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Smart sealants for prevention and monitoring of gastrointestinal anastomotic leaks using portable smartphone-controlled ultrasound transducers

Anthis, Alexandre H. C. and Abundo, Maria Paulene and Neuer, Anna L. and Tsolaki, Elena and Rosendorf, Jachym and Rduch, Thomas and Starsich, Fabian H. L. and Liska, Vaclav and Schlegel, Andrea A. and Shapiro, Mikhail G. and Herrmann, Inge K. (2022) Smart sealants for prevention and monitoring of gastrointestinal anastomotic leaks using portable smartphone-controlled ultrasound transducers. . (Unpublished) https://resolver.caltech.edu/CaltechAUTHORS:20220128-118576700

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Abstract

Millions of patients every year undergo gastrointestinal surgery. While often lifesaving, sutured and stapled reconnections leak in around 10% of the cases. Penetration of digestive fluids into the peritoneal cavity may lead to dreadful complications, including sepsis and premature death. Modern suture supports and tissue adhesives only insufficiently address the issue. Due to the scarcity of alternatives, surgeons rely on monitoring surrogate markers and clinical symptoms, which oftentimes lack sensitivity and specificity, hence only offering late-stage detection of already fully developed leaks. Here, a first-of-its-kind, modular, intelligent suture support patch capable of sealing and monitoring leaks under harsh gastrointestinal conditions is presented. The smart adhesive layered hydrogel patch provides, in addition to unprecedented tissue sealing under most demanding conditions, unique leak-detection capabilities based on pH and/or enzyme-responsive sensing elements, which can be read out by non-invasive point-of-need ultrasound imaging. Reliable detection of the breaching of sutures in as little as 3 hours in intestinal leak and 15 minutes in gastric leak conditions, and before an actual leak develops, is demonstrated. This technology paves the way for next-generation suture support materials that offer disambiguation in cases of anastomotic leaks based on point-of-need monitoring, without reliance on complex electronics or bulky (bio)electronic implantables.


Item Type:Report or Paper (Discussion Paper)
Related URLs:
URLURL TypeDescription
https://doi.org/10.1101/2022.01.24.477460DOIArticle
ORCID:
AuthorORCID
Tsolaki, Elena0000-0003-1436-7834
Liska, Vaclav0000-0002-7755-3856
Schlegel, Andrea A.0000-0002-9385-9847
Shapiro, Mikhail G.0000-0002-0291-4215
Herrmann, Inge K.0000-0002-3018-6796
Additional Information:The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. This version posted January 27, 2022. We acknowledge financial support from the Swiss National Science Foundation (Eccellenza grant. 181290), the SwissLife Foundation, the Vontobel Foundation and the Claude et Giuliana Foundation. A.H.C.A is supported by an ETH Pioneer Fellowship. We thank Apolline Anthis for her contributions towards the development of the layer-by-layer incorporation of sensing and therapeutic elements in model patches. We thank Michel Calame for access to the Raman microscope, the Empa Biointerfaces lab for access to the bacteria lab and the Empa Electron Microscopy Center for access to the SEM. The schematics and pictograms in the figures were created using BioRender.com. Data and materials availability: The data that support the findings of this study are available within the article and its supplementary information. Conflict of Interest: A.H.C.A. and I.K.H. declare that a patent applications have been filed on parts of the technology reported in this publication (PCT/EP2022/051137 and PCT/EP2022/051141). All other authors report no conflict of interest.
Funders:
Funding AgencyGrant Number
Swiss National Science Foundation (SNSF)181290
SwissLife FoundationUNSPECIFIED
Vontobel FoundationUNSPECIFIED
Claude et Giuliana FoundationUNSPECIFIED
ETH ZurichUNSPECIFIED
Subject Keywords:Sensing, post-operative complications, monitoring, adhesives, echogenic
DOI:10.1101/2022.01.24.477460
Record Number:CaltechAUTHORS:20220128-118576700
Persistent URL:https://resolver.caltech.edu/CaltechAUTHORS:20220128-118576700
Official Citation:Smart sealants for prevention and monitoring of gastrointestinal anastomotic leaks using portable smartphone-controlled ultrasound transducers. Alexandre H.C. Anthis, Maria Paulene Abundo, Anna Lena Neuer, Elena Tsolaki, Jachym Rosendorf, Thomas Rduch, Fabian Starsich, Vaclav Liska, Andrea A Schlegel, Mikhail G. Shapiro, Inge K Herrmann. bioRxiv 2022.01.24.477460; doi: https://doi.org/10.1101/2022.01.24.477460
Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:113149
Collection:CaltechAUTHORS
Deposited By: Tony Diaz
Deposited On:28 Jan 2022 17:56
Last Modified:28 Jan 2022 17:56

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