Modular stimuli-responsive hydrogel sealants for early gastrointestinal leak detection and containment

Alexandre H. C. Anthis, Maria Paulene Abundo, Anna L. Neuer, Elena Tsolaki, Jachym Rosendorf, Thomas Rduch, Fabian H. L. Starsich, Bernhard Weisse, Vaclav Liska, Andrea A. Schlegel, Mikhail G. Shapiro and Inge K. Herrmann ()
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Alexandre H. C. Anthis: Nanoparticle Systems Engineering Laboratory, Department of Mechanical and Process Engineering, ETH Zurich
Maria Paulene Abundo: California Institute of Technology
Anna L. Neuer: Nanoparticle Systems Engineering Laboratory, Department of Mechanical and Process Engineering, ETH Zurich
Elena Tsolaki: Nanoparticle Systems Engineering Laboratory, Department of Mechanical and Process Engineering, ETH Zurich
Jachym Rosendorf: Charles University
Thomas Rduch: Swiss Federal Laboratories for Materials Science and Technology (Empa)
Fabian H. L. Starsich: Nanoparticle Systems Engineering Laboratory, Department of Mechanical and Process Engineering, ETH Zurich
Bernhard Weisse: Empa - Swiss Laboratories for Materials Science and Technology
Vaclav Liska: Charles University
Andrea A. Schlegel: University Hospital Zurich
Mikhail G. Shapiro: California Institute of Technology
Inge K. Herrmann: Nanoparticle Systems Engineering Laboratory, Department of Mechanical and Process Engineering, ETH Zurich

Nature Communications, 2022, vol. 13, issue 1, 1-15

Abstract: Abstract Millions of patients every year undergo gastrointestinal surgery. While often lifesaving, sutured and stapled reconnections leak in around 10% of cases. Currently, surgeons rely on the monitoring of surrogate markers and clinical symptoms, which often lack sensitivity and specificity, hence only offering late-stage detection of fully developed leaks. Here, we present a holistic solution in the form of a modular, intelligent suture support sealant patch capable of containing and detecting leaks early. The pH and/or enzyme-responsive triggerable sensing elements can be read out by point-of-need ultrasound imaging. We demonstrate reliable detection of the breaching of sutures, in as little as 3 hours in intestinal leak scenarios and 15 minutes in gastric leak conditions. This technology paves the way for next-generation suture support materials that seal and offer disambiguation in cases of anastomotic leaks based on point-of-need monitoring, without reliance on complex electronics or bulky (bio)electronic implantables.

Date: 2022
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DOI: 10.1038/s41467-022-34272-y

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