Food bolus ingestion and foreign body 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 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. Rigid and flexible endoscopy, with accessories such as various forceps and snares, is the most common technique for removing these impacted esophageal foreign bodies. Lack of reliability and flexibility of grasping tools, however, make the procedure time-consuming and risky. Often bolus and foreign body removal procedures lead to more invasive surgical procedures and even death, an especially tragic result for a child who has swallowed a coin or battery, the most common event in pediatric cases of obstruction. It is also the most difficult scenario because the contracted esophagus holds the object with substantial force. Power needs to be applied to the prongs of the forceps to overcome these forces;no current technology provides this force. Lack of a secure hold on the object as it is being removed and as the esophagus relaxes often causes the object to go into the trachea, resulting in death. Therefore, physicians involved in these procedures need a tool that can mimic human fingers, which provide maximum articulation. To address these needs, Intelligent Optical Systems (IOS) proposes to develop a new device for ingested foreign body removal, specifically focusing on the withdrawal of the most difficult and least successful procedures, such as coins and button batteries. Based on the highly successful Phase I results of IOS'Artificial Hand (AH), Phase II research will focus on developing, engineering, and testing a novel endoscope with unique distal end tips attachments that will secure the object, allowing its complete and safe removal from the patient. One attachment, the AH's Seeing Fingers, will use a pair of strong pneumatically controlled fingers that will deliver and secure a net around the object. Another attachment, the AH's Seeing Grabber, will use 2 two- or three-finger hands, and will provide distraction and removal of bolus. All Seeing Fingers and Seeing Grabber fingers will have autonomous illumination and visualization channels. IOS will develop the AH's Seeing Fingers and Seeing Grabber in stages. The MEMS microfabrication lab at University of California, Los Angeles, IOS's collaborator, will help to develop the fingers;the optical channels and controls will be developed at IOS. After completion of this step, IOS will assemble the distal manipulating parts, generate the manipulation protocol, evaluate the procedure, and make improvements in the benchtop experiments. The Seeing Grabber prototype will then be fabricated and tested. Finally, the Seeing Fingers will be designed, fabricated, tested, and presented to a potential strategic partner. IOS'proposed Seeing Fingers and Seeing Grabber system will be a vast improvement over existing tools, providing a life-saving tool for physicians.

Public Health Relevance

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 endoscopic technique, currently the gold standard for removing ingested foreign bodies, is inefficient and unsafe, often resulting in death. A safer device, IOS'Artificial Hand's Seeing Fingers, employs two hands with fingers and secures the trapped object, allowing safer removal than is currently available and saving many lives.

National Institute of Health (NIH)
National Center for Research Resources (NCRR)
Small Business Innovation Research Grants (SBIR) - Phase II (R44)
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Special Emphasis Panel (ZRG1-SBMI-T (10))
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Sachs, Jody
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Intelligent Optical Systems, Inc.
United States
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