Development of a Universal Electric Medical Clamp for Rotational Intraperitoneal Aerosol Chemotherapy

Peritoneal metastasis is associated with poor prognosis and low response rates to systemic chemotherapy due to multidrug resistance. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) has improved local drug delivery but remains limited by uneven drug distribution, with most aerosol deposition concentrated opposite the nozzle. To overcome this, rotational intraperitoneal aerosol chemotherapy (RIPAC) was developed. This study aimed to design a universal electric medical clamp enabling stable nozzle rotation for RIPAC.

A prototype device was constructed using a miniaturized electric motor mounted within a modular clamp to induce conical pendulum motion of the aerosol nozzle. Iterative design optimizations addressed instability and vibration, evolving from simple fixed joints to reinforced mechanical assemblies and finally a hydraulic joint system. Prototypes were evaluated in benchtop and porcine models for motion stability, spray uniformity, and mechanical robustness under operative conditions.

The initial mockup device achieved pendulum-like motion but failed to maintain stability during in vivo testing due to shifts in the nozzle's center of gravity and joint collapse. Reinforced joint designs improved stability but required cumbersome adjustments. The final hydraulic joint-integrated clamp provided enhanced fixation strength, increased degrees of freedom, and smoother fine-tuned positioning, while accommodating motor load. This configuration enabled consistent nozzle motion with greater clinical feasibility.

A universal electric medical clamp was successfully developed for RIPAC, providing stable rotational motion and improved drug distribution potential compared with PIPAC. This innovation lays the groundwork for clinical translation of RIPAC as a promising strategy to enhance intraperitoneal chemotherapy efficacy.