Mechanical pull stimulates stunted hollow organs to grow; could help treat defects like esophageal atresia and short bowel syndrome
An implanted, programmable medical robot can gradually lengthen tubular organs by applying traction forces — stimulating tissue growth in stunted organs without interfering with organ function or causing apparent discomfort, report researchers at Boston Children’s Hospital.
The robotic system, described today in Science Robotics, induced cell proliferation and lengthened part of the esophagus in a large animal by about 75 percent, while the animal remained awake and mobile. The researchers say the system could treat long-gap esophageal atresia, a rare birth defect in which part of the esophagus is missing, and could also be used to lengthen the small intestine in short bowel syndrome.
The most effective current operation for long-gap esophageal atresia, called the Foker process, uses sutures anchored on the patient’s back to gradually pull on the esophagus. To prevent the esophagus from tearing, patients must be paralyzed in a medically induced coma and placed on mechanical ventilation in the intensive care unit for one to four weeks. The long period of immobilization can also cause medical complications such as bone fractures and blood clots.
“This project demonstrates proof-of-concept that miniature robots can induce organ growth inside a living being for repair or replacement, while avoiding the sedation and paralysis currently required for the most difficult cases of esophageal atresia,” says Russell Jennings, MD, surgical director of the Esophageal and Airway Treatment Center at Boston Children’s Hospital, and a co-investigator on the study. “The potential uses of such robots are yet to be fully explored, but they will certainly be applied to many organs in the near future.”
The motorized robotic device is attached only to the esophagus, so would allow a patient to move freely. Covered by a smooth, biocompatible, waterproof “skin,” it includes two attachment rings, placed around the esophagus and sewn into place with sutures. A programmable control unit outside the body applies adjustable traction forces to the rings, slowly and steadily pulling the tissue in the desired direction.
The device was tested in the esophagi of pigs (five received the implant and three served as controls). The distance between the two rings (pulling the esophagus in opposite directions) was increased by small, 2.5-millimeter increments each day for 8 to 9 days. The animals were able to eat normally even with the device applying traction to its esophagus, and showed no sign of discomfort.
On day 10, the segment of esophagus had increased in length by 77 percent on average. Examination of the tissue showed a proliferation of the cells that make up the esophagus. The organ also maintained its normal diameter.
“This shows we didn’t simply stretch the esophagus — it lengthened through cell growth,” says Pierre Dupont, PhD, the study’s senior investigator and Chief of Pediatric Cardiac Bioengineering at Boston Children’s.
The research team is now starting to test the robotic system in a large animal model of short bowel syndrome. While long-gap esophageal atresia is quite rare, the prevalence of short bowel syndrome is much higher. Short bowel can be caused by necrotizing enterocolitis in the newborn, Crohn’s disease in adults, or a serious infection or cancer requiring a large segment of intestine to be removed.
“Short bowel syndrome is a devastating illness requiring patients to be fed intravenously,” says gastroenterologist Peter Ngo, MD, a coauthor on the study. “This, in turn, can lead to liver failure, sometimes requiring a liver or multivisceral (liver-intestine) transplant, outcomes that are both devastating and costly.”
The team hopes to get support to continue its tests of the device in large animal models, and eventually conduct clinical trials. They will also test other features.
“No one knows the best amount of force to apply to an organ to induce growth,” explains Dupont. “Today, in fact, we don’t even know what forces we are applying clinically. It’s all based on surgeon experience. A robotic device can figure out the best forces to apply and then apply those forces precisely.”
The Latest on: Robotic implants
- Robot-assisted knee replacement surgery launchedon November 27, 2020 at 4:34 pm
Knee replacement surgeries are done when bones become arthritic, due to disease, age or fractures. BENGALURU: A private hospital in the city has launched a robotic joint replacement programme to ...
- Munster bricklayer undergoes robotic surgery for double bypasson November 27, 2020 at 9:00 am
At first I was in shock and didn’t want to believe it, but when they recommended robotic surgery, I really started researching it, and I liked everything I heard about ...
- Delhi-NCR: Doctors Perform Complex Robotic Surgery To Treat Woman With Tumouron November 27, 2020 at 2:54 am
A 48-year-old woman from Mauritius with a pancreatic tail tumour was successfully treated with complex robotic surgery in Delhi-NCR. Thee patient underwent a 'robotic distal pancreatectomy with ...
- Doctors perform rare robotic surgery to treat woman with tumouron November 27, 2020 at 1:50 am
The patient underwent a 'robotic distal pancreatectomy with splenectomy' to remove the tumour which was four centimetres in size.
- Robotic Surgery Market Booming By Size, Revenue And Trend In 2020 Scrutinized In New Researchon November 26, 2020 at 5:14 am
The global robotic surgery market has been analyzed By Region (North America, Europe, Asia Pacific, RoW) and By Country (U.S., Canada, U.K., Germany, France, Italy, China, Japan, India, Brazil) for ...
- Robotic surgery system used across Europe completes 1,000 operationson November 26, 2020 at 2:33 am
Robot surgery is burgeoning across Europe and the wider world, with one UK-built surgical robot now completing more than 1,000 operations.
- Robotic-Assisted Surgery Has a Bright Future in Indiaon November 24, 2020 at 7:28 pm
Robotic-assisted surgeries have been there for quite some time. In recent times however, with a growing emphasis on improving the quality of care and with AI ma ...
- Hamilton’s St. Joe’s hospital uses $5-million robot to assist with lung cancer surgeryon November 24, 2020 at 3:22 am
If Holly Mauro’s lung cancer surgery had been performed the traditional way, removing about 30 per cent of her lung along with the tumour, you wonder if she would be speaking like this. That is, ...
- Global Robotic Surgery Market Size, Share to attain considerable expansion through 2024 - Live Nowon November 19, 2020 at 10:58 pm
The report Robotic Surgery Market Size and Analysis maintains enhanced dynamics and is overshadowed by a top player across the globe. The research report provides Robotic Surgery Market Growth and ...
- Robotic surgery at Columbia VA is making a big difference for patientson November 19, 2020 at 5:09 pm
The Dorn VA Hospital in Columbia has started a new program with robotic surgery that's making a big difference for patients. Doctor Kurt Fichtner is a surgeon at the Dorn VA Hospital in Columbia. He ...
via Google News and Bing News