An ingestible self-propelling device for intestinal reanimation.

Journal: Science robotics
PMID: 38416855

Abstract

Postoperative ileus (POI) is the leading cause of prolonged hospital stay after abdominal surgery and is characterized by a functional paralysis of the digestive tract, leading to symptoms such as constipation, vomiting, and functional obstruction. Current treatments are mainly supportive and inefficacious and yield acute side effects. Although electrical stimulation studies have demonstrated encouraging pacing and entraining of the intestinal slow waves, no devices exist today to enable targeted intestinal reanimation. Here, we developed an ingestible self-propelling device for intestinal reanimation (INSPIRE) capable of restoring peristalsis through luminal electrical stimulation. Optimizing mechanical, material, and electrical design parameters, we validated optimal deployment, intestinal electrical luminal contact, self-propelling capability, safety, and degradation of the device in ex vivo and in vivo swine models. We compared the INSPIRE's effect on motility in models of normal and depressed motility and chemically induced ileus. Intestinal contraction improved by 44% in anesthetized animals and up to 140% in chemically induced ileus cases. In addition, passage time decreased from, on average, 8.6 days in controls to 2.5 days with the INSPIRE device, demonstrating significant improvement in motility. Luminal electrical stimulation of the intestine via the INSPIRE efficaciously restored peristaltic activity. This noninvasive option offers a promising solution for the treatment of ileus and other motility disorders.

Authors

  • Shriya S Srinivasan
    MIT Center for Extreme Bionics, Massachusetts Institute of Technology, Cambridge, MA.
  • Julien Dosso
    Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
  • Hen-Wei Huang
    The Koch Institute for Integrated Cancer Research, Massachusetts Institute of Technology, Cambridge.
  • George Selsing
    Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
  • Amro Alshareef
    Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
  • Johannes Kuosmanen
    Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
  • Keiko Ishida
    Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
  • Joshua Jenkins
    David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
  • Wiam Abdalla Mohammed Madani
    Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
  • Alison Hayward
    Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA, USA.
  • Giovanni Traverso
    David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Division of Gastroenterology, Hepatology and Endoscopy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA; MIT-IBM Watson AI Lab, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA. Electronic address: cgt20@mit.edu.

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