Soft robotic sleeve supports heart function

Roche, Ellen T.; Horvath, Markus A.; Wamala, Isaac; Alazmani, Ali; Song, Sang-Eun; Whyte, William; Machaidze, Zurab; Payne, Christopher J.; Weaver, James; Fishbein, Gregory A.; Kuebler, Joseph D.; Vasilyev, Nikolay V.; Mooney, David J.; Pigula, Frank A.; Walsh, Conor J.

doi:10.1126/scitranslmed.aaf3925

Cited by 330 publications

(250 citation statements)

References 54 publications

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“…[55] Also usage of soft pneumatic actuators may suggest another approach for the contraction of bladder, but such devices need extra compressors for their operation. [56,57] The flexibility of our proposed actuator makes it suitable for the common keyhole surgeries on bladder, since it can be easily compressed to pass through the small incision and expanded inside the body for the implantation onto a bladder. The size of anchor points can be reduced further after coating of the vest with a biocompatible polymer to improve the strength of fingers of vest.…”

Section: Discussionmentioning

confidence: 99%

Design and Anchorage Dependence of Shape Memory Alloy Actuators on Enhanced Voiding of a Bladder

Hassani

Gammad

Mogan

et al. 2017

Adv Materials Technologies

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for such transformation. [3] Voluntary repeatable shape transformation, material biocompatibility, and small weight of NiTi shape memory alloy (SMA) actuators make them suitable for medical applications. [4][5][6][7][8][9][10][11][12] Usage of NiTi SMA actuators for muscular contraction, [8] artificial anal sphincter, [7] urethral valve, [13] myocardium, [8] drug delivery system, [3] and most recently, voiding of a bladder, [14] has been reported.The previous SMA-based actuator for voiding of a bladder consisted of a flexible vest that covered the bladder surface and physically contracted it upon the actuation of assembled SMA wires. [14] Since a fixed length was considered for SMA wires in this design, the device could be used for only one bladder size that was matched with the total inner diameter of actuator. The proposed design in our study has a more conformable vest that can be fitted for a wider range of bladder sizes in rats with similar body weight, and can substantially improve the voiding volume and energy consumption of the device.The previous SMA-based actuator was proposed for assisting the detrusor muscle in myogenic underactive bladder (UAB) patient with detrusor muscle contractility disorder but intact nerves. [14] Our study broadens the application of the actuating device also to neurogenic UAB patients suffering from both damaged detrusor muscle and nervous system; these patients are not able to rely on the natural nerve pathways to realize The use of shape memory alloy (SMA) actuators to restore voiding of bladder for myogenic under active bladder (UAB) patients is proposed recently. Even though previous work show the unique capability of this technology for bladder voiding, the low voiding volume and high energy consumption of the device limit the advancement of this technique. This study proposes a novel approach using an interlaced configuration to overcome these limitations. In this device, SMA actuators are threaded through rigid anchor points of the flexible vest. The novel anchorage of SMA actuators provides more conformability for the vest and lower energy consumption for the device, while the new interlaced configuration enhances the voiding volume. The device is tested initially on a rubber model for the bladder, then it is implanted in an anesthetized rat, and a voiding volume of more than 20% at 4 V is successfully achieved. A commercial force sensor is integrated with the device to make it suitable for neurogenic UAB patients. The sensor provides a feedback control signal to the patient to initiate the actuation of the device upon fullness of bladder. The overall system is a promising advance over the state-of-the-art providing bladder voiding in UAB patients.

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Section: Discussionmentioning

confidence: 99%

Design and Anchorage Dependence of Shape Memory Alloy Actuators on Enhanced Voiding of a Bladder

Hassani

Gammad

Mogan

et al. 2017

Adv Materials Technologies

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“…In contrast, robotic implants represent an unexplored frontier. Such devices can be implanted in the body for an extended period of time and interact mechanically with tissues to regulate tissue forces or fluid flow rates (9) in response to sensed physiological signals as well as external commands.…”

Section: Introductionmentioning

confidence: 99%

In vivo tissue regeneration with robotic implants

Damian

Price

Arabagi³

et al. 2018

Sci. Robot.

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Abstract:Robots that reside inside the body to restore or enhance biological function have long been a staple of science fiction. Creating such robotic implants poses challenges both in signaling between the implant and the biological host as well as in implant design. To investigate these challenges, we created a robotic implant to perform in vivo tissue regeneration via mechano-stimulation. The robot is designed to induce lengthening of tubular organs, such as the esophagus and intestines, by computer-controlled application of traction forces. Esophageal testing in swine demonstrates that the applied forces can induce cell proliferation and lengthening of the organ without a reduction in diameter, while the animal is awake, mobile and able to eat normally. Such robots can serve as research tools for studying mechanotransduction-based signaling and can also be employed clinically for conditions such as long-gap esophageal atresia and short bowel syndrome. One Sentence Summary:We have created a robotic implant for inducing tissue growth in tubular organs and demonstrated its potential through esophageal lengthening in swine.

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Section: Discussionmentioning

confidence: 99%

“…19,22,23 The PAM actuators are lightweight, have fast response times, and are tunable to match physiologic requirements of the heart. 19,21 In contrast to previous designs that provide biventricular support using an enclosing sleeve, 22,23 the RVED is specifically conceived to address the structural changes that are seen in advanced right heart failure. 6,10,20,27 In this study, by employing a combination of soft robotics and precision engineering we developed a device that is small enough to be safely deployed inside the beating heart.…”

Section: Discussionmentioning

confidence: 99%

“…22,23 In contrast to previous designs that provide compressive biventricular support on the heart surface, the proposed RVED operates inside the RV, specifically addressing the structural changes that are seen in RHF. 20 A low profile device such as this, which can be easily deployed into the beating heart under echocardiography guidance, may be very well suited for the short-term support of a failing RV.…”

Section: Introductionmentioning

confidence: 99%

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An Intracardiac Soft Robotic Device for Augmentation of Blood Ejection from the Failing Right Ventricle

et al. 2017

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We introduce an implantable intracardiac soft robotic right ventricular ejection device (RVED) for dynamic approximation of the right ventricular (RV) free wall and the interventricular septum (IVS) in synchrony with the cardiac cycle to augment blood ejection in right heart failure (RHF). The RVED is designed for safe and effective intracardiac operation and consists of an anchoring system deployed across the IVS, an RV free wall anchor, and a pneumatic artificial muscle linear actuator that spans the RV chamber between the two anchors. Using a ventricular simulator and a custom controller, we characterized ventricular volume ejection, linear approximation against different loads and the effect of varying device actuation periods on volume ejection. The RVED was then tested in vivo in adult pigs (n = 5). First, we successfully deployed the device into the beating heart under 3D echocardiography guidance (n = 4). Next, we performed a feasibility study to evaluate the device’s ability to augment RV ejection in an experimental model of RHF (n = 1). RVED actuation augmented RV ejection during RHF; while further chronic animal studies will provide details about the efficacy of this support device. These results demonstrate successful design and implementation of the RVED and its deployment into the beating heart. This soft robotic ejection device has potential to serve as a rapidly deployable system for mechanical circulatory assistance in RHF.

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Soft robotic sleeve supports heart function

Cited by 330 publications

References 54 publications

Design and Anchorage Dependence of Shape Memory Alloy Actuators on Enhanced Voiding of a Bladder

Design and Anchorage Dependence of Shape Memory Alloy Actuators on Enhanced Voiding of a Bladder

In vivo tissue regeneration with robotic implants

An Intracardiac Soft Robotic Device for Augmentation of Blood Ejection from the Failing Right Ventricle

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