RoSE: A Robotic Soft Esophagus for Endoprosthetic Stent Testing
Authors: Dipankar Bhattacharya, Sherine Jesna V. A., Leo K. Cheng, Weiliang Xu
Organizations: Department of Mechanical Engineering, The University of Auckland, Auckland 1010, New Zealand. · Riddet Institute, Palmerston North 4442, New Zealand. · Auckland Bioengineering Institute, The University of Auckland, Auckland 1010, New Zealand · The University of Auckland, Auckland 1010, New Zealand · Medical Technologies Centre of Research Excellence, Auckland 1010, New Zealand
Abstract
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.
Strictures caused by esophageal cancer can narrow down the esophageal lumen, leading to dysphagia. Palliation of dysphagia has driven the development of a Robotic Soft Esophagus (RoSE), which provides a novel in vitro platform for esophageal stent testing and food viscosity studies. In RoSE, peristaltic wave generation and control were done in an open-loop manner since the conduit lacked visibility and embedded sensing capability. Hence, in this work, RoSE version 2.0 (RoSEv2.0) is designed with embedded Time Of Flight (TOF) and pressure sensors to measure conduit displacement and air pressure, respectively, for modeling and control. Model Predictive Control (MPC) of RoSEv2.0 is implemented to govern the peristalsis and air pressure profile autonomously. The implemented MPC used Sparse Identification Nonlinear Dynamics with Control (SINDYC) models to estimate the future states of ROSEv2.0. The dynamic models are discovered from the TOF and pressure sensor data. Peristalsis waves of speed 20 mm/s, wavelength 75 mm, and amplitudes 5, 7.5, and 10 mm were successfully generated by the MPC. Additionally, RoSEv2.0 with the MPC was employed to perform stent migration testing with various food bolus consistencies. The major contribution claimed in this paper is the application of SINDYC-based MPC to solve the closed-loop control problem of RoSE for achieving desired peristaltic waves.
Dipankar Bhattacharya, Ryman Hashem, Leo K. Cheng +1
Conventional colonoscopy remains limited by patient discomfort and procedural risks, motivating research into compliant robotic alternatives. Eversion robots, which advance via pressure-driven tip growth, eliminate sliding friction against the colon wall and offer a less intrusive approach to traversal. However, no existing design simultaneously satisfies all clinical requirements. This paper benchmarks four recent eversion robot architectures against the key anatomical and clinical constraints of colonoscopy, including colon length, minimum luminal diameter, bending angle, and working-channel needs. We identify the central trade-offs each design reveals, particularly the difficulty of integrating steering and payload delivery without sacrificing the soft, low-friction behaviour that makes eversion robots attractive. We then provide design guidance across material selection, steering strategy, and payload delivery, and highlight open problems for clinical translation.
An endovascular intervention begins with a skilled clinician manually navigating a long, slender wire, called a guidewire, to the target location within the vasculature. Due to factors, such as vessel tortuosity and lack of steerability at the guidewire tip, manual navigation of a guidewire could be challenging, potentially resulting in vessel damage, perforation, dissection, and occlusion, as well as postsurgical complications, such as thrombosis. This work details the development of a handheld actuation mechanism for tendon-driven robotic guidewires by utilizing the aforementioned spooling mechanism. Incorporating the compact spooling mechanism into a handheld device enables clinicians to leverage both motorized guidewire steering and manual rotation and translation, if desired. The proposed device is designed such that, while holding the device, the clinician can execute feeding, rotation, and bending motions for up to 1.5 m of the robotically steerable guidewire using a joystick and momentary switch on the handle. Furthermore, the proposed device is demonstrated through navigation in an anatomically accurate phantom aorta model.
Saima Chavenet, Timothy A. Brumfiel, Revanth Konda +1