Surgical Repair of Enterotomies Using Three-Dimensional Printed Biopatches in a Rat Model
*Renee M Maina1, *Taras Lysyy1, *Peter Geibel1, *Maria J Barahona1, *Michele Finotti1,2, David Mulligan1, *John P Geibel1
1Yale School of Medicine, New Haven, CT;2University of Padua, Transplant and Hepatobiliary Surgery, Padua, Italy
Objective: In patients with loss of functional intestine due to ischemic or traumatic injury, intestinal transplant is an effective treatment option. However, it is rarely available as a therapeutic option because the need for allografts outweighs their availability. We demonstrate the feasibility of three-dimensional (3D) bioprinted patches as conduits for repair of intestinal injuries.Design: Patches were printed on an Organovo MMX 3D bioprinter using rat vascular smooth muscle and fibroblast cells encapsulated in a crosslinked hyaluronic acid and gelatin matrix. The prints were resected along the transverse axis to allow access to the apical surface, and sized to form 7-10 mm patches. 4-6mm enterotomies were made an inch away from the ileocecal junction in rats, the apical side of the biopatches was placed over the enterotomies, and cyanoacrylate surgical adhesive was used to seal the patches in place.Setting: This study was conducted in a BSL-2 laboratory and appropriate animal facilities.Patients: Male Wistar rats.Interventions: small intestine enterotomy patch repairMain Outcome Measures:The animals were monitored daily and sacrificed at post-op day 7, 14, 21, and 30. Blinded histopathological analysis was conducted to compare the patch segments to native intestine.Results: The animals had normal activity, weight gain, and stool output. Histopathological examination of the explanted segments at 7, 14, and 21 days showed progressive villi and crypt formation. At 30 days, the endothelium had grown back fully and the patch was indistinguishable from native intestine.Conclusions: Bioprinted intestinal patches can successfully be used to seal enterotomies in vivo and fully integrate into the native intestine. 3D printed biopatches are thus a novel option for the surgical repair of intestinal injuries.
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