Robotic Implant Treats Esophagus Birth Defect

Kevin Kunzmann
JANUARY 23, 2018
An implantable robot is capable of treating a rare birth defect in infants through tissue stimulation.
 Researchers from the University of Sheffield and Boston’s Children Hospital at Harvard Medical School have created a device designed to aid in treating esophageal atresia, a defect which occurs when the upper and lower parts of the esophagus don’t connect.

The prototype device is a robotic implant that attaches to the patient’s esophagus and stimulates cells by pulling tissue with an incorporated motor. Its function is similar to that of the Foker technique—a correction of esophageal atresia in which doctors manually pull tissue using sutures over an extended period of time.

The implant capable of monitoring and applying appropriate tissue traction using 2 types of sensors to measure tissue tension and displacement. Its power comes from a control unit attached to a vest outside of the patient’s body, allowing doctors to monitor patients at any time.

Common treatment for the defect calls for patient sedation, in order to ensure the applied sutures do not tear. Developers hope the device will free babies to movement and interaction while undergoing treatment, relieving stress for involved family members.

Esophageal atresia currently affects about 1 in every 4,000 babies born in the US and Europe.

Dana Damian, PhD, from the Department of Automatic Control and Systems Engineering (ASCE) at Sheffield, said the Foker procedure is widely accepted for treating the condition, though experts are uncertain how much force should be applied to lengthen tissue.

“Although the technique is one of the best standards, sometimes the sutures surgeons attach to the esophagus can tear which can result in repetitive surgeries or scar tissue can form that can cause problems for the patient in the future,” Damian said.

Such an issue is overcome with the device, as its sensors allows constant monitoring and adjustments to the applied force of tissue lengthening.

Early research has shown that cells multiply in response to the pulling action, giving health care experts a better understanding of mechanical stimulation’s potential for tissue growth. Sheila MacNeil, PhD, Professor of Tissue Engineering in the Department of Materials Science and Engineering at the University of Sheffield, said increased knowledge on the subject has been needed for some time.

“Doctors and researchers understand that tissues will normally grow in response to traction forces, for example this occurs naturally during pregnancy as the growing baby increases the pressure inside the mother, the abdominal wall and skin increase in area to relieve the tension generated from stretching these tissues,” MacNeil said.

MacNeil called the robotic implant a breakthrough in applied tissue-response knowledge. Damian, responsible for designing a functioning robot for a technology-hostile environment, called it the just first step in the field.

“We have made a device that can provide long-term control of the tissue growth using on-board medical expertise,” Damian said. “We further want to look at other tubular tissues, such as the intestine and the vascular system, to see if this sort of technology can be used to help with other conditions, such as Short Bowel Syndrome."

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