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. ? ? ?
