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.
Sci Robot. 2021 Aug 18;6(57). doi: 10.1126/scirobotics.abh3328.
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.
创建可完全植入并能替代或恢复生理机能的机器人是医学机器人领域的一个重大挑战。从这个意义上说,恢复 1 型糖尿病患者的血糖稳态尤其具有吸引力。腹腔内胰岛素输送可能会彻底改变 1 型糖尿病的治疗方式。目前,腹腔内途径很少使用,因为它依赖于进入连接腹腔内导管和外部储液器的端口。以微创方式经消化道输送载药丸来为可植入储液器重新填充药物,可能会为腹腔内输送开辟新的可能性。在这里,我们描述了 PILLSID(用于腹腔内输送的可再填充 Pill 型植入系统),这是一种可通过携带药物的可摄入磁性丸来再填充的完全可植入机器人设备。填充后,该设备可作为用于精确腹腔内输送的可编程微输注系统。该机器人设备基于磁开关组件、微型机电元件、无线供电系统和控制单元的组合来实现再填充和输注过程的控制。在这项研究中,我们描述了 PILLSID 的原型设计。该设备的关键部件作为单个组件以及在集成设备中都在临床前水平进行了验证。我们证明了再填充机制在体内的高效运行,并且可以安全地调节糖尿病猪的血糖水平。该设备重 165 克,尺寸为 78 毫米×63 毫米×35 毫米,与商业可植入设备相当,但克服了与储液器再填充和供电相关的紧急关键问题。