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

开发用于内窥镜手术的止血胶和装置。

基本信息

批准号：
07557358
负责人：
NAKAYAMA Yasuhide
金额：
$ 1.79万
依托单位：
National Cardiovascular Center Research Institute
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (A)
财政年份：
1995
资助国家：
日本
起止时间：
1995 至 1997
项目状态：
已结题

项目摘要

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

这项研究提出了一种新型光化学驱动的手术组织粘合技术，使用光反应明胶，该明胶部分衍生于光反应基团，例如紫外线（UV）反应性二苯甲酮和可见光反应性呫吨染料（例如荧光素钠盐、余弦Y、和玫瑰红），以及水溶性双官能大分子单体[聚（乙二醇）二丙烯酸酯：PEGDA系列]。制备了光固化组织粘合胶，该胶在加热时为粘稠溶液，由光反应明胶、PEDA 和含或不含抗坏血酸作为还原剂的盐水溶液组成，并评估了它们在心血管手术中的止血和吻合效果。所检查的光反应基团类型，在不过度加热的情况下，用紫外线或可见光照射光固化组织粘合剂1分钟内，产生水溶胀由于光反应基团引发的光交联和光接枝聚合的能量反作用，凝胶对湿胶原膜具有高粘合强度，随着照射时间的增加，其保水能力下降。 PEGDA 的分子量以及光反应明胶和 PEGDA 浓度的增加导致大鼠的保水能力降低并增加所得凝胶的拉伸强度和破裂强度。肝脏在剖腹手术中被环钻损伤，出血点被涂上光固化胶水，通过光纤进行光照射后，涂上的溶液立即转化为膨胀的凝胶，紧紧地粘附在肝组织上。通过相互渗透并同时止血，完成了犬腹部或胸部切口的光固化粘合胶的吻合治疗。取出夹子后，在脉动流下刀割，出现少量出血。组织学检查显示，大鼠肝脏表面光固化的胶在体内逐渐降解，有炎症细胞和结缔组织浸润，但周围组织没有坏死。在腹腔镜手术中，使用专门设计的纤维镜证明了光固化粘合剂的经皮输送及其在大鼠肝脏表面上的原位光凝胶化，这些结果表明所开发的光固化化合物可以发挥作用。作为可生物降解的组织粘合胶，用于心血管手术和内窥镜手术。