| Summary: | <p>Flexible endoscopic systems have revolutionised both diagnostic and therapeutic standards of care for a variety of health conditions. Extending the capacity and safety of these devices, could enable broad deployment of endolumenal therapeutic actions, preventing unnecessary surgery. Although previous biocompatible inflatable balloon systems for invivo use have demonstrated some utility in small-bowel locomotion, little is known about the potential for double balloon systems to facilitate surgeries within the gastrointestinal tract. While considerable advances have been demonstrated in other clinical specialties due to innovative technology, these have been historically absent in gastrointestinal therapy, where reliance on formal surgery as the primary treatment modality for benign and malignant disease has persisted. Such innovations seen in other fields have shifted diagnosis and treatment to an earlier stage with minimally invasive approaches.</p> <p>In this thesis, I present my DPhil work that shows evidence of the design and operation of a double-balloon oversheath for flexible endoscope stabilisation and visualisation through the development of a lumenal inter-balloon zone. The device delivered an increased visible mucosal surface area and improved tumour removal strategies through immersion and retraction capabilities in the lower gastrointestinal tract of large animals. Following this, I go onto consolidate this pre-clinical work in a clinical context with an emphasis on safety as well as some of the challenges encountered during this process.</p> <p>Taken together, these data indicate that such devices could provide endolumenal surgical capabilities to the next generation of flexible endoscopic systems for the gastrointestinal tract.</p>
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