AI 中文总结
本研究开发了仿生机器人软食管RoSE作为腔内支架体外测试装置，通过测试两种不同径向刚度支架的径向力、迁移情况及对吞咽功能的影响，为支架评估提供创新平台。
AI 中文摘要
软体机器人系统非常适合开发生物医学应用设备。本研究开发了一种仿生机器人软食管（RoSE），作为用于吞咽困难管理的腔内支架体外测试装置。腔内支架置入是治疗食管癌导致的恶性食管狭窄引起的吞咽困难的即时且具有成本效益的方法。然而，后期并发症如支架迁移可能会削弱食管的吞咽功能。支架对食管壁的径向力（RF）是避免支架迁移的关键。由于患者的随机对照试验有限，支架设计和置入指南仍不完善。为解决这一知识缺口，本研究在RoSE中置入两种具有不同径向刚度特性的支架（A和B），以测量支架RF及其对迁移的影响；还在蠕动条件下进行内镜测压，以研究支架置入及支架功能障碍对食团内压力特征（IBPSs）和吞咽功能的影响。每个置入的支架都在不同的蠕动速度、波长和食团浓度下进行实验。结果显示，刚度更高的支架B具有更高的RF，而支架A因刚度较低保持更低的RF分布；在RoSE的长时间蠕动收缩下，高RF是最小化迁移所必需的。在测压方面，支架A略微增加IBPS，但更硬的支架B显著降低IBPS，尤其是对于高浓度食团。如果更硬的支架发生屈曲，会降低吞咽功能并导致复发性吞咽困难。因此，RoSE是一种用于测试腔内支架并解决支架评估中临床挑战的创新软体机器人平台。
英文摘要
Soft robotic systems are well suited for developing devices for biomedical applications. A bio-mimicking robotic soft esophagus (RoSE) is developed as an in vitro testing device of endoprosthetic stents for dysphagia management. Endoprosthetic stent placement is an immediate and cost-effective therapy for dysphagia caused by malignant esophageal strictures from esophageal cancer. However, later stage complications, like stent migration, could weaken swallow efficacy in the esophagus. The stent radial force (RF) on the esophageal wall is pivotal in avoiding stent migration. Due to limited randomized controlled trials in patients, stent design and stenting guidelines remain incomplete. To address this knowledge deficit, we investigate RoSE by implanting two stents (A and B) of different radial stiffness characteristics, to measure stent RF and its effect on migration. Endoscopic manometry under peristalsis is also performed to study the impact of stenting and stent dysfunction on intra-bolus pressure signatures (IBPSs) and swallowing efficacy. Each implanted stent undergoes experiments with varied peristalsis velocity, wavelength, and bolus concentrations. The results show that stiffer stent B has a higher RF, whereas stent A maintains a lower RF profile due to lesser stiffness. High RF is necessary to minimize migration under prolonged peristaltic contractions in RoSE. For manometry, stent A slightly increases IBPS, but stiffer stent B significantly decreases IBPS, especially for higher-concentration boluses. If a stiffer stent buckles, it can reduce swallow efficacy and cause recurrent dysphagia. RoSE is therefore an innovative soft robotic platform for testing endoprosthetic stents and addressing clinical challenges in stent evaluation.
CommentsAuthor accepted manuscript. 31 pages, 13 figures, 3 tables. Published in Soft Robotics (2021). Project page: https://bhattner143.github.io/rose-stent.github.io/
Journal refSoft Robotics, Vol. 8, No. 4 (2021)
