Soft robotic systems are well suited for developing devices for biomedical applications. A bio-mimicking robotic soft esophagus (RoSE) is developed as an in vitro testing device of endoprosthetic stents for dysphagia management. Endoprosthetic stent placement is an immediate and cost-effective therapy for dysphagia caused by malignant esophageal strictures from esophageal cancer. However, later stage complications, such as stent migration, could weaken the swallow efficacy in the esophagus. The stent radial force (RF) on the esophageal wall is pivotal in avoiding stent migration. Due to limited randomized controlled trials in patients, the stent design and stenting guidelines are still unconstructive. To address the knowledge deficit, we have investigated the capabilities of the RoSE by implanting two stents (stent A and B) of different radial stiffness characteristics, to measure the stent RF and its effect on the stent migration. Also, endoscopic manometry on the RoSE under peristalsis has been performed to study the impact of stenting and stent dysfunctionality on the intrabolus pressure signatures (IBPSs) in the RoSE, and further its effects on the swallowing efficacy. Each implanted stent in the RoSE underwent a set of experiments with various test variables (peristalsis velocity and wavelength, and bolus concentrations). In this study, the conducted tests are representative of the application of RoSE to perform a wide-ranging assessment of the stent behavior. The usability of RoSE has been discussed by comparing the results of stent A and B, for various combinations of the test variables mentioned earlier. The results have demonstrated that the stiffer stent B has a higher RF, whereas stent A maintained its RF at a low profile due to its lesser stiffness. The results have also implicated that a high RF is necessary to minimize the stent migration under prolonged peristaltic contractions in the RoSE. For the manometry experiments, stent A slightly increased the IBPS, but the stiffer stent B significantly decreased the IBPS, especially for the higher concentration boluses. It was found that if a stiffer stent buckles, it can reduce the swallow efficacy and cause recurrent dysphagia. Therefore, RoSE is an innovative soft robotic platform that is capable of testing various endoprosthetic stents, thereby offering a solution to many existing clinical challenges in the area of stent testing.

中文翻译：

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RoSE：用于内置支架测试的机器人软食道

软机器人系统非常适合开发用于生物医学应用的设备。一种仿生机器人软食道（RoSE）被开发为体外用于吞咽困难管理的内置支架测试装置。内支架置入术是治疗食管癌恶性食管狭窄引起的吞咽困难的直接且经济有效的治疗方法。然而，后期并发症，如支架移位，可能会削弱食道的吞咽功效。食管壁上的支架径向力 (RF) 是避免支架移位的关键。由于在患者中进行的随机对照试验有限，支架设计和支架置入指南仍然不具建设性。为了解决知识缺陷，我们通过植入两个具有不同径向刚度特性的支架（支架 A 和 B）来研究 RoSE 的能力，以测量支架 RF 及其对支架迁移的影响。还，已经对蠕动下的 RoSE 进行内窥镜测压，以研究支架和支架功能障碍对 RoSE 中的丸内压力特征 (IBPS) 的影响，并进一步研究其对吞咽功效的影响。RoSE 中的每个植入支架都经历了一组具有各种测试变量（蠕动速度和波长，以及推注浓度）的实验。在这项研究中，所进行的测试代表了 RoSE 对支架行为进行广泛评估的应用。已经通过比较支架 A 和 B 的结果来讨论 RoSE 的可用性，用于前面提到的测试变量的各种组合。结果表明，较硬的支架 B 具有较高的 RF，而支架 A 由于其较小的刚度而将其 RF 保持在低剖面。结果还表明，在 RoSE 长时间蠕动收缩下，需要高 RF 才能最大限度地减少支架迁移。对于测压实验，支架 A 略微增加了 IBPS，但较硬的支架 B 显着降低了 IBPS，尤其是对于较高浓度的推注。研究发现，如果较硬的支架弯曲，会降低吞咽功效并导致反复吞咽困难。因此，RoSE 是一个创新的软机器人平台，能够测试各种内置支架，从而为支架测试领域的许多现有临床挑战提供解决方案。但较硬的支架 B 显着降低了 IBPS，尤其是对于较高浓度的推注。研究发现，如果较硬的支架弯曲，会降低吞咽功效并导致反复吞咽困难。因此，RoSE 是一个创新的软机器人平台，能够测试各种内置支架，从而为支架测试领域的许多现有临床挑战提供解决方案。但较硬的支架 B 显着降低了 IBPS，尤其是对于较高浓度的推注。研究发现，如果较硬的支架弯曲，会降低吞咽功效并导致反复吞咽困难。因此，RoSE 是一个创新的软机器人平台，能够测试各种内置支架，从而为支架测试领域的许多现有临床挑战提供解决方案。