Triboelectric metamaterial stents: self-powered motility monitoring in post-esophagectomy conduits

Abstract

Anastomotic leaks following esophagectomy remain a major source of morbidity and mortality, yet current postoperative surveillance relies on intermittent imaging and clinical assessment, which may delay recognition. There is a paucity of objective, ongoing gastric conduit function monitoring. We suggest a self-powered stent made of triboelectric metamaterials that produce electrical signals by capturing mechanical energy from peristaltic motion. The conduit’s cyclic deformation generates measurable intraluminal pressure data that is wirelessly delivered for analysis in real time. Motility profiles that deviate from expectations may be early signs of anastomotic compromise. While earlier research validates the accuracy of intraluminal pressure monitoring in the gastrointestinal tract, recent developments in triboelectric nanogenerators and implantable biodegradable devices support the viability of this strategy. A unique approach to ongoing postoperative surveillance is provided by integrating triboelectric energy harvesting with stent design, which may enable earlier leak detection and improve patient outcomes.

Letter to Editor,

Anastomotic leaks after esophagectomy are associated with a significantly higher risk of mortality and reduced long-term survival, with meta-analyses demonstrating worse overall survival among patients who develop leaks compared to those who do not[1]. Current postoperative surveillance relies on intermittent imaging and clinical indicators, which have variable diagnostic performance and may not detect anastomotic leaks early after esophagectomy. Because timely recognition is important for patient outcomes, clinical assessment alone can sometimes delay intervention[2].

The key challenge in postoperative esophagectomy care is the absence of continuous, objective monitoring of gastric conduit function. We propose a self-powered gastric conduit stent composed of triboelectric metamaterials that harvest mechanical energy from peristaltic motion to generate electrical signals. Through contact electrification driven by physiological movement, the device would enable real-time, wireless measurement of intraluminal pressure, providing an early indicator of anastomotic compromise before clinical deterioration becomes evident. The proposed system involves the deployment of a flexible triboelectric metamaterial stent within the gastric conduit. Cyclic deformation induced by peristalsis generates electrical output proportional to local mechanical forces. This signal is converted into quantitative intraluminal pressure data and wirelessly transmitted to an external receiver. Temporal pressure patterns can then be analyzed to identify deviations from expected postoperative motility profiles, with alerts triggered by abnormal pressure patterns.

Recent advances support the feasibility of this concept. Triboelectric nanogenerators (TENG) have demonstrated that contact electrification can convert mechanical motion into stable and quantifiable electrical output suitable for biomedical sensing applications[3]. Biodegradable and implantable triboelectric systems have been successfully deployed in vivo, demonstrating compatibility with physiological environments and suitability for temporary postoperative use[4]. Furthermore, emerging reports indicate that implantable TENG designs have already been developed with features such as stretchability, bioadhesion, biodegradability, and stimuli responsiveness to adapt to physiological conditions[5]. Finally, ingestible and intraluminal pressure sensors have shown that the gastrointestinal tract supports reliable real-time pressure monitoring[6], establishing a foundation for self-powered conduit surveillance.

Continuous intraluminal pressure monitoring with a self-powered triboelectric stent could allow clinicians to detect abnormal motility or pressure elevations early, enabling timely intervention and reducing reliance on intermittent imaging or subjective assessment.

In conclusion, integrating triboelectric energy harvesting with metamaterial-based stent design offers a novel strategy for postoperative monitoring after esophagectomy. By leveraging peristaltic motion as an intrinsic power source, this approach enables continuous, objective assessment of gastric conduit integrity using existing physiological signals. We encourage studies to evaluate the clinical potential of this device for early detection of anastomotic leaks.

Ethical approval

Not applicable (conceptual LTE).

Sources of funding

We have not received any financial support for this manuscript.

Author contributions

All authors have approved the final manuscript for submission. Z.Y.: Conceptualization of ideas, critical reviews with comments, and final draft. M.N.: Conceptualization of ideas, critical reviews with comments, and final draft. N.u.A.S.: Conceptualization of ideas, critical reviews with comments, and final draft. A.H.H.: Conceptualization of ideas, critical reviews with comments, and final draft.

Conflicts of interest disclosure

The author declared no conflicts of interest.

Research registration unique identifying number (UIN)

Not applicable.

Guarantor

Abdul Haseeb Hasan.

Data availability statement

Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.

Declaration of generative Al and Al-assisted technologies in the writing process

There is nothing to disclose.

Transparency statement

The lead author, Zarqa Yasin, affirms that this manuscript is an honest, accurate, and transparent account of the study being reported, that no important aspects of the study have been omitted, and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.