Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

IMPLANTED BIOMATERIALS

Sutureless gastrointestinal anastomoses

Nature Biomedical Engineering volume 6, pages 1089–1091 (2022)Cite this article

Subjects

An adhesive hydrogel patch made from off-the-shelf materials seals and aids the healing of gastrointestinal-tissue defects without the need for sutures, as shown with the repair of gastrointestinal leaks in live rats and pigs.

Anastomotic procedures in the gastrointestinal tract can be technically demanding1. They are performed during surgery for bowel cancers, inflammatory bowel disease or other gastrointestinal conditions, and involve the sewing or stapling of the two ends of the severed tract after the resection of the diseased segment of tissue. Leaks after anastomosis — which occur for about 10% of the procedures — can be deadly2, as leaked gastrointestinal fluid can put the patient at imminent risk of sepsis and other life-threatening complications. To limit leaks, surgeons routinely use patches of fibrin or other adhesives, applied directly after suturing or stapling, to support the reconnected tissue. However, the containment of leaks by such support materials is inadequate; in particular, many adhesives are degraded within hours of contact with digestive gastrointestinal fluid. In fact, for the most part, fibrin glue3 and other surgical adhesives have not reduced the incidence rate of complications after gastrointestinal anastomosis. Reporting in Science Translational Medicine, Xuanhe Zhao, Christoph Nabzdyk, Leigh Griffiths, Hyunwoo Yuk and colleagues now describe the design and performance of an easy-to-manufacture and slowly degrading adhesive patch for supporting, and even replacing, the commonly performed stitching-and-stapling procedures involved in gastrointestinal anastomosis4.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Learn more

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: An adhesive patch for the sutureless sealing of anastomotic gastrointestinal leaks.
Fig. 2: Mechanisms of adhesion, and conditions for the testing of adhesives for the repair of gastrointestinal leaks.

References

  1. Foppa, C., Ng, S. C., Montorsi, M. & Spinelli, A. Eur. J. Surg. Oncol. 46, 943–954 (2020).

    Article  Google Scholar 

  2. Hammond, J., Lim, S., Wan, Y., Gao, X. & Patkar, A. J. Gastrointest. Surg. 18, 1176–1185 (2014).

    Article  Google Scholar 

  3. Nordentoft, T., Pommergaard, H.-C., Rosenberg, J. & Achiam, M. P. Eur. Surg. Res. 54, 1–13 (2015).

    Article  CAS  Google Scholar 

  4. Wu, J. et al. Sci. Transl. Med. 14, eabh2857 (2022).

    Article  CAS  Google Scholar 

  5. Tan, W. P., Hong, E. Y., Phillips, B., Isenberg, G. A. & Goldstein, S. D. Am. Surg. 80, 868–872 (2014).

    Article  Google Scholar 

  6. Annabi, N. et al. Nano Today 9, 574–589 (2014).

    Article  CAS  Google Scholar 

  7. Li, J. et al. Science 357, 378–381 (2017).

    Article  CAS  Google Scholar 

  8. Yuk, H. et al. Nature 575, 169–174 (2019).

    Article  CAS  Google Scholar 

  9. Anthis, A. H. C. et al. Adv. Funct. Mater. 31, 2007099 (2021).

    Article  CAS  Google Scholar 

  10. Yauw, S. T. K., Wever, K. E., Hoesseini, A., Ritskes-Hoitinga, M. & van Goor, H. Br. J. Surg. 102, 726–734 (2015).

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Nanoparticle Systems Engineering Laboratory, Institute of Energy and Process Engineering (IEPE), Department of Mechanical and Process Engineering (D-MAVT), ETH Zurich, Zurich, Switzerland

    Alexandre H. C. Anthis & Inge K. Herrmann

  2. Particles-Biology Interactions, Department of Materials Meet Life, Swiss Federal Laboratories for Materials Science and Technology (Empa), St. Gallen, Switzerland

    Alexandre H. C. Anthis & Inge K. Herrmann

  3. Department of Visceral Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland

    Andrea A. Schlegel

  4. Center for Preclinical Research, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

    Andrea A. Schlegel

  5. Clinic for Visceral Surgery, Cantonal Hospital Aarau, Aarau, Switzerland

    Mark Hartel

Authors
  1. Alexandre H. C. Anthis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrea A. Schlegel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mark Hartel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Inge K. Herrmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Inge K. Herrmann.

Ethics declarations

Competing interests

A.H.C.A. and I.K.H. are inventors on the patent application ‘Kit comprising adhesive hydrogel and impregnating fluid’ (PCT/EP2022/051137). The other authors declare no competing interests.

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Anthis, A.H.C., Schlegel, A.A., Hartel, M. et al. Sutureless gastrointestinal anastomoses. Nat. Biomed. Eng 6, 1089–1091 (2022). https://doi.org/10.1038/s41551-022-00900-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41551-022-00900-7

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing