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
- Roving Surgical Robot: da Vinci Robot Visiting Jaipur on January 17, 2018 at 10:31 pm
Introduces surgeons to minimally invasive surgery for cancer relief Practising surgeons to de-mystify Robotic Surgery at USICON 2018 from Jan 18 In an effort to familiarise surgeons and hospital administrators in Jaipur with computer-assisted surgeries ... […]
- Sleep apnea treatment uses 'snake-like' surgical robot on January 17, 2018 at 7:35 pm
a surgeon at Lenox Hill Hospital in New York who performs surgery using a Flex Robotic System to treat cases of sleep apnea. The robot is designed to navigate the body's natural twists and turns so tissue can be removed or repaired safely and efficiently. […]
- Doctors use robotic surgery to correct pelvic floor dysfunction on January 17, 2018 at 1:02 pm
It can be an embarrassing situation for older women - not making it to the restroom in time due to a personal health issue. Now there's a robotic operation that is helping them resume a normal, active lifestyle. "A lot of things I didn't do like swimming. […]
- First robotic knee replacement surgery takes place in Dubai on January 17, 2018 at 4:02 am
Dubai: After suffering from a knee condition for over two years, Emirati Ahmad Al Rais underwent the first successful robotic-assisted orthopaedic surgery in the Middle East on January 8. The 47-year-old patient was one of two patients to undergo a partial ... […]
- New Robotic Spine Surgery: Get Better, Faster on January 16, 2018 at 11:25 pm
BALTIMORE, Jan. 17, 2018 /PRNewswire/ -- Surgeons at The Johns Hopkins Hospital have for the first time used a real-time, image-guided robot to insert screws into a patient's spine, alleviating her from severe pain and improving her mobility. "People get ... […]
- Robotic Kidney Transplantation Safe, Feasible on January 16, 2018 at 12:00 am
“Surgical data show that RAKT is safe, feasible, and reproducible when performed by surgeons with experience in both robotic and KT surgery,” the authors concluded. “Use of a robotic technique also has low complication rates in selected cases and ... […]
- Gynecology Robotic Surgery Global Market by Applications, Analysis and Outlook to 2020 on January 15, 2018 at 10:45 am
Publisher's analysts forecast the global gynecology robotic surgery market to grow at a CAGR of 10.07% during the period 2016-2020. For more information http://www.reportsweb.com/global-gynecology-robotic-surgery-market-2016-2020 Covered in this report The ... […]
- Australian Surgeons Fit Robotic Legs to Islamic State Bomb Victim on January 14, 2018 at 4:13 am
A young Kurdish filmmaker who lost both legs in a terrorist attack in Turkey is walking after receiving pioneering robotic surgery in Australia. Lisa Calan was among dozens of people injured when Islamic State militants bombed a Kurdish political rally in ... […]
- OSU cancer hospital tries less invasive robotic surgery on January 12, 2018 at 8:57 am
COLUMBUS, Ohio (AP) — Daniel Brown just wanted to get off the phone and back to fishing. Months earlier, doctors had found cancerous polyps during a colonoscopy, and then a pre-cancerous mass in his pancreas during a follow-up MRI. But at that moment ... […]
- Doctors are secretly teaching themselves how to do robotic surgery on January 11, 2018 at 4:05 pm
Residents no longer work in coordination with the senior surgeons — and some have turned to "shadow learning" to gain the skills they need. This is the practice of focusing on robotic surgery in school at the expense of general medicine, using YouTube ... […]
via Google News and Bing News