Artificial Hand's Seeing Fingers: A New Device for Ingested Foreign Bodies Remova

人造手的可视手指：一种清除摄入异物的新装置

• 批准号: 7934614
• 负责人: VLADIMIR RUBTSOV
• 金额: $ 46.5万
• 依托单位: INTELLIGENT OPTICAL SYSTEMS, INC.
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-03-01 至 2011-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7934614
• 关键词: Accounting; Address; Adult; Area; Back; Biopsy; Bolus Infusion; Books; Caliber; California; Cessation of life; Chemistry; Child; Childhood; Coin; Collaborations; Contracts; Deglutition; Dentures; Development; Device Removal; Devices; Distal; Doctor of Medicine; Doctor of Philosophy; Dreams; Drops; Endoscopes; Endoscopy; Engineering; Esophageal; Esophagus; Evaluation; Event; Excision; Expert Systems; Family; Fiber Optics; Fingers; Food; Forcep; Foreign Bodies; Gastroenterology; Goals; Gold; Government; Hand; Health; Housing; Human; Image; Imagery; Ingestion; Joints; Lead; Left; Legal patent; Lesion; Life; Light; Lighting; Literature; Los Angeles; Mechanics; Medical; Medical center; Memory; Methods; Microfabrication; Obstruction; Operative Surgical Procedures; Optics; Patients; Perforation; Persons; Phalanx; Phase; Physicians; Poison; Population; Positioning Attribute; Prisoner; Procedures; Process; Protocols documentation; Reporting; Research; Rest; Risk; Rotation; Secure; Security; Security Measures; Side; Silicon; Solutions; Source; Specific qualifier value; Staging; Stomach; Stroke; System; Techniques; Technology; Test Result; Testing; Time; Trachea; Tube; United States; Universities; Visual; Withdrawal; Work; base; blind; cognitive function; commercialization; design; distraction; flexibility; grasp; improved; innovation; instrument; millimeter; novel; older patient; optical fiber; prevent; professor; prototype; public health relevance; research study; tool

DESCRIPTION (provided by applicant): Food bolus ingestion and foreign body impaction occur frequently and are serious threats to human health. In the United States alone, approximately 1,500 people die each year after swallowing foreign bodies, with children accounting for about 80% of foreign body ingestions. Other groups at increased risk include prisoners, psychiatric patients, and the elderly, especially those who have decreased cognitive function, impaired swallowing after a stroke, or poorly fitting dentures. Rigid and flexible endoscopy, with accessories such as various forceps and snares, is the most common technique for removing these impacted esophageal foreign bodies. Lack of reliability and flexibility of grasping tools, however, make the procedure time-consuming and risky. Often bolus and foreign body removal procedures lead to more invasive surgical procedures and even death, an especially tragic result for a child who has swallowed a coin or battery, the most common event in pediatric cases of obstruction. It is also the most difficult scenario because the contracted esophagus holds the object with substantial force. Power needs to be applied to the prongs of the forceps to overcome these forces; no current technology provides this force. Lack of a secure hold on the object as it is being removed and as the esophagus relaxes often causes the object to go into the trachea, resulting in death. Therefore, physicians involved in these procedures need a tool that can mimic human fingers, which provide maximum articulation. To address these needs, Intelligent Optical Systems (IOS) proposes to develop a new device for ingested foreign body removal, specifically focusing on the withdrawal of the most difficult and least successful procedures, such as coins and button batteries. Based on the highly successful Phase I results of IOS' Artificial Hand (AH), Phase II research will focus on developing, engineering, and testing a novel endoscope with unique distal end tips attachments that will secure the object, allowing its complete and safe removal from the patient. One attachment, the AH's Seeing Fingers, will use a pair of strong pneumatically controlled fingers that will deliver and secure a net around the object. Another attachment, the AH's Seeing Grabber, will use 2 two- or three-finger hands, and will provide distraction and removal of bolus. All Seeing Fingers and Seeing Grabber fingers will have autonomous illumination and visualization channels. IOS will develop the AH's Seeing Fingers and Seeing Grabber in stages. The MEMS microfabrication lab at University of California, Los Angeles, IOS's collaborator, will help to develop the fingers; the optical channels and controls will be developed at IOS. After completion of this step, IOS will assemble the distal manipulating parts, generate the manipulation protocol, evaluate the procedure, and make improvements in the benchtop experiments. The Seeing Grabber prototype will then be fabricated and tested. Finally, the Seeing Fingers will be designed, fabricated, tested, and presented to a potential strategic partner. IOS' proposed Seeing Fingers and Seeing Grabber system will be a vast improvement over existing tools, providing a life-saving tool for physicians. PUBLIC HEALTH RELEVANCE: The ingestion of foreign bodies is a common problem worldwide, especially in the pediatric population, where more than 100,000 cases occur each year. The endoscopic technique, currently the gold standard for removing ingested foreign bodies, is inefficient and unsafe, often resulting in death. A safer device, IOS' Artificial Hand's Seeing Fingers, employs two hands with fingers and secures the trapped object, allowing safer removal than is currently available and saving many lives.

描述（由申请方提供）：食团摄入和异物嵌塞经常发生，严重威胁人体健康。仅在美国，每年约有1,500人因吞食异物而死亡，其中儿童约占异物吞食者的80%。其他风险增加的群体包括囚犯，精神病患者和老年人，特别是那些认知功能下降，中风后吞咽受损或假牙不合适的人。刚性和柔性内窥镜检查，以及各种镊子和圈套器等附件，是取出这些嵌顿食管异物的最常见技术。然而，缺乏抓取工具的可靠性和灵活性使得该过程耗时且有风险。通常，食团和异物取出手术会导致更具侵入性的外科手术，甚至死亡，对于吞下硬币或电池的儿童来说，这是一个特别悲惨的结果，这是儿科梗阻病例中最常见的事件。这也是最困难的情况，因为收缩的食管以相当大的力保持物体。需要向镊子的叉状物施加功率以克服这些力;当前技术没有提供这种力。当物体被移除时以及当食道松弛时，缺乏对物体的牢固保持通常会导致物体进入气管，导致死亡。因此，参与这些手术的医生需要一种可以模仿人类手指的工具，以提供最大的关节连接。为了满足这些需求，智能光学系统公司（IOS）提出开发一种新的异物取出设备，专门用于取出最困难和最不成功的手术，如硬币和纽扣电池。基于IOS人工手（AH）非常成功的第一阶段结果，第二阶段研究将专注于开发、设计和测试一种新型内窥镜，该内窥镜具有独特的远端尖端附件，可固定物体，使其完全安全地从患者体内取出。其中一个附件，AH的视觉手指，将使用一对强大的气动控制手指，将在物体周围提供并固定一个网。另一个附件，AH的视觉抓取器，将使用2个两个或三个手指的手，并将提供分心和删除丸。所有Seeing Fingers和Seeing Grabber手指将具有自主照明和可视化通道。iOS将分阶段开发AH的Seeing Fingers和Seeing Grabber。IOS的合作者加州大学洛杉矶的MEMS微加工实验室将帮助开发手指;光学通道和控制将在IOS开发。完成该步骤后，IOS将组装远端操纵部件，生成操纵方案，评估程序，并在台架实验中进行改进。然后将制造和测试Seeing Grabber原型。最后，视觉手指将被设计、制造、测试，并提交给潜在的战略合作伙伴。IOS提出的Seeing Fingers和Seeing Grabber系统将是对现有工具的巨大改进，为医生提供一个拯救生命的工具。公共卫生关系：异物的摄入是世界范围内的常见问题，尤其是在儿科人群中，每年发生超过10万例。内窥镜技术目前是去除摄入异物的金标准，但效率低下且不安全，经常导致死亡。一个更安全的设备，IOS的人造手的看得见的手指，采用两只手的手指和固定被困的物体，允许更安全的删除比目前可用的，挽救了许多生命。