Injectable temperature-sensitive hydrogel facilitating endoscopic submucosal dissection.

Area of Science:

• Biomaterials Science
• Gastroenterology
• Endoscopic Surgery

Background:

• Endoscopic mucosal dissection (ESD) for early gastrointestinal tumors requires submucosal fluid injection for mucosal elevation.
• Current methods using normal saline offer short-lived elevation, necessitating repeated injections and increasing procedure time.
• Existing submucosal injection materials (SIM) face challenges in preparation, cost, and biocompatibility.

Purpose of the Study:

• To develop and evaluate a novel submucosal injection material for improved mucosal elevation during ESD.
• To address the limitations of current SIMs, including short duration, inconvenience, and poor biocompatibility.

Main Methods:

• FS hydrogel synthesized by mixing polyethylene-polypropylene glycol (F-127) with sodium alginate (SA).
• Characterization of FS hydrogel physicochemical properties and biosafety assessments.
• Evaluation of FS hydrogel performance through in vitro submucosal injection and in vivo swine ESD.

Main Results:

• FS hydrogel is liquid at room temperature for easy injection and undergoes temperature-induced gelation to a solid state under the mucosa.
• Demonstrates controllable gelation, stability, and good biocompatibility.
• Achieved high, long-lasting mucosal augmentation and effective submucosal cushioning in vitro and in vivo ESD models.

Conclusions:

• F-127/SA hydrogel offers a simple, cost-effective, safe, and stable alternative for submucosal injection.
• The FS hydrogel effectively supports ESD procedures, presenting an ideal substitute for current submucosal injection materials.