A Soft-Robotic Biomimetic Benchtop Model for Esophageal Motility Simulation

Area of Science:

• Biomedical Engineering
• Gastroenterology
• Robotics

Background:

• Current large animal and benchtop models inadequately represent the esophageal environment and cannot simulate swallowing dysfunction (dysphagia).
• Limitations hinder progress in understanding esophageal motility disorders like achalasia and developing evidence-based dietary advice.

Purpose of the Study:

• To develop and validate RoboGullet+, a biomimetic soft-robotic platform capable of simulating normal and diseased esophageal motility.
• To assess the platform's utility in evaluating stent migration, simulating achalasia subtypes, and analyzing bolus swallowing.

Main Methods:

• Development of RoboGullet, a soft-robotic model with independent longitudinal and circumferential muscle actuation.
• Enhancement to RoboGullet+ incorporating porcine esophageal mucosa/submucosa for biohybrid realism.
• Application testing for stent migration, achalasia simulation (Types I-III), and bolus transit analysis.

Main Results:

• Stent migration increased over fivefold with longitudinal muscle movement compared to circumferential alone.
• Viscous non-Newtonian bolus improved high-resolution manometry sensitivity for Achalasia III by increasing Distal Latency by 20.83%.
• Stirred Greek-style yoghurt significantly improved bolus transit for Achalasia Types I-II patients compared to unstirred.

Conclusions:

• RoboGullet+ provides a versatile and realistic simulation of esophageal function and dysfunction.
• The platform advances understanding of esophageal motility disorders and therapeutic interventions.
• Findings support the use of specific bolus properties and dietary modifications for achalasia management.