Development of hemostatic glue and devices for use in endoscopic surgery.

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This research presents a novel photochemically-driven surgical tissue adhesive technology using photoreactive gelatins, which were partially derivatized with photoreactive groups, such as ultraviolet light (UV)-reactive benzophenone and visible light-reactive xanthene dye (e.g. fluorescein sodium salt, cosin Y,and rose bengal), anda water-soluble difunctional macromer [poly (ethylene glycol) diacrylate : PEGDA]. a series of photocurable tissue adhesive glues, which are viscous solutions when warmed, consisting of the photoreactive gelatin, PEDA, anda saline solution with or without ascorbic acidas a reducing agent, were prepared and evaluated for their effectiveness on hemostasis and anastomosis in cardiovascular surgery. Regardless of the type of photoreactive group examined, irradiation of the photocurable tissue adhesive glues by UV or visible light within 1 min, without excess heating, produced water-swollen gels, which had high adhesive strength to wet collagen film, due to the sy … More nergistic antion of photoreactive group-initiated photocrosslinking and photograft polymerization. As irradiation time increased, get yield increased and its ability to hold water decreased. a decrease in the molecular weight of PEGDA and an increase in concentration of both photoreactive gelatin and PEGDA resulted in a reduced ability to hold water and increased the tensile and burst strengths of the resultant gels. In rats in which the livers had been injured with a trephine during laparotomy, the bleeding spots were coated with the photocurable adhesive glue. Upon photoirradiation through an optical fiber, the coated solution was immediately converted to a swollen gel, which tightly adhered to the liver tissue, presumably by interpenetration and, concomitantly, hemostasis was completed. The anastomosis treatment with a photocurable adhesive glue in canine abdominal or thoracic aortas incised with a knife resulted in little bleeding under pulsatile flow after removing the clamps. Histological examination revealed that the adhesive glues photocured on rat liver surfaces gradually degraded in vivo with the infiltration of inflammatory cells and connectiv tissues, but without necrosis in the surrounding tissue. In addition, during laparoscopic surgery, percutaneous delivery of a photocurable adhesive glue and its in situ photogelation on rat liver surfaces was demonstrated using a specially designed fiberscope. These results suggest that the photocurable compound developed hear may serve as a biodegradable tissue adhesive glue for use in cardiovascular surgery and endoscopic surgery. Less