Vanessa Leung

Artificial Muscle Devices: Innovations and Prospects for Fecal Incontinence Treatment

Fecal incontinence describes the involuntary loss of bowel content, which is responsible for stigmatization and social exclusion. It affects about 45% of retirement home residents and overall more than 12% of the adult population. Severe fecal incontinence can be treated by the implantation of an artificial sphincter. Currently available implants, however, are not part of everyday surgery due to long-term re-operation rates of 95% and definitive explantation rates of 40%. Such figures suggest that the implants fail to reproduce the capabilities of the natural sphincter. This article reviews the artificial sphincters on the market and under development, presents their physical principles of operation and critically analyzes their performance. We highlight the geometrical and mechanical parameters crucial for the design of an artificial fecal sphincter and propose more advanced mechanisms of action for a biomimetic device with sensory feedback. Dielectric electro-active polymer actuators are especially attractive because of their versatility, response time, reaction forces, and energy consumption. The availability of such technology will enable fast pressure adaption comparable to the natural feedback mechanism, so that tissue atrophy and erosion can be avoided while maintaining continence during daily activities.

Morphology and conductivity of Au films on polydimethylsiloxane using (3-mercaptopropyl)trimethoxysilane (MPTMS) as an adhesion promoter

Dielectric elastomer actuators (DEA) are often referred to as artificial muscles due to their high specific continuous power, which is comparable to that of human skeletal muscles, and because of their millisecond response time. We intend to use nanometer-thin DEA as medical implant actuators and sensors to be operated at voltages as low as a few tens of volts. The conductivity of the electrode and the impact of its stiffness on the stacked structure are key to the design and operation of future devices. The stiffness of sputtered Au electrodes on polydimethylsiloxane (PDMS) was characterized using AFM nanoindentation techniques. 2500 nanoindentations were performed on 10 x 10 μm2 regions at loads of 100 to 400 nN using a spherical tip with a radius of (522 ± 2) nm. Stiffness maps based on the Hertz model were calculated using the Nanosurf Flex-ANA system. The low adhesion of Au to PDMS has been reported in the literature and leads to the formation of Au-nanoclusters. The size of the nanoclusters was (25 ± 10) nm and can be explained by the low surface energy of PDMS leading to a Volmer-Weber growth mode. Therefore, we propose (3-mercaptopropyl)trimethoxysilane (MPTMS) as a molecular adhesive to promote the adhesion between the PDMS and Au electrode. A beneficial side effect of these self-assembling monolayers is the significant improvement of the electrode’s conductivity as determined by four-point probe measurements. Therefore, the application of a soft adhesive layer for building a dielectric elastomer actuator appears promising.

Micro- and nanostructured electro-active polymer actuators as smart muscles for incontinence treatment

Treatments of severe incontinence are currently based on purely mechanical systems that generally result in revision after three to five years. Our goal is to develop a prototype acting in a natural-analogue manner as artificial muscle, which is based on electro-active polymers. Dielectric actuators have outstanding performances including millisecond response times, mechanical strains of more than 10 % and power to mass densities similar to natural muscles. They basically consist of polymer films sandwiched between two compliant electrodes. The incompressible but elastic polymer film transduces the electrical energy into mechanical work according to the Maxwell pressure. Available polymer films are micrometers thick and voltages as large as kV are necessary to obtain 10 % strain. For medical implants, polymer films should be nanometer thin to realize actuation below 48 V. The metallic electrodes have to be stretchable to follow the strain of 10 % and remain conductive. Recent results on the stress/strain ...

Strain-dependent characterization of electrode and polymer network of electrically activated polymer actuators

Fecal incontinence describes the involuntary loss of bowel content and affects about 45 % of retirement home residents and overall more than 12 % of the adult population. Artificial sphincter implants for treating incontinence are currently based on mechanical systems with failure rates resulting in revision after three to five years. To overcome this drawback, artificial muscle sphincters based on bio-mimetic electro-active polymer (EAP) actuators are under development. Such implants require polymer films that are nanometer-thin, allowing actuation below 24 V, and electrodes that are stretchable, remaining conductive at strains of about 10 %. Strain-dependent resistivity measurements reveal an enhanced conductivity of 10 nm compared to 30 nm sputtered Au on silicone for strains higher than 5 %. Thus, strain-dependent morphology characterization with optical microscopy and atomic force microscopy could demonstrate these phenomena. Cantilever bending measurements are utilized to determine elastic/viscoelastic properties of the EAP films as well as their long-term actuation behavior. Controlling these properties enables the adjustment of growth parameters of nanometer-thin EAP actuators.

Biomimetic artificial sphincter muscles: status and challenges

Fecal incontinence is the involuntary loss of bowel content and affects more than 12% of the adult population, including 45% of retirement home residents. Severe fecal incontinence is often treated by implanting an artificial sphincter. Currently available implants, however, have long-term reoperation rates of 95% and definitive explantation rates of 40%. These statistics show that the implants fail to reproduce the capabilities of the natural sphincter and that the development of an adaptive, biologically inspired implant is required. Dielectric elastomer actuators (DEA) are being developed as artificial muscles for a biomimetic sphincter, due to their suitable response time, reaction forces, and energy consumption. However, at present the operation voltage of DEAs is too high for artificial muscles implanted in the human body. To reduce the operating voltage to tens of volts, we are using microfabrication to reduce the thickness of the elastomer layer to the nanometer level. Two microfabrication methods are being investigated: molecular beam deposition and electrospray deposition. This communication covers the current status and a perspective on the way forward, including the long-term prospects of constructing a smart sphincter from low-voltage sensors and actuators based on nanometer-thin dielectric elastomer films. As DEA can also provide sensory feedback, a biomimetic sphincter can be designed in accordance with the geometrical and mechanical parameters of its natural counterpart. The availability of such technology will enable fast pressure adaption comparable to the natural feedback mechanism, so that tissue atrophy and erosion can be avoided while maintaining continence du ring daily activities.

Nanomechanical probing of thin-film dielectric elastomer transducers

Dielectric elastomer transducers (DETs) have attracted interest as generators, actuators, sensors, and even as self-sensing actuators for applications in medicine, soft robotics, and microfluidics. Their performance crucially depends on the elastic properties of the electrode-elastomer sandwich structure. The compressive displacement of a single-layer DET can be easily measured using atomic force microscopy (AFM) in the contact mode. While polymers used as dielectric elastomers are known to exhibit significant mechanical stiffening for large strains, their mechanical properties when subjected to voltages are not well understood. To examine this effect, we measured the depths of 400 nanoindentations as a function of the applied electric field using a spherical AFM probe with a radius of (522 ± 4) nm. Employing a field as low as 20 V/μm, the indentation depths increased by 42% at a load of 100 nN with respect to the field-free condition, implying an electromechanically driven elastic softening of the DET. T...

Electro-spraying and ultra-violet light curing of polydimethylsiloxane to fabricate thin films for low-voltage dielectric elastomer actuators

Currently, dielectric elastomer actuators (DEA) are mainly based on micrometer-thin polymer films and require operating voltages of several hundred volts. In medical applications, however, voltages as low as a few tens of volts are required. To this end, we prepared nanometer-thin dielectric elastomer layers. It is demonstrated that alternating current, electro-spray deposition allows for the fabrication of homogenous, flat, nanometer-thin polydimethylsiloxane (PDMS) films. The growth of the PDMS with average number molecular weights ranging from 800 to 62,700 g/mol, at a constant flow rate of 267 nL/s, was in situ monitored by means of spectroscopic ellipsometry. The Cauchy layer model used for data interpretation may only be applied to flat PDMS layers. Thus, in the present study the droplet morphology was also determined by atomic force microscopy. Spectroscopic ellipsometry does allow for the qualitative determination of the thin film morphology. However, for high molecular weight polymers the precise measurement during deposition is challenging. Independent of the molecular weight, the roughness of the deposited PDMS films considerably smoothens during the ultra-violet radiation treatment. After curing, the electro-sprayed nanometer-thin PDMS films are homogeneous enough to qualify for the fabrication of low-voltage DEA.