Postoperative ileus (POI) is the leading cause of prolonged hospital stay after abdominal surgery and is characterized by a functional paralysis of the digestive tract, leading to symptoms such as constipation, vomiting, and functional obstruction. Current treatments are mainly supportive and inefficacious and yield acute side effects. Although electrical stimulation studies have demonstrated encouraging pacing and entraining of the intestinal slow waves, no devices exist today to enable targeted intestinal reanimation. Here, we developed an ingestible self-propelling device for intestinal reanimation (INSPIRE) capable of restoring peristalsis through luminal electrical stimulation. Optimizing mechanical, material, and electrical design parameters, we validated optimal deployment, intestinal electrical luminal contact, self-propelling capability, safety, and degradation of the device in ex vivo and in vivo swine models. We compared the INSPIRE’s effect on motility in models of normal and depressed motility and chemically induced ileus. Intestinal contraction improved by 44% in anesthetized animals and up to 140% in chemically induced ileus cases. In addition, passage time decreased from, on average, 8.6 days in controls to 2.5 days with the INSPIRE device, demonstrating significant improvement in motility. Luminal electrical stimulation of the intestine via the INSPIRE efficaciously restored peristaltic activity. This noninvasive option offers a promising solution for the treatment of ileus and other motility disorders.

中文翻译：

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用于肠道复活的可吞咽自推进装置

术后肠梗阻（POI）是腹部手术后住院时间延长的主要原因，其特点是消化道功能性麻痹，导致便秘、呕吐和功能性梗阻等症状。目前的治疗主要是支持性的，效果不佳，并且会产生严重的副作用。尽管电刺激研究已证明肠道慢波的起搏和夹带具有令人鼓舞的作用，但目前尚不存在能够实现有针对性的肠道复苏的设备。在这里，我们开发了一种用于肠道复苏的可摄入自推进装置（INSPIRE），能够通过管腔电刺激恢复蠕动。通过优化机械、材料和电气设计参数，我们在离体和体内猪模型中验证了该装置的最佳部署、肠电腔接触、自推进能力、安全性和降解。我们比较了 INSPIRE 对正常和运动抑制以及化学诱导肠梗阻模型中运动的影响。麻醉动物的肠收缩改善了 44%，而化学诱导的肠梗阻病例则改善了 140%。此外，通过时间从对照组的平均 8.6 天减少到 INSPIRE 装置的 2.5 天，这表明运动能力显着改善。通过 INSPIRE 对肠道进行腔内电刺激，可有效恢复蠕动活动。这种非侵入性选择为肠梗阻和其他运动障碍的治疗提供了一种有前途的解决方案。