Sutureless Anastomosis: Electroadhering a Hydrogel Sleeve Over Cut Pieces of Tubular Tissue

Abstract

Recently, our lab demonstrated that cationic gels could be adhered to animal tissues by applying an electric field (10 V DC, for ~ 20 s). This phenomenon, termed electroadhesion (EA), could potentially be used to repair injured tissues without sutures. An extreme injury is when a tube in the body (e.g., a blood vessel or an intestine) is cut into two segments. The surgical process of joining the segments is termed anastomosis, and thus far has only been done clinically with sutures. Here, we explore the use of EA for performing sutureless anastomoses in vitro with bovine aorta and chicken intestine. For this purpose, we make a strong and stretchable cationic gel in the form of a sleeve (i.e., a hollow tube). By using a custom plastic mold, we control both the sleeve diameter and wall thickness. A sleeve with a diameter matching that of the tubular tissue is slipped over the cut segments of the tube, followed by application of the DC electric field. Thereby, the sleeve becomes strongly adhered by EA to the underlying tube. Water or blood is then flowed through the repaired tube, and we record the burst pressure Pburst of the tube. We find that Pburst is > 80 mm Hg and close to the Pburst of an intact (uncut) tube. In comparison to the sleeve, a long strip of the gel attached around the cut tubular pieces allows a much lower Pburst. Thus, our study shows that gel-sleeves adhered by EA could enable anastomoses to be performed in the clinic without the need for sutures.