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Reconnecting severed blood vessels without sutures

As someone who struggles with threading a needle, I naturally was awed with a story Geoffrey Gurtner, MD, a microsurgeon at Stanford Hospital & Clinics, told me about an operation he did in 2002 requiring some major-league dexterity: reattaching an infant's finger, including severed arteries and veins, that had been amputated by the wheel of spinning exercise bike. "The blood vessels were so small - maybe half a millimeter," said Gurtner, who is also a professor of surgery at Stanford University School of Medicine. "The surgery took more than five hours, and at the end we were only able to get in three sutures."

The experience started him thinking about possible ways to reconnect blood vessels without sutures. Today, Nature Medicine published a study by Gurtner and his colleagues about one possible alternative that makes use of a poloxamer gel and bioadhesive rather than a needle and thread.

The gel is made of molecular polymer blocks and solidifies at higher temperatures. When injected into both ends of a severed vessel and heated, it distends the openings to allow the surgeons to glue them together precisely using a surgical sealant. As I wrote in our news release:

The researchers used a simple halogen lamp to heat the gel. In tests on animals, the technique was found to be five times faster than the traditional hand-sewn method, according to the study. It also resulted in considerably less inflammation and scarring after two years. The method even worked on extremely slim blood vessels - those only 0.2 mm wide - which would have been too tiny and delicate for sutures. "That's where it really shines," Gurtner said. . . .

Gurtner said he believes the new technique could satisfy a huge unmet need and prove especially useful in minimally invasive surgeries, in which manipulating sutures takes on a whole new level of difficulty.

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