Electromechanical reshaping of tissue

组织机电重塑

• 批准号: 7790533
• 负责人: Brian WONG
• 金额: $ 22.95万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-25 至 2011-08-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7790533
• 关键词: Address; Anesthesia procedures; Animal Model; Area; Attention; Behavior; California; Cartilage; Cauterization - action; Charge; Chemicals; Clinical; Congenital Abnormality; Conventional Surgery; Cornea; Defect; Deformity; Dependence; Development; Devices; Digestion; Disadvantaged; Discipline; Disease; Ear; Ear Cartilages; Electrodes; Electrosurgery; Endoscopes; Esthetics; Face; Family suidae; General Anesthesia; Generations; Grant; Harvest; Head and neck structure; Healed; Heating; Hemorrhage; Human; In Situ; Joints; Knowledge; Larynx; Lasers; Life; Malignant Neoplasms; Mechanics; Memory; Methods; Modality; Modeling; Morbidity - disease rate; Motivation; Movement; Needles; Nose; Operating Rooms; Operative Surgical Procedures; Ophthalmology; Organ; Orthopedics; Oryctolagus cuniculus; Phonation; Plastic Surgical Procedures; Platinum; Polymers; Power Sources; Procedures; Process; Property; Public Health; Reaction; Reconstructive Surgical Procedures; Rejuvenation; Relaxation; Reporting; Role; Shapes; Site; Skin; Source; Specimen; Stress; Structure; Surgeon; Surgical Staplers; Surgical incisions; Surgical sutures; Techniques; Technology; Temperature; Tendon structure; Therapeutic; Thick; Time; Tissue Grafts; Tissues; Trachea; Trauma; Universities; Vision; base; cancer surgery; clinical efficacy; cost; costal cartilage; electric field; external ear auricle; healing; heat injury; in vivo; in vivo Model; innovation; instrumentation; interest; minimally invasive; novel; novel therapeutics; public health relevance; radiofrequency; response; rib bone structure; scalpel; soft tissue; surgical technique development; technology development; voltage; wasting

DESCRIPTION (provided by applicant): For more than a century, surgeons have envisioned reshaping tissue without the use of scalpels and sutures. Recently, developments with multiple therapeutic modalities have brought this vision closer to reality through development of new procedures, minimally invasive instrumentation, and innovative devices for treating skin and other tissues; each of which exploits the ability of these modalities to alter the intrinsic material properties of the tissue. In the head and neck, cartilage tissue is of particular interest as it serves functional and structural roles, including the support of soft tissue (ear and nose), airway patency (trachea), phonation (larynx), and joint movement (i.e.,TMJ). The defects that result from cancer, trauma, or congenital malformations in these organs are currently corrected by "cut and suture" surgery, which has numerous disadvantages including shape memory, donor site morbidity, and usually general anesthesia. We have developed electromechanical reshaping (EMR), a novel minimally invasive technique that combines mechanical deformation with the application of very low-current DC electric fields. In EMR cartilage is bent into a new shape by a jig, platinum needle electrodes are inserted into regions of increased internal stress, and a small current (<25 mA) is delivered. The jig is removed, and the cartilage assumes a new stable shape. EMR is a novel and compelling technology that exploits the native properties of cartilage to change its mechanical state by simply altering the electrical and chemical milieu that interacts with the charged cartilage tissue matrix. To drive this technology forward, we aim to: 1) determine the relationships between shape change, voltage, and application time during EMR; 2) determine the degree of tissue damage produced during EMR as a function of voltage and application time; and 3) determine the stability, functionality, and long-term behavior of electroformed cartilage grafts in an in vivo rabbit model. As with all emerging surgical technologies, efficacy must be demonstrated in an animal model to fuel clinical interest and provide justifiable motivation to pursue more extensive basic studies focusing on both mechanisms and optimization. Knowing how cartilage heals, remodels, and maintains shape after EMR will provide impetus to further develop and investigate methods to understand, optimize, and control this process and ultimately usher in a new therapeutic surgical modality. EMR is an elegant and simple, low-cost technology, and has the potential to become a clinically useful surgical treatment modality as ubiquitous as the Bovie cautery, surgical stapler, or endoscope in reconstructive surgery. PUBLIC HEALTH RELEVANCE: Deformities of the ear, nose, and airway are common and surgery to correct these disorders requires general anesthesia, incisions, sutures and bleeding. The development of the technology proposed in this grant is aimed at advancing this simple, non-surgical method to reshape tissue in these organs in the face, head, and neck. This technology is potentially simpler, safer, and less expensive than current existing surgical techniques.

描述（由申请人提供）：在一个多世纪以来，外科医生设想在不使用手术刀和缝合线的情况下重塑组织。最近，具有多种治疗方式的发展通过开发新程序，微创仪器以及用于治疗皮肤和其他组织的创新设备，使这种愿景更接近现实。每种方法都利用了这些方式改变组织的内在材料特性的能力。在头部和颈部，软骨组织特别感兴趣，因为它具有功能性和结构性作用，包括支持软组织（耳朵和鼻子），气道通畅（气管），发声（喉）和关节运动（即TMJ）。目前，这些器官中癌症，创伤或先天性畸形导致的缺陷通过“切割和缝合”手术纠正，该手术具有许多缺点，包括形状记忆，供体部位的发病率，通常是全身麻醉。我们开发了机电重塑（EMR），这是一种新型的微创技术，将机械变形与非常低电流的直流电场的应用结合在一起。在EMR软骨中，夹具弯曲成新的形状，将铂针电极插入增加内部应力的区域，并传递小电流（<25 mA）。去除夹具，软骨采用新的稳定形状。 EMR是一种新颖而引人注目的技术，可利用软骨的天然特性来改变其机械状态，以改变与带电的软骨组织基质相互作用的电和化学环境。为了推动这项技术向前发展，我们的目标是：1）确定EMR期间形状变化，电压和应用时间之间的关系； 2）确定EMR期间产生的组织损伤程度是电压和应用时间的函数； 3）确定体内兔模型中电动软骨移植物的稳定性，功能和长期行为。与所有新兴手术技术一样，必须在动物模型中证明功效以促进临床兴趣，并提供合理的动机，以追求更广泛的基础研究，重点是机制和优化。知道软骨如何治愈，重塑和保持EMR后的形状将提供动力，以进一步开发和研究理解，优化和控制这一过程的方法，并最终引入新的治疗性手术模式。 EMR是一种优雅而简单，低成本的技术，并且有潜力成为临床上有用的手术治疗方式，例如无处不在的烧烤，手术订书机或内窥镜在重建手术中。 公共卫生相关性：耳朵，鼻子和气道的畸形是常见的，纠正这些疾病的手术需要全身麻醉，切口，缝合线和出血。该赠款中提出的技术的发展旨在推进这种简单的，非手术的方法，以在面部，头部和颈部这些器官中重塑组织。该技术可能比当前现有的手术技术更简单，更安全且便宜。