Rapid prototyped sutureless anastomosis device from self-curing silk bio-ink.
Sutureless anastomosis devices are designed to reduce surgical time and difficulty, which may lead to quicker and less invasive cardiovascular anastomosis. The implant uses a barb-and-seat compression fitting composed of one male and two female components. The implant body is resorbable and capable of eluting heparin. Custom robotic deposition equipment was designed to fabricate the implants from a self-curing silk solution. Curing did not require deleterious processing steps but devices demonstrated high crush resistance, retention strength, and leak resistance. Radial crush resistance is in the range of metal vascular implants. Insertion force and retention strength of the anastomosis was dependent on fit sizing of the male and female components and subsequent vessel wall compression. Anastomotic burst strength was dependent on the amount of vessel wall compression, and capable of maintaining higher than physiological pressures. In initial screening using a porcine implant, the devices remained intact for 28 days (the length of study). Histological sections revealed cellular infiltration within the laminar structure of the male component, as well as at the interface between the male and female components. Initial degradation and absorption of the implant wall were observed. The speed per anastomosis using this new device was much faster than current systems, providing significant clinical improvement.
Department of Biomedical Engineering, Science and Technology Center, Tufts University, Medford, Massachusetts, 02155.
Rod R
RR
Jose
Department of Biomedical Engineering, Science and Technology Center, Tufts University, Medford, Massachusetts, 02155.
Waseem K
WK
Raja
Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, 02215.
Ahmed M S
AM
Ibrahim
Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, 02215.
Pieter G L
PG
Koolen
Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, 02215.
Kuylhee
K
Kim
Department of Biomedical Engineering, Science and Technology Center, Tufts University, Medford, Massachusetts, 02155.
Abdurrahman
A
Abdurrob
Department of Biomedical Engineering, Science and Technology Center, Tufts University, Medford, Massachusetts, 02155.
Jonathan A
JA
Kluge
Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, 02215.
Samuel J
SJ
Lin
Department of Infectious Disease and Global Health, Cummings School of Veterinary Medicine, Tufts Clinical and Translational Science Institute, Tufts University, Grafton, MA 01536.
Gillian
G
Beamer
Department of Biomedical Engineering, Science and Technology Center, Tufts University, Medford, Massachusetts, 02155.
David L
DL
Kaplan
D000714:Anastomosis, Surgical / Q000295:instrumentation*; D000818:Animals; D005260:Female; D008297:Male; D008422:Materials Testing; D047011:Silk; D015607:Stents; D013552:Swine
D047011:Silk
bio-ink; drug delivery; resorbable implant; silk; sutureless anastomosis