Artificial Hand: A New Device for Ingested Foreign Bodies Removal

描述(申请人提供)：异物摄入和食物丸嵌塞频繁发生，严重威胁人类健康。仅在美国，每年约有1500人死于吞咽异物，其中儿童约占异物摄入的80%。其他风险较高的群体包括囚犯、精神病患者和老年人，特别是那些认知功能下降、中风后吞咽障碍或假牙安装不良的人。食物团塞也经常发生在动物身上。硬性和柔韧性内窥镜及其各自的附件，如不同类型的钳子和圈套，是积极处理嵌顿的食道异物最常用的技术。用于抓住和保持物体的工具缺乏可靠性和灵活性，使得该过程耗时和危险，在许多不成功的情况下，导致执行更具侵入性的外科手术的必要性。开发一种灵活、安全的工具，理想情况下可以模仿人类的手指(没有什么比人类的手更清晰)是参与这些手术的医生的梦想。智能光学系统(IOS)计划开发一种独特的异物取出装置。该设备将使用一对四指假手，并在设备的远端具有内部照明和可视化通道。从加州大学洛杉矶分校最初的研究演变而来的“假手”，是一种四指气动控制的机械手。硅微加工被用来制造每个手指的多个指骨，使整个封闭的“拳头”可以放入一毫米直径的管子中。手将被缩放，以提供移除异物所需的力量，光纤照明将嵌入手掌中。手将被整合到一个柔性轴中，以及一个可视化通道和一个类似于传统内窥镜的关节尖端。这种装置将优于现有的技术，因为它具有高度的灵活性，并且能够确保要移除的物体。在第一阶段，iOS将展示将视觉、照明和操纵相结合的概念，利用商业上可获得的成像光学和光纤光学，以及对加州大学洛杉矶分校开发的现有设备的创新改进，开发出一种人造“看得见的手”。第一阶段测试将确定整个设备所需的参数和初步设计。在第二阶段，iOS将建造和测试一套完整的视觉辅助异物取出装置，其中包括定制的光学装置和计算机控制的气动硅指。异物摄取是世界范围内的普遍问题，特别是在儿科人口中，每年发生超过10万例。内窥镜技术被认为是取出摄取异物的黄金标准，但在某种程度上，这种技术本身效率低下，不安全，因为用于这种手术的许多抓取式钳子本质上是不安全和低效的。开发一种使用双手和手指的更安全的设备，将代表着异物取出程序的巨大改进。

DESCRIPTION (provided by applicant): The ingestion of foreign bodies and food bolus 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, who are 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. Food bolus impaction also occurs frequently in animals. Rigid and flexible endoscopy, with the respective accessories, such as forceps of different types and snares, is the most commonly used technique for the active management of impacted esophageal foreign bodies. The lack of reliability and flexibility of the tools used for grasping and holding the object make the procedure time consuming and risky, and in many unsuccessful situations, leads to the necessity for performing a more invasive surgical procedure. The development of a flexible, safe tool that can, ideally, mimic human fingers (there is nothing more articulating than the human hand) is the dream of physicians involved in these procedures. Intelligent Optical Systems (IOS) proposes to develop a unique device for ingested foreign body removal. The device will utilize a pair of four-finger artificial hands, and will have internal illumination and visualization channels, in the distal end of the device. The "Artificial Hand," which evolved from initial studies at UCLA, is a four-finger pneumatically controlled manipulator. Silicon micromachining is used to fabricate multiple phalanges per finger, allowing the entire closed "fist" to fit into a one-millimeter diameter tube. The hand will be scaled to provide the force necessary to remove foreign bodies, and fiber optic illumination will be embedded in the "palm" of the hand. The hands will be incorporated into a flexible shaft, along with a visualization channel and an articulating tip similar to a conventional endoscope. Such a device will be superior to existing techniques because of its high degree of flexibility, and its ability to secure the object to be removed. In Phase I, IOS will demonstrate the concept of combining vision, illumination, and manipulation to develop an artificial "Seeing Hand," using commercially available imaging optics and fiber optics, and innovative modifications to existing devices developed at UCLA. Phase I tests will establish the parameters and preliminary designs required for the overall device. In Phase II, IOS will construct and test a complete vision-assisted device for foreign bodies removal, incorporating custom- fabricated optics and computer-controlled pneumatically-actuated silicon phalanges. 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 endoscopy technique, which is considered the gold standard for removing ingested foreign bodies, is to some degree intrinsically inefficient and unsafe, because many of the grasping type forceps that are used for this procedure are unsafe and inefficient by their nature. The development of a safer device, which employs two hands with fingers, will represent a vast improvement in foreign body removal procedures.