Laparoscopic electrospinning for in situ hemostasis in minimally invasive operation
Laparoscopic electrospinning for in situ hemostasis in minimally invasive operation
复制标题
腹腔镜静电纺丝在微创手术中的原位止血
DOI：
10.1016/j.cej.2020.125089
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发表时间：
2020-09-01
影响因子：
15.1
通讯作者：
Long, Yun-Ze
中科院分区：
文献类型：
--
作者：
Zhang, Jun;Zhao, Ying-Tao;Long, Yun-Ze
将纳米纤维原位沉积在活体器官上，可以改善血管膜与器官之间的粘附，从而加速止血效果。对于原位止血，静电纺丝优于吹气纺丝，因为吹气纺丝可能由于强气流而损伤伤口，并且当气流遇到器官时引入反冲现象，纤维将存款到周围器官上，导致组织粘连。近年来，微创手术因其创伤小、疼痛轻而成为患者的首选。在此，我们将联合收割机原位静电纺丝与微创手术相结合，并表明静电纺丝纳米纤维可以通过腹腔镜制造并直接沉积到活体器官上。在该腹腔镜静电纺丝中还引入了锥形会聚结构，该结构可以在不增厚纤维直径的情况下更精确地沉积纳米纤维并减小纳米纤维膜的沉积面积。在对猪进行的微创手术中，这种腹腔镜静电纺丝技术表现出快速止血，术后炎症反应更少，比传统止血方法恢复更快。静电纺丝法止血时间约为5 s，快于缝合组的3 min和涂抹组的14 s。电纺膜的厚度约为300 μ m，比涂抹组的厚度薄约1 mm。电纺NOCA膜的沉积区域也可以通过锥形会聚结构和电纺距离进行微调，并且由于操作是通过长的腹腔镜管进行的，所以它比涂抹方法优越上级（类似于37 cm），这最小化了握手对靶向伤口部位的影响。
In situ deposition of nanofibers onto living organs could improve the adhesion between nanofiber membranes and organs and thus accelerate the hemostatic effect. Electrospinning is preferable over blow spinning for in situ hemostasis, as blow spinning may damage the wound because of the strong airflow and introduces a recoil phenomenon when the airflow encounters the organ that fibers would deposit onto the surrounding organs causing tissue adhesion. Minimally invasive surgery has increased recently and become the first choice for patients due to its minimal trauma and slight pain. Herein, we combine in situ electrospinning with minimally invasive surgery and show that electrospun nanofibers can be fabricated through the laparoscope and directly deposited onto the living organ. A cone converging structure was also introduced in this laparoscopic electrospinning, which can more precisely deposit nanofibers and decrease the deposition area of the nanofiber membrane without thickening the fiber diameter. During a minimally invasive surgery performed on pigs, this laparoscopic electrospinning technique exhibited rapid hemostasis, less postoperative inflammatory responses and faster recovery than traditional hemostasis methods. The hemostasis time of electrospinning method was approximately 5 s, which was faster than that of the suture group at 3 min and smear group at 14 s. The electrospun membrane thickness was approximately 300 mu m, which was thinner than that of the smearing group at approximately 1 mm. The deposition area of the electrospun NOCA membrane can also be finely tuned by the cone converging structure and electrospinning distance, and it is superior to the smear method because the operation is performed through a long laparoscopic tube (similar to 37 cm), which minimizes the effect of hand shaking on targeting the wound site.