Development and feasibility study of a piezoresistive pressure sensor-based automated system for monitoring and controlling gastric pressure in endoscopy

Maintaining precise intragastric pressure during gastrointestinal endoscopy is critical for patient safety and diagnostic accuracy, yet current methods relying on manual adjustments pose risks of improper insufflation. This study aimed to develop an automated gastric pressure control system for flexible endoscopy, addressing these challenges with a piezoresistive pressure sensor that can be integrated into a 7.3 mm diameter flexible endoscope. The system, incorporating air and suction pumps controlled by a microcontroller, was calibrated in an acrylic chamber and validated through comprehensive testing in both an endoscopy simulator and a porcine specimen. Testing scenarios included normal breathing, coughing, belching, and combined events, assessing accuracy, stability, and real-time pressure regulation under conditions mimicking physiological responses. Results demonstrated high accuracy (R² = 0.9999), minimal bias (0.23 mmHg), and strong agreement with reference standards, confirming effective pressure management. Simulated clinical scenarios in simulator and porcine specimen further showed the system's ability to maintain target pressure with minimal errors, indicating robustness under dynamic conditions. These findings suggest that the automated pressure control system significantly improves safety and procedural efficiency in endoscopy, with potential applicability to other minimally invasive procedures. Further animal model testing is recommended to validate the clinical performance under realistic physiological conditions.