טכניון מכון טכנולוגי לישראל
הטכניון מכון טכנולוגי לישראל - בית הספר ללימודי מוסמכים  
M.Sc Thesis
M.Sc StudentTal Eshel-Green
SubjectMedical Sealant for Gastrointestinal Surgeries
DepartmentDepartment of Polymer Engineering
Supervisor Full Professor Bianco-Peled Havazelet
Full Thesis textFull thesis text - English Version


Abstract

Gastrointestinal (GI) surgeries involve manipulation of the gastrointestinal tract, from the stomach to the intestine. These include tissue manipulations and organs removals, ranging from colorectal anastomosis to obesity surgeries. A major attention has been given in the literature to staple line leaks associated with GI surgeries and extensive research has been performed in an effort to prevent this side effect. Tissue sealants have been introduced into numerous surgery fields ranging from cardiovascular to cosmetic surgery in the last several decades, with good results. The sealants connect tissues, strengthen the area, and prevent staple line bleeding and leak. Choosing the right sealant has a tremendous effect on the outcome of the procedure and the ideal reinforcing material should be easy to use, biocompatible, have sufficient strength and flexibility, and be cost-effective. Among the difficulties tissue sealants have to face, the most challenging one is gluing and curing in moist environment exposed, for example, to blood or lymphatic fluids. A tissue sealant inspired from the brown algae attachment to wet surfaces that was previously developed in Prof. Bianco-Peled’s laboratory, was used as the starting point for our research. The sealant consisted of the natural polysaccharide alginate was evaluated on fresh porcine intestine and necessary composition changes were made to achieve better suitability to the porcine tissue. Further characterization was done, studying its mechanical and adhesion properties, to affirm its use as a possible tissue sealant for gastrointestinal surgeries. A combination device was later developed by implementing the antibiotics doxycycline, which has anti-bacterial characteristics as well as matrix metaloproteases inhibitory effect, in the hydrogel, in an effort to achieve sustained release of the drug in vitro as a proof of concept for the ability to maintain controlled and sustained release in vivo. Our main conclusion from the research was that barium performed better than calcium as a cross linker when sealing or adhering to porcine intestine, and that the sealants elongation at ultimate stress when cross linked with barium matched the elongation of the porcines' intestine. Thus the sealant when cross linked with barium could act as a potential sealant for GI surgeries.