用仿生软体食道测试支架，帮医生选更合适的吞咽支架。
RoSE: A Robotic Soft Esophagus for Endoprosthetic Stent Testing
- 构建可模拟蠕动的软体食道模型，测试支架力学性能。
- 较硬支架提供更高径向力，减少移位风险，但可能影响吞咽。
- 适合临床研究者、支架设计师和消化科医生参考使用。
软体机器人系统适用于生物医学设备开发。本文提出一种仿生软体食道（RoSE），用于体外测试用于治疗吞咽困难的内植支架。内植支架是针对食管癌引起的恶性狭窄导致吞咽困难的即时且低成本疗法。然而，后期并发症如支架移位可能削弱食管吞咽功能。支架对食管壁的径向力（RF）对防止移位至关重要。由于患者中随机对照试验有限，支架设计与置入指南仍不完善。为填补这一知识空白，我们通过植入两种不同径向刚度特性的支架（A 和 B），在 RoSE 中测量了支架径向力及其对移位的影响。同时进行内镜测压，研究支架置入及功能障碍对腔内压力特征（IBPS）和吞咽效能的影响。每个支架在不同蠕动速度、波长和食物浓度下进行实验。结果显示，较硬支架B具有更高径向力，而支架A因刚度较低维持更低径向力水平。在长时间蠕动收缩下，高径向力有助于最小化移位。测压结果表明，支架A轻微增加IBPS，而较硬支架B显著降低IBPS，尤其在高浓度食物时。若较硬支架发生屈曲，会降低吞咽效能并引发复发性吞咽困难。因此，RoSE是一个创新的软体机器人平台，可用于支架测试并解决临床支架评估难题。
原文摘要 · Abstract (English)
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.
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