1
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Prata F, Lucarini G, Menciassi A, Ricotti L, Mazzocchi T, Marziale L, Gruppioni E, Scarpa RM, Papalia R. A magnetic endourethral sphincter against stress urinary incontinence: preliminary pilot study in humans. Minerva Urol Nephrol 2023; 75:514-520. [PMID: 37166131 DOI: 10.23736/s2724-6051.23.05190-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND Urinary incontinence (UI) is a common and frustrating condition that affects patients' quality of life as well as the Healthcare systems. Currently, the most severe cases of UI are treated using implanted, invasive artificial sphincters. We propose an innovative, minimally invasive magnetic endourethral sphincter for the treatment of stress UI (SUI) in patients for whom previous medical and surgical treatments have failed. METHODS Six patients with severe SUI were enrolled at a single center and underwent cystoscopic sphincter implantation. After 10 days, correct device position was confirmed by ultrasonography. The sphincter was explanted after 28 days. RESULTS In all patients, the sphincter was successfully implanted using an endoscopic approach. One patient reached the end of the pilot test (28 days) with the sphincter correctly placed. Patients' responses on the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form questionnaire improved from a score of 18 out of 21 at the screening visit (UI without reasons) to a score of 3 out of 21 (almost perfect continence). No major pain and discomfort were reported. CONCLUSIONS This study showed the feasibility of sphincter implantation, explantation, and overall tolerability, although a redesign of the sphincter distal part is needed.
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Affiliation(s)
- Francesco Prata
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Gioia Lucarini
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy -
| | | | - Leonardo Ricotti
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | | | | | | | - Roberto M Scarpa
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Rocco Papalia
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
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2
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Liao Y, Wang M, Liu Y, Zhou W, Liu J, Yu H. Magnetically controlled artificial urinary sphincter: An overview from existing devices to future developments. Artif Organs 2023. [PMID: 37114754 DOI: 10.1111/aor.14535] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Urinary incontinence is a common clinical problem in the world today. Artificial urinary sphincter is a good treatment approach for severe urinary incontinence, which is designed to mimic the action of the human urinary sphincter and assist patients to regain urinary function. METHODS There are many control methods based on artificial urinary sphincter, such as hydraulic control, electromechanical control, magnetic control, and shape memory alloy control. In this paper, the literature was first searched and documented based on PRISMA search strategy for selected specific subject terms. Then, a comparison of artificial urethral sphincters based on different control methods was conducted, and the research progress of magnetically controlled artificial urethral sphincters was reviewed, and their advantages and disadvantages were summarized. Finally, the design factors for the clinical application of magnetically controlled artificial urinary sphincter are discussed. RESULTS As magnetic control allows for non-contact force transfer and does not generate heat, it is proposed that magnetic control may be one of the more promising control methods. The design of future magnetically controlled artificial urinary sphincters will need a variety of considerations, including the structural design of the device, manufacturing materials, manufacturing costs, and convenience. In addition, validation of the safety and effectiveness of the device and device management are equally important. CONCLUSIONS The design of an ideal magnetically controlled artificial urinary sphincter is of great importance to enhance patient treatment outcomes. However, there are still great challenges to be faced for the clinical application of such devices.
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Affiliation(s)
- Yucheng Liao
- Institute of Rehabilitation Engineering and Technology, School of Intelligent Rehabilitation Engineering, University of Shanghai for Science and Technology, Shanghai, China
- Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
| | - Minghui Wang
- Institute of Rehabilitation Engineering and Technology, School of Intelligent Rehabilitation Engineering, University of Shanghai for Science and Technology, Shanghai, China
- Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
| | - Yunlong Liu
- Institute of Rehabilitation Engineering and Technology, School of Intelligent Rehabilitation Engineering, University of Shanghai for Science and Technology, Shanghai, China
- Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
| | - Wei Zhou
- Institute of Rehabilitation Engineering and Technology, School of Intelligent Rehabilitation Engineering, University of Shanghai for Science and Technology, Shanghai, China
- Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
| | - Ji Liu
- Institute of Rehabilitation Engineering and Technology, School of Intelligent Rehabilitation Engineering, University of Shanghai for Science and Technology, Shanghai, China
- Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
| | - Hongliu Yu
- Institute of Rehabilitation Engineering and Technology, School of Intelligent Rehabilitation Engineering, University of Shanghai for Science and Technology, Shanghai, China
- Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
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3
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Toniolo I, Mascolini MV, Carniel EL, Fontanella CG. Artificial sphincters: An overview from existing devices to novel technologies. Artif Organs 2023; 47:617-639. [PMID: 36374175 DOI: 10.1111/aor.14434] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/21/2022] [Accepted: 10/11/2022] [Indexed: 11/16/2022]
Abstract
Artificial sphincters (ASs) are used to replace the function of the biological sphincters in case of severe urinary and fecal incontinence (UI and FI), and gastroesophageal reflux disease (GERD). The design of ASs is established on different mechanisms, e.g., magnetic forces or hydraulic pressure, with the final goal to achieve a implantable and durable AS. In clinical practice, the implantation of in-commerce AS is considered a reasonable solution, despite the sub-optimal clinical outcomes. The failure of these surgeries is due to the malfunction of the devices (between 46 and 51%) or the side effects on the biological tissues (more than 38%), such as infection and atrophy. Concentrating on this latter characteristic, particular attention has been given to the interaction between the biological tissues and AS, pointing out the closing mechanism around the duct and the effect on the tissues. To analyze this aspect, an overview of existing commercial/ready-on-market ASs for GERD, UI, and FI, together with the clinical outcomes available from the in-commerce AS, is given. Moreover, this invited review discusses ongoing developments and future research pathways for creating novel ASs. The application of engineering principles and design concepts to medicine enhances the quality of healthcare and improves patient outcomes. In this context, computational methods represent an innovative solution in the design of ASs, proving data on the occlusive force and pressure necessary to guarantee occlusion and avoid tissue damage, considering the coupling between different device sizes and individual variability.
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Affiliation(s)
- Ilaria Toniolo
- Department of Industrial Engineering, University of Padova, Padova, Italy
- Centre for Mechanics of Biological Materials, University of Padova, Padova, Italy
| | - Maria Vittoria Mascolini
- Department of Industrial Engineering, University of Padova, Padova, Italy
- Centre for Mechanics of Biological Materials, University of Padova, Padova, Italy
| | - Emanuele Luigi Carniel
- Department of Industrial Engineering, University of Padova, Padova, Italy
- Centre for Mechanics of Biological Materials, University of Padova, Padova, Italy
| | - Chiara Giulia Fontanella
- Department of Industrial Engineering, University of Padova, Padova, Italy
- Centre for Mechanics of Biological Materials, University of Padova, Padova, Italy
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4
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Casagrande G, Ibrahimi M, Semproni F, Iacovacci V, Menciassi A. Hydraulic Detrusor for Artificial Bladder Active Voiding. Soft Robot 2022; 10:269-279. [PMID: 35759369 DOI: 10.1089/soro.2021.0140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The gold standard treatment for bladder cancer is radical cystectomy that implies bladder removal coupled to urinary diversions. Despite the serious complications and the impossibility of controlled active voiding, bladder substitution with artificial systems is a challenge and cannot represent a real option, yet. In this article, we present hydraulic artificial detrusor prototypes to control and drive the voiding of an artificial bladder (AB). These prototypes rely on two actuator designs (origami and bellows) based either on negative or positive operating pressure, to be combined with an AB structure. Based on the bladder geometry and size, we optimized the actuators in terms of contraction/expansion performances, minimizing the liquid volume required for actuation and exploring different actuator arrangements to maximize the voiding efficiency. To operate the actuators, an ad hoc electrohydraulic circuit was developed for transferring liquid between the actuators and a reservoir, both of them intended to be implanted. The AB, actuators, and reservoir were fabricated with biocompatible flexible thermoplastic materials by a heat-sealing process. We assessed the voiding efficiency with benchtop experiments by varying the actuator type and arrangement at different simulated patient positions (horizontal, 45° tilted, and vertical) to identify the optimal configuration and actuation strategy. The most efficient solution relies on two bellows actuators anchored to the AB. This artificial detrusor design resulted in a voiding efficiency of about 99%, 99%, and 89%, in the vertical, 45° tilted, and horizontal positions, respectively. The relative voiding time was reduced by about 17, 24, and 55 s compared with the unactuated bladder.
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Affiliation(s)
- Giada Casagrande
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Michele Ibrahimi
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Federica Semproni
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Veronica Iacovacci
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy.,Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Hong Kong, China
| | - Arianna Menciassi
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
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5
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Mazzocchi T, Lucarini G, Roehrer I, Menciassi A, Ricotti L. PDMS and DLC-coated unidirectional valves for artificial urinary sphincters: Opening performance after 126 days of immersion in urine. J Biomed Mater Res B Appl Biomater 2021; 110:817-827. [PMID: 34726338 PMCID: PMC9298115 DOI: 10.1002/jbm.b.34961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 10/14/2021] [Accepted: 10/16/2021] [Indexed: 12/05/2022]
Abstract
In this work, unidirectional valves made of bare polydimethylsiloxane (PDMS) and PDMS provided with a micrometric diamond‐like carbon (DLC) coating were fabricated and characterized, in terms of surface properties and opening pressure. The valve performance was also tested over 1250 repeated cycles of opening/closure in water, finding a slight decrease in the opening pressure after such cycles (10%) for the PDMS valves, while almost no variation for the PDMS + DLC ones. The valves were then immersed in urine for 126 days, evaluating the formation of encrustations and the trend of the opening pressure over time. Results showed that PDMS valves were featured by a thin layer of encrustations after 126 days, but the overall encrustation level was much smaller than the one shown by PDMS in static conditions. Furthermore, the opening pressure was almost not affected by such a thin layer of crystals. DLC‐coated valves showed even less encrustations at the same time‐point, with no significant loss of performance over time, although they were featured by a higher variability. These results suggest that most encrustations can be removed by the mechanical action of the valve during daily openings/closures. Such a self‐cleaning behavior with respect to a static condition opens exciting scenarios for the long‐term functionality of mobile devices operating in the urinary environment.
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Affiliation(s)
- Tommaso Mazzocchi
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.,Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Gioia Lucarini
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.,Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Irene Roehrer
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.,Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Arianna Menciassi
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.,Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Leonardo Ricotti
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.,Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
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6
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Iacovacci V, Tamadon I, Kauffmann EF, Pane S, Simoni V, Marziale L, Aragona M, Cobuccio L, Chiarugi M, Dario P, Del Prato S, Ricotti L, Vistoli F, Menciassi A. A fully implantable device for intraperitoneal drug delivery refilled by ingestible capsules. Sci Robot 2021; 6:6/57/eabh3328. [PMID: 34408097 DOI: 10.1126/scirobotics.abh3328] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 07/28/2021] [Indexed: 12/18/2022]
Abstract
Creating fully implantable robots that replace or restore physiological processes is a great challenge in medical robotics. Restoring blood glucose homeostasis in patients with type 1 diabetes is particularly interesting in this sense. Intraperitoneal insulin delivery could revolutionize type 1 diabetes treatment. At present, the intraperitoneal route is little used because it relies on accessing ports connecting intraperitoneal catheters to external reservoirs. Drug-loaded pills transported across the digestive system to refill an implantable reservoir in a minimally invasive fashion could open new possibilities in intraperitoneal delivery. Here, we describe PILLSID (PILl-refiLled implanted System for Intraperitoneal Delivery), a fully implantable robotic device refillable through ingestible magnetic pills carrying drugs. Once refilled, the device acts as a programmable microinfusion system for precise intraperitoneal delivery. The robotic device is grounded on a combination of magnetic switchable components, miniaturized mechatronic elements, a wireless powering system, and a control unit to implement the refilling and control the infusion processes. In this study, we describe the PILLSID prototyping. The device key blocks are validated as single components and within the integrated device at the preclinical level. We demonstrate that the refilling mechanism works efficiently in vivo and that the blood glucose level can be safely regulated in diabetic swine. The device weights 165 grams and is 78 millimeters by 63 millimeters by 35 millimeters, comparable with commercial implantable devices yet overcoming the urgent critical issues related to reservoir refilling and powering.
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Affiliation(s)
- Veronica Iacovacci
- BioRobotics Institute, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy.,Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy.,Department of Mechanical and Automation Engineering, Chinese University of Hong Kong, Shatin NT, Hong Kong SAR
| | - Izadyar Tamadon
- BioRobotics Institute, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy.,Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy
| | - Emanuele Federico Kauffmann
- Division of General and Transplant Surgery, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - Stefano Pane
- BioRobotics Institute, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy.,Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy
| | - Virginia Simoni
- BioRobotics Institute, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy.,Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy
| | - Leonardo Marziale
- BioRobotics Institute, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy.,Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy
| | - Michele Aragona
- Department of Clinical and Experimental Medicine, Section of Metabolic Diseases and Diabetes, University of Pisa, Via Savi 10, 56126 Pisa, Italy
| | - Luigi Cobuccio
- Emergency Surgery Unit, Azienda Ospedaliero Universitaria Pisana Cisanello Hospital, Via Piero Trivella, 56124 Pisa, Italy
| | - Massimo Chiarugi
- Emergency Surgery Unit, Azienda Ospedaliero Universitaria Pisana Cisanello Hospital, Via Piero Trivella, 56124 Pisa, Italy
| | - Paolo Dario
- BioRobotics Institute, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy.,Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy.,Dubai Future Labs, Dubai, United Arab Emirates.,Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Beijing, China.,Department of Mechanical Engineering, Tianjin University, Tianjin, China
| | - Stefano Del Prato
- Department of Clinical and Experimental Medicine, Section of Metabolic Diseases and Diabetes, University of Pisa, Via Savi 10, 56126 Pisa, Italy
| | - Leonardo Ricotti
- BioRobotics Institute, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy.,Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy
| | - Fabio Vistoli
- Division of General and Transplant Surgery, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - Arianna Menciassi
- BioRobotics Institute, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy. .,Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy
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7
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Iacovacci V, Naselli I, Salgarella AR, Clemente F, Ricotti L, Cipriani C. Stability and in vivo safety of gold, titanium nitride and parylene C coatings on NdFeB magnets implanted in muscles towards a new generation of myokinetic prosthetic limbs. RSC Adv 2021; 11:6766-6775. [PMID: 35423178 PMCID: PMC8694929 DOI: 10.1039/d0ra07989h] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 01/31/2021] [Indexed: 01/11/2023] Open
Abstract
Rare earth magnets are the elective choice when high magnetic field density is required and they are particularly intriguing for inclusion in implantable devices. A safe implantation of NdFeB magnets in muscles would enable the control of limb prostheses using a myokinetic interface i.e., direct control of artificial limb movements by means of magnetic tracking of residual muscle contractions. However, myokinetic prosthesis control is prevented by NdFeB magnets poor biocompatibility, at present. Here we investigated three biocompatible materials as NdFeB magnet coating candidates, namely gold, titanium nitride and parylene C, which have not been analyzed in a systematic way for this purpose, so far. In vitro testing in a tissue-mimicking environment and upon contact with C2C12 myoblasts enabled assessment of the superiority of parylene C coated magnets in terms of corrosion prevention and lack of cytotoxicity. In addition, parylene C coated magnets implanted in rabbit muscles for 28 days confirmed, both locally and systemically, their biocompatibility, with a lack of irritation and toxicity associated with the implant. These findings pave the way towards the development of implantable devices based on permanent magnets and of a new generation of limb prostheses.
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Affiliation(s)
- Veronica Iacovacci
- The BioRobotics Institute, Scuola Superiore Sant'Anna Piazza Martiri della Libertà 33 56127 Pisa Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna Piazza Martiri della Libertà 33 56127 Pisa Italy
| | - Irene Naselli
- The BioRobotics Institute, Scuola Superiore Sant'Anna Piazza Martiri della Libertà 33 56127 Pisa Italy
| | - Alice Rita Salgarella
- The BioRobotics Institute, Scuola Superiore Sant'Anna Piazza Martiri della Libertà 33 56127 Pisa Italy
| | - Francesco Clemente
- The BioRobotics Institute, Scuola Superiore Sant'Anna Piazza Martiri della Libertà 33 56127 Pisa Italy
- Prensilia SRL Viale Rinaldo Piaggio 32 56025 Pontedera Italy
| | - Leonardo Ricotti
- The BioRobotics Institute, Scuola Superiore Sant'Anna Piazza Martiri della Libertà 33 56127 Pisa Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna Piazza Martiri della Libertà 33 56127 Pisa Italy
| | - Christian Cipriani
- The BioRobotics Institute, Scuola Superiore Sant'Anna Piazza Martiri della Libertà 33 56127 Pisa Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna Piazza Martiri della Libertà 33 56127 Pisa Italy
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8
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Menciassi A, Iacovacci V. Implantable biorobotic organs. APL Bioeng 2020; 4:040402. [PMID: 33263096 PMCID: PMC7688341 DOI: 10.1063/5.0032508] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 11/10/2020] [Indexed: 11/15/2022] Open
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9
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LI YAPENG, LI XIAO, ZHANG RAN, CAO RUI, GUAN TING. MODELING AND PERFORMANCE ANALYSIS FOR THE URETHRAL VALVE USED TO MANAGE SEVERE URINARY INCONTINENCE. J MECH MED BIOL 2020. [DOI: 10.1142/s0219519419500131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This paper presents a new urethral valve to deal with severe urinary incontinence (UI) caused by sphincter injury or dysneuria. This valve consists of a wireless power transfer system and a valve body structure driven by SMA (shape memory alloy) spring. The mechanical model of SMA spring and coupling model of wireless energy transfer are derived. Special attention is also given to the biological effects of electromagnetic filed as the proposed device is powered by wireless power transfer system. This valve is validated by simulation experiment and the models are used to investigate the influence of SMA spring parameters, control parameters and coil parameters on the driving characteristics of the proposed urethral valve.
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Affiliation(s)
- YAPENG LI
- School of Electromechanical Engineering, Guangdong University of Technology, Guangzhou 510006, P. R. China
| | - XIAO LI
- School of Electromechanical Engineering, Guangdong University of Technology, Guangzhou 510006, P. R. China
| | - RAN ZHANG
- School of Electromechanical Engineering, Guangdong University of Technology, Guangzhou 510006, P. R. China
| | - RUI CAO
- School of Electromechanical Engineering, Guangdong University of Technology, Guangzhou 510006, P. R. China
| | - TING GUAN
- General Hospital of the Southern Theater Command of the Chinese People’s Liberation Army, Guangzhou 510010, China
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10
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Pane S, Mazzocchi T, Iacovacci V, Ricotti L, Menciassi A. Smart Implantable Artificial Bladder: An Integrated Design for Organ Replacement. IEEE Trans Biomed Eng 2020; 68:2088-2097. [PMID: 32903176 DOI: 10.1109/tbme.2020.3023052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Substituting the natural bladder with an artificial solution, after cancer and other pathologies, is an ambitious challenge in biomedical engineering. In this work we propose a fully implantable smart artificial bladder system (ABS) that collects urinary fluids and provides the subject with real-time feedback on the implant status. To achieve long term duration, the ABS was designed to be unstretchable in order to be treated with urine resistant coatings and included built-in passive check valves preventing reflux to kidneys. To estimate the amount of fluid collected, the ABS was provided with four electromagnetic distance sensing units and a control unit. An algorithm implemented on an embedded controller enabled the reconstruction of the bladder volume through sensors readings. A wireless data transfer system allows for providing a real-time feedback to the subject. Bench tests validated volume reconstruction accuracy and ex-vivo experiments verified the implantability of the proposed device on a human cadaver, proving the reliability of a Bluetooth data transmission system and paving the way towards an in-body/out-body communication. The proposed solution has the potential to overcome the limitations of currently available replacement strategies towards a new generation of implantable devices for lost organ functions replacement.
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11
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Marziale L, Lucarini G, Mazzocchi T, Ricotti L, Menciassi A. Comparative analysis of occlusion methods for artificial sphincters. Artif Organs 2020; 44:995-1005. [PMID: 32216102 DOI: 10.1111/aor.13684] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/25/2020] [Accepted: 03/19/2020] [Indexed: 12/19/2022]
Abstract
An artificial sphincter is a device that replaces the function of the biological sphincter by occluding the relative biological lumen. The investigation of occlusion methods for artificial sphincters is crucial for a reliable and effective design of such devices. The compression induced onto the tissue by a certain pressure depends on the biomechanical and physiological features of the lumen and on the specific occlusion method. A numerical model and an experimental evaluation are presented here to assess the efficiency of different occlusion methods. Numerical models of circumferential occlusion and clamping occlusion methods to simulate the compression of the biological lumen were developed. Results revealed a relationship between the efficiency of the occlusion method and the physiological condition of the lumen. With differences related to the testing setup, this relationship was also confirmed experimentally by conducting tests on biological simulators. We analyzed the occlusion method to adopt as the physiological pressure (ie, leakage pressure values) changed. In particular, we focused on the urinary incontinence, which is a dysfunction involving the external sphincter surrounding the urethra. In this scenario, we demonstrated that a clamping occlusion is an efficient method to compress the urethra, whose physiological pressures range between 4 and 12 kPa. The clamping occlusion method resulted up to 35% more efficient in terms of sealing pressure than the circumferential one for a closing pressure varying between 2.3 and 11.5 kPa.
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Affiliation(s)
- Leonardo Marziale
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Gioia Lucarini
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Tommaso Mazzocchi
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Leonardo Ricotti
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Arianna Menciassi
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
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12
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Cardona A, Iacovacci V, Mazzocchi T, Menciassi A, Ricotti L. Novel Nanostructured Coating on PDMS Substrates Featuring High Resistance to Urine. ACS APPLIED BIO MATERIALS 2018; 2:255-265. [DOI: 10.1021/acsabm.8b00586] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Angelo Cardona
- Scuola Superiore Sant’anna, The BioRobotics Institute, Viale Rinaldo Piaggio 34, 56025 Pontedera (PI), Italy
| | - Veronica Iacovacci
- Scuola Superiore Sant’anna, The BioRobotics Institute, Viale Rinaldo Piaggio 34, 56025 Pontedera (PI), Italy
| | - Tommaso Mazzocchi
- Scuola Superiore Sant’anna, The BioRobotics Institute, Viale Rinaldo Piaggio 34, 56025 Pontedera (PI), Italy
| | - Arianna Menciassi
- Scuola Superiore Sant’anna, The BioRobotics Institute, Viale Rinaldo Piaggio 34, 56025 Pontedera (PI), Italy
| | - Leonardo Ricotti
- Scuola Superiore Sant’anna, The BioRobotics Institute, Viale Rinaldo Piaggio 34, 56025 Pontedera (PI), Italy
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Marziale L, Lucarini G, Mazzocchi T, Gruppioni E, Castellano S, Davalli A, Sacchetti R, Pistolesi D, Ricotti L, Menciassi A. Artificial Sphincters to Manage Urinary Incontinence: A Review. Artif Organs 2018; 42:E215-E233. [DOI: 10.1111/aor.13164] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 03/16/2018] [Accepted: 03/28/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Leonardo Marziale
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Viale R. Piaggio, Pontedera; Pisa Italy
| | - Gioia Lucarini
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Viale R. Piaggio, Pontedera; Pisa Italy
| | - Tommaso Mazzocchi
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Viale R. Piaggio, Pontedera; Pisa Italy
| | | | - Simona Castellano
- Prothesis Center INAIL, Via Rabuina, Vigoroso di Budrio; Bologna Italy
| | - Angelo Davalli
- Prothesis Center INAIL, Via Rabuina, Vigoroso di Budrio; Bologna Italy
| | - Rinaldo Sacchetti
- Prothesis Center INAIL, Via Rabuina, Vigoroso di Budrio; Bologna Italy
| | | | - Leonardo Ricotti
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Viale R. Piaggio, Pontedera; Pisa Italy
| | - Arianna Menciassi
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Viale R. Piaggio, Pontedera; Pisa Italy
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