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Flexible piezoelectric devices for gastrointestinal motility sensing

Nature Biomedical Engineering volume 1, pages 807–817 (2017)Cite this article

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Abstract

Improvements in ingestible electronics with the capacity to sense physiological and pathophysiological states have transformed the standard of care for patients. Yet, despite advances in device development, significant risks associated with solid, non-flexible gastrointestinal transiting systems remain. Here, we report the design and use of an ingestible, flexible piezoelectric device that senses mechanical deformation within the gastric cavity. We demonstrate the capabilities of the sensor in both in vitro and ex vivo simulated gastric models, quantify its key behaviours in the gastrointestinal tract using computational modelling and validate its functionality in awake and ambulating swine. Our proof-of-concept device may lead to the development of ingestible piezoelectric devices that might safely sense mechanical variations and harvest mechanical energy inside the gastrointestinal tract for the diagnosis and treatment of motility disorders, as well as for monitoring ingestion in bariatric applications.

Systems for sensing of the gastrointestinal (GI) lumen have significantly extended our ability to diagnose and treat patients. Specifically, ingestible electronics have been developed to monitor pH (refs 1,2), manometric pressure2, temperature2, dosage from ingestion to facilitate adherence monitoring3 and even vital signs4, as well as for optical imaging in wireless endoscopy5. Although these systems have had a significant impact on clinical practice, they are associated with complications, including GI obstruction6 and limited battery lifespan, which may impact the completion rates of the evaluation7. Recent progress in flexible electronics8,9,10,11,12 raises the potential for the development of systems capable of both sensing and remaining flexible, allowing for deformation through the GI tract, potentially mitigating GI obstruction. This advancement could reduce the risk for intestinal obstruction and extend current sensing capabilities by providing systems amenable to implantation for long-term monitoring and/or stimulation. Particularly, active piezoelectric materials13,14,15, which are more favourable than resistive materials due to their low power, high sensitivity and easy readout features16,17, recent fabrication techniques18,19 and associated unusual device structures20,21 are helping to advance electronic device integration within the body. Thus, ingestible, flexible electronic devices offer an advanced platform for the diagnosis and treatment of motility disorders, monitoring of ingestion to aid in the treatment of obesity and development of flexible therapies in the form of GI electroceuticals22.

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Fig. 1: PZT GI-S.
Fig. 2: Cell culture study and biocompatibility.
Fig. 3: In vitro experimental characterization.
Fig. 4: In vivo evaluation in Yorkshire swine model.
Fig. 5: In vivo evaluation in a Yorkshire swine model.

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Acknowledgements

We thank J. Haupt and M. Jamiel for help with the in vivo swine work. We thank Y-A. Lee for assistance with the SEM. We thank the Hope Babette Tang Histology Facility at the Koch Institute at MIT for the histology work and consultation. We also thank the MIT Microsystems Technology Laboratories and MIT Microscopy Core Facility. C.D. thanks the late G. Caliskanoglu for useful suggestions on the device design. This work was funded in part by a postdoctoral fellowship from the Swiss National Foundation (to T.v.E.), National Institutes of Health grant EB-000244, the Max Planck Research Award (Award Ltr Dtd. 2/11/08), the Alexander von Humboldt-Stiftung Foundation (to R.L.) and the Division of Gastroenterology, Brigham and Women’s Hospital (to G.T.).

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Authors and Affiliations

  1. Media Lab, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA

    Canan Dagdeviren, Zijun Wei & Robert Langer

  2. David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, 02142, USA

    Farhad Javid, Pauline Joe, Thomas von Erlach, Taylor Bensel, Sarah Saxton, Cody Cleveland, Lucas Booth, Shane McDonnell, Joy Collins, Alison Hayward, Robert Langer & Giovanni Traverso

  3. Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA

    Robert Langer

  4. Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA

    Robert Langer

  5. Division of Gastroenterology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA

    Giovanni Traverso

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Contributions

C.D. designed and fabricated the PZT GI-S. C.D. and G.T. designed the in vitro, ex vivo and in vivo experiments. T.v.E. performed the cell culture study and studied the biocompatibility of the PZT GI-S. C.D., P.J., T.B. and Z.W. designed an in vitro setup to simulate stomach behaviour and conducted in vitro trials of PZT GI-S. F.J. performed ABAQUS/Standard for finite element modelling. C.D., S.S., C.C. and L.B. designed and conducted the ex vivo studies. C.D., P.J., S.M., J.C., A.H. and G.T. performed in vivo evaluations of the GI-S in Yorkshire swine models. All authors discussed and interpreted the results, and wrote and edited the paper.

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Correspondence to Canan Dagdeviren or Giovanni Traverso.

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Dagdeviren, C., Javid, F., Joe, P. et al. Flexible piezoelectric devices for gastrointestinal motility sensing. Nat Biomed Eng 1, 807–817 (2017). https://doi.org/10.1038/s41551-017-0140-7

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