Hydrogen Bond-Driven Conductive Thermosensitive Hydrogel for Advancing Endoscopic Electrosurgery.

Area of Science:

• Biomaterials Science
• Surgical Technology
• Polymer Chemistry

Background:

• Endoscopic electrosurgery, particularly endoscopic submucosal dissection (ESD), faces challenges with current submucosal injection agents.
• Conventional agents like saline diffuse rapidly and have poor electrical conductivity, leading to procedural disruptions and thermal risks such as tissue carbonization and perforation.

Purpose of the Study:

• To develop a novel hydrogel for improved submucosal injection in endoscopic electrosurgery.
• To overcome the limitations of rapid diffusion and poor electrical conductivity associated with traditional agents.

Main Methods:

• A hydrogen bond-driven conductive thermosensitive hydrogel, poly(3,4-ethylenedioxythiophene):polystyrene sulfonate/Pluronic F127 (PEDOT:PSS/F127), was engineered.
• The hydrogel's properties, including mechanical strength (G' = 13.11 ± 0.22 kPa) and temperature-triggered gelation, were characterized.
• In vitro and in vivo studies evaluated its performance in reducing temperature and improving electrosurgical safety compared to controls.

Main Results:

• The PEDOT:PSS/F127 hydrogel demonstrated sustained mucosal elevation for over 60 minutes.
• In vitro studies showed an 8.7°C and 3°C temperature reduction during ESD compared to saline and F127 controls, respectively.
• In vivo experiments indicated reduced tissue burns and bleeding, enhancing surgical safety.

Conclusions:

• The engineered PEDOT:PSS/F127 hydrogel effectively addresses mechanical instability and electrical limitations of conventional submucosal agents.
• This platform offers sustained tissue elevation and optimized current conduction for safer and more precise electrosurgery.
• The hydrogel shows significant potential for advancing energy-based interventions in minimally invasive surgery.