RoSE: A Robotic Soft Esophagus for Endoprosthetic Stent Testing

Area of Science:

• Biomedical Engineering
• Soft Robotics
• Gastroenterology

Background:

• Dysphagia management often involves endoprosthetic esophageal stents.
• Stent migration and impaired swallowing efficacy are critical complications.
• Limited clinical data hinders optimal stent design and stenting guidelines.

Purpose of the Study:

• To develop and utilize a bio-mimicking robotic soft esophagus (RoSE) as an in vitro testing device for endoprosthetic esophageal stents.
• To investigate the effect of stent radial stiffness on radial force, stent migration, and swallowing efficacy.
• To assess the impact of stenting on intrabolus pressure signatures (IBPSs) and swallowing function using endoscopic manometry.

Main Methods:

• Developed a robotic soft esophagus (RoSE) mimicking human esophageal biomechanics.
• Implanted two stents with differing radial stiffness (stent A and B) into the RoSE.
• Conducted experiments measuring radial force, stent migration, and performing endoscopic manometry under simulated peristalsis with varying bolus concentrations.

Main Results:

• Stiffer stent B exhibited higher radial force, effectively minimizing migration compared to less stiff stent A.
• Stent A slightly increased IBPS, while stiffer stent B significantly decreased IBPS, particularly with higher concentration boluses.
• Buckling of stiffer stents was observed to reduce swallow efficacy and potentially cause recurrent dysphagia.

Conclusions:

• The RoSE platform is a viable tool for evaluating endoprosthetic esophageal stent performance in vitro.
• Optimal stent design requires balancing radial force for migration prevention with maintaining sufficient swallowing function.
• This soft robotic system offers a solution for addressing clinical challenges in esophageal stent testing and development.