Project

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Sutureless Endoluminal and Transmural Microvascular Laser-Anastomosis for Minimally Invasive Microsurgical Procedures in Bypass and Revascularization Surgery

English title Sutureless Endoluminal and Transmural Microvascular Laser-Anastomosis for Minimally Invasive Microsurgical Procedures in Bypass and Revascularization Surgery
Applicant Constantinescu Mihai Adrian
Number 133083
Funding scheme Project funding (Div. I-III)
Research institution Klinik und Poliklinik für Plastische, Rekonstruktive und Ästhetische Chirurgie Inselspital
Institution of higher education University of Berne - BE
Main discipline Surgery
Start/End 01.04.2011 - 30.09.2015
Approved amount 300'000.00
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All Disciplines (5)

Discipline
Surgery
Biomedical Engineering
Technical Physics
Physiology : other topics
Structural Research

Keywords (9)

laser surgery; laser soldering; microsurgery; tissue fusion; minimally invasive surgery; bypass; revascularization; vascular patency; animal model

Lay Summary (English)

Lead
Lay summary

Background:Current surgicaldevelopments are evolving towards minimally invasive approaches, such asendoscopic and endovascular techniques. Patients with abdominal, cardiac andorthopaedic problems benefit already of these techniques. In the field of microsurgery,there are to date no available similar techniques for patients withneurovascular diseases or in need of microsurgical revascularization (bypass)procedures. They have to bear the risks of lengthy procedures with end-organischemia while classical microvascular anastomoses are being sutured. Thedevelopment of fast, effective and minimally invasive tissue fusion techniquesin the area of microvascular anastomosis are necessary.?The previous researchof our neurovascular and reconstructive teams, (SNF-grants # 32003B-107611 and# 310030-108447) succeeded in developing first microvascular tissue solderingtechniques capable of withstanding mechanical stress (i.e. extension with jointmovement etc) and pressures (i.e. blood pressure) encountered in the humanbody.

Goals: The proposed combined researchrepresents our combined interdisciplinary research interests aiming at two maingoals: The first part of the research investigates basic scientific concepts atcellular level in order to improve the understanding of the underlyinginteractions of variables and multiple factors present and necessary forsuccessful sutureless tissue fusion. The second part investigates clinicallynovel concepts of side-to-side and endovascular balloon assisted end-to-end lasersoldered microvascular tissue fusion and is planned to bring this research to apreclinical application level in large animal models to prove the necessaryblood flow can be established.

Methods: The basic principle of tissuefusion investigated in this project relies on Laser beams applied with the helpof a balloon catheter from inside the microvessel. They then pass through thevessel wall and are absorbed on the outside by a specially developed soldermaterial which hardens and fuses with the vessel wall leading to the necessarystrength of the minimally invasive repair. In the bypass technique, after twovessels will be fused parallel side-to-side an additional laser will beutilized to create the necessary holes across the walls of the two parallelsoldered microvessels in order to establish blood flow in the bypass.

Expectedimpact: The advantagecompared to the current „state-of-the-art“ sutured microsurgical vascularanastomosis lies in the increased velocity of the minimally invasive tissuefusion procedure. Furthermore this technique will enable bypass surgery withoutthe need of interrupting the blood flow to the organs and thus avoidingischemia by the side-to-side soldering technique 

Direct link to Lay Summary Last update: 21.02.2013

Responsible applicant and co-applicants

Employees

Publications

Publication
Electrospinning of a combined chromophore and protein patch to improve laser tissue soldering
Annemarie Schönfeld Pascal Moll Zacharia Mbaïdjol Kabra Mihai A. Constantinescu Martin Frenz (2016), Electrospinning of a combined chromophore and protein patch to improve laser tissue soldering, in NART, http://nart.tul.cz/files/sample.pdf, ed.: Stanislav Petrik, vol.: NART 2015, pp, Czech Republic.

Collaboration

Group / person Country
Types of collaboration
Dept of Neurosurgery, Ospedale Civico, Lugano Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Exchange of personnel

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
Biomedical Photonics Network BMPN Talk given at a conference Development of a layered electrospun chromophore and protein patch to improve laser-assisted vascular anastomosis 11.12.2015 Biel, Switzerland Schönfeld Annemarie; Constantinescu Mihai Adrian; Frenz Martin; Mbaidjol Kabra Zacharia;
Swiss congress of Plastic, Reconstructive and Esthetic Surgery, Thun Sept.2015 Talk given at a conference Laser assisted vascular anastomosis: In vivo patency rates, 25.09.2015 Thun, Switzerland Constantinescu Mihai Adrian; Mbaidjol Kabra Zacharia; Olariu Radu; Frenz Martin; Schönfeld Annemarie;
NART 2015, Liberec, Czech Republic, Talk given at a conference Electrospinning of a combined chromophore and protein patch to improve laser tissue soldering, 01.09.2015 Liberec, Czech Republic Frenz Martin; Mbaidjol Kabra Zacharia; Constantinescu Mihai Adrian; Schönfeld Annemarie;
V Internatrional Symposium Topical Problems of Biophotonics, Nizhny Novgorod, Russia, 23 Jul 2015 Talk given at a conference In-vivo laser-assisted vessel soldering using an electrospun patch 23.07.2015 Nizhny Novgorod, Belarus Constantinescu Mihai Adrian; Schönfeld Annemarie; Frenz Martin; Mbaidjol Kabra Zacharia;
Seminar, University of Rostock, Department of Cell Biology Talk given at a conference Improving and understanding vascular laser soldering, 16.07.2015 Rostock, Germany Constantinescu Mihai Adrian; Mbaidjol Kabra Zacharia; Frenz Martin;
Biomedical Photonics Network Talk given at a conference Electrospinning: A novel application for tissue soldering, , , 01.11.2013 Inselspital, Bern, Switzerland Frenz Martin; Schönfeld Annemarie;
CTI Medtech Event 2013 Poster Tissue Soldering with Nano Particle Scaffold, , Bern, Kursaal, 27 Aug 2013 27.08.2013 Bern, Kursaal, Switzerland Frenz Martin; Schönfeld Annemarie; Reinert Michael;
NRP 64 2nd Progress Report Meeting, Lausanne, 20 Mar 2013 Individual talk Nanoparticles in a patch for laser tissue soldering, 20.03.2013 Lausanne, Switzerland Frenz Martin; Schönfeld Annemarie;
Biologisierung der Medizintechnik, Workshop III, NMI Innovationsforum Talk given at a conference Nanostrukturierte resorbierbare Polymere zur endoskopischen Gewebeverbindung, 22.11.2012 Reutlingen, Germany, Germany Frenz Martin;
International Conference on Bioinspired and Biobased Chemistry & Materials Individual talk Biocompatible silica nanomaterials grafted amphiphilic block copolymer conjugated with indocyanine green, 04.10.2012 Nice, France, France Frenz Martin;
7th International Summer School on Advanced Biotechnology Talk given at a conference Electrospinning of a nanoparticle-doped polycaprolactone scaffold for laser tissue soldering, 12.09.2012 Santa Margherita di Belice (AG), Italy, Italy Frenz Martin;
ALT'12 conference Individual talk Laser tissue soldering using nanoparticle-doped electrospun polycaprolactone scaffolds 02.09.2012 Thun, Switzerland, Switzerland Frenz Martin;
CLINAM 5/12 European Summit for Clinical Nanomedicine Talk given at a conference Biocompatible Nanoparticles Delivery System for Indocyanine Green: Synthesis and Study of Nanocomposites based ICG- Poly (ε-Caprolactone) Grafted from the Silica Surface, 09.05.2012 Basel, Switzerland, Switzerland Frenz Martin;
Symposium der Schweizerischen Arbeitsgemeinschaft Laserchirurgie Individual talk Basiskurs: Laser-tissue-interaction, 17.11.2011 Zürich, Switzerland, Switzerland Frenz Martin;
Topical Problems of Biophotonics Talk given at a conference Laser-tissue soldering using ICG loaded silica nanoshells, 19.07.2011 St. Petersburg - Nizhny Novgorod, Russia, Russia Frenz Martin;


Associated projects

Number Title Start Funding scheme
108447 Effects of intraluminal, transmural, laser soldered microvascular anastomoses on vascular tissues and patency rates 01.01.2006 Project funding (Div. I-III)
108447 Effects of intraluminal, transmural, laser soldered microvascular anastomoses on vascular tissues and patency rates 01.01.2006 Project funding (Div. I-III)
107611 Nahtlose, laser basierte hochfluss Anastomose von Hirnarterien, ohne temporäre Abklemmung 01.05.2005 Project funding (Div. I-III)

Abstract

SummaryEven though classical surgery will remain mandatory for the treatment of certain conditions, the current developments are evolving more and more towards minimally invasive approaches, such as by using endoscopic and endovascular techniques. These benefit already patients with abdominal, cardiac and orthopaedic problems. The group of patients with neurovascular diseases or in need of microsurgical revascularization procedures can not yet benefit of these advantages to date and have to bear the risks of lengthy procedures with end-organ ischemia during classical sutured microvascular anastomoses. For a successful translation into clinical application the development of effective and minimally invasive tissue fusion techniques are necessary.The interdisciplinary study group applying for this follow-up grant have combined their common interests and fused their previous research (SNF-grants # 32003B-107611 and # 310030-108447) in a common follow-up research proposal herein described.The proposed research investigates basic scientific concepts at cellular level in order to improve the understanding of the underlying interactions of variables and multiple factors present and necessary in successful sutureless tissue fusion. Furthermore, based on previous experiments, clinically novel concepts of side-to-side and endovascular balloon assisted end-to-end laser soldering bring this research to a preclinical application level in large animal models and allow a focused development for minimally invasive microsurgical techniques precluding the need for temporary vascular occlusion during the bypass surgery.
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