Journal Article

Surgical Sealant with Integrated Shape‐Morphing Dual Modality Ultrasound and Computed Tomography Sensors for Gastric Leak Detection

Schlegel, Andrea A., Suter, Benjamin, Anthis, Alexandre H. C., Rosendorf, Jachym, Korcakova, Eva, Liska, Vaclav, Mergen, Victor, Gerken, Lukas R. H., Herrmann, Inge K., Zehnder, Anna‐Katharina

2023

Overview

Postoperative anastomotic leaks are the most feared complications after gastric surgery. For diagnostics clinicians mostly rely on clinical symptoms such as fever and tachycardia, often developing as a result of an already fully developed, i.e., symptomatic, surgical leak. A gastric fluid responsive, dual modality, electronic‐free, leak sensor system integrable into surgical adhesive suture support materials is introduced. Leak sensors contain high atomic number carbonates embedded in a polyacrylamide matrix, that upon exposure to gastric fluid convert into gaseous carbon dioxide (CO2). CO2 bubbles remain entrapped in the hydrogel matrix, leading to a distinctly increased echogenic contrast detectable by a low‐cost and portable ultrasound transducer, while the dissolution of the carbonate species and the resulting diffusion of the cation produces a markedly reduced contrast in computed tomography imaging. The sensing elements can be patterned into a variety of characteristic shapes and can be combined with nonreactive tantalum oxide reference elements, allowing the design of shape‐morphing sensing elements visible to the naked eye as well as artificial intelligence‐assisted automated detection. In summary, shape‐morphing dual modality sensors for the early and robust detection of postoperative complications at deep tissue sites, opening new routes for postoperative patient surveillance using existing hospital infrastructure is reported. Gastric leaks are a greatly feared postsurgical complication. Here dual modality ultrasound and computed tomography sensors for early gastric leak detection is presented. The electronic‐free sensors are fully integrable into adhesive surgical sealant patches as well as patternable, achieving shape morphing contrast changes under conditions of leak, therefore allowing for facile leak diagnostics.

• Publisher: John Wiley & Sons, Inc,John Wiley and Sons Inc,Wiley
• Subject: adhesives / anastomotic leak / Automation / Barium / Bubbles / Carbon dioxide / Gastric cancer / Gastrointestinal surgery / Hydrogels / Leak detection / monitoring / Obesity / Patients / postoperative complications / Radiation / Sealing compounds / sensing / Sensors / Surgical anastomosis / Tomography / Ultrasonic imaging