Tissue-Responsive Robotic Implants for In Vivo Mechanostimulation-Based Tissue Regeneration (Tissue-RIMOTE)

长间隙食道闭锁（LGOA）和短肠综合征（SBS）等情况是胃肠道组织重建的慢性儿科病例的两个例子，分别可能缺失多达三分之二的食道和肠道。这些是最复杂和最具破坏性的儿科畸形，对患者造成终生衰弱的影响。他们目前的治疗方法并不普遍，复杂、原始、长期且结果质量有争议。家属和外科医生长期以来一直在寻求有效的治疗方法来改善这些患者的生活质量。该项目旨在启动一项雄心勃勃的研究议程，利用机器人和组织再生原理，开发一种修复和重建体内软管状组织的新技术。其基础技术将组织工程、外科和医疗植入领域整合为“机器人植入”的新概念。拟议的机器人植入物是管状组织的一刀切衬里，使自主组织响应与组织的机械相互作用能够诱导它们的生长。基于细胞生物学研究和临床实践的证据，表明组织如何在体内对机械刺激作出反应，提出的机器人植入物直接对组织施加温和的力，通过细胞增殖诱导生长。因此，这些机器人植入物以一种前所未有的方式为组织提供可控的、长期的、可定制的和最佳的重建治疗。这项拟议的技术有可能恢复患者的行动能力和社交活动，同时减少住院和术后并发症、治疗和费用。该提案具有开创性的重点：开发机器人植入物的设计，制造和控制，这些植入物可以在物理和生理上适应组织变化的特性并刺激其生长。这些机器人植入物将由基本的、紧凑的、功能性的弹性体链组成，这些弹性体链可以组装成一个结构，可以随着组织的生长而拉长，并对组织施加可控的、定向的机械刺激。该项目是一个令人兴奋的跨学科研究框架的基础，它将使外科医生、生物学家、组织工程师和组织力学研究人员能够研究组织生长的基本机制，并了解组织应变、组织再生和炎症反应之间的关系。特别是，在该项目中开发的技术将成为LGOA和SBS的先驱临床设备。该项目还启动了对软性机器人的研究，这些机器人可以在身体上适应并在体内工作，这对于组织再生和生长以及需要适应儿童发育阶段的可穿戴技术都是必不可少的。

Conditions such as long-gap oesophageal atresia (LGOA) and short bowel syndrome (SBS) are two examples of chronic paediatric cases of gastrointestinal tissue reconstruction where up to two thirds of the oesophagus and bowel, respectively, may be missing. These are among the most complex and devastating paediatric anomalies that have a life-long debilitating effect on patients. Their current treatments are not widely available, are complex, primitive, long-term, and have disputed outcome quality. Families and surgeons have long sought an effective treatment to improve these patients' quality of life.The proposed project aims to initiate an ambitious research agenda for a novel technology for the repair and reconstruction of soft tubular tissues inside the body using robotic and tissue regeneration principles. The underlying technology unifies the fields of tissue engineering, surgery and medical implants into a new concept of 'robotic implants'. The proposed robotic implants are one-size-fits-all linings for tubular tissues that enable autonomous tissue-responsive mechanical interaction with tissues to induce their growth. Based on evidence from cell biology studies and clinical practice showing how tissues respond to mechanical stimulation in vivo, the proposed robotic implant applies gentle force directly to tissues to induce growth through cell proliferation. Thus, these robotic implants deliver controlled, long-term, customisable and optimal reconstructive therapy for tissues in an unprecedented way. The proposed technology has the potential to restore patients' mobility and social activity, as well as reduce hospitalisation and post-surgery complications, treatment and costs.This proposal has a pioneering focus: to develop the design, fabrication and control of robotic implants that can physically and physiologically adapt to the changing properties of tissues and stimulate their growth. These robotic implants will consist of fundamental, compact and functional elastomeric strands that can be assembled into an architecture that can elongate with the growing tissue and apply controlled, directional mechanical stimulation to the tissue.This project is the basis of an exciting interdisciplinary research framework that will allow communities of surgeons, biologists, tissue engineers and tissue mechanics researchers to investigate basic mechanisms of tissue growth and understand the relationships among tissue strain, tissue regeneration and inflammatory responses. In particular, the technology to be developed in this project will be a precursor clinical device for LGOA and SBS. This project also launches an investigation into soft robots that physically adapt and perform inside the body, which is imperative for tissue regeneration and growth as well as for wearable technologies that need to adapt to children's developmental stages.