患者之家