Biological welding enables rapid and efficient bladder cystotomy closure and reveals the underlying repair mechanism

Bladder rupture repair surgery is limited by its long duration, significant blood loss, and complex procedures. Biological welding technology, which integrates multiple functions such as cutting, hemostasis, and tissue fusion, has shown potential in the field of soft tissue repair surgery but has not yet been widely explored in clinical applications for bladder rupture repair. This study used 32 adult male Beagle dogs to establish a bladder rupture model, randomly assigned to the biological welding group or the traditional suturing group. Outcomes assessed included surgical time, blood loss, postoperative inflammation, and hematuria. Histopathological analysis and RNA sequencing analysis were performed at multiple postoperative time points to evaluate the tissue recovery process and repair mechanisms. The results demonstrated that biological welding significantly reduced surgical time (21.80 ± 4.79 min vs. 75.15 ± 13.26 min, p < 0.001) and intraoperative blood loss (6.37 ± 0.89 g vs. 30.36 ± 6.59 g, p < 0.001) compared to traditional suturing. Postoperative complications, such as hematuria and inflammatory response, were notably lower in the biological welding group. Histopathological analysis revealed enhanced cell migration and tissue fusion in the biological welding group, leading to accelerated bladder healing and reduced adhesions. Transcriptomic sequencing indicated that biological welding activated a limited number of immune-related genes and signaling pathways in the early postoperative period, facilitating rapid repair and a shorter duration of abnormal gene expression. Our research indicates that biological welding technology demonstrates significant advantages in bladder rupture repair surgery, including enhanced surgical efficiency, reduced incidence of postoperative complications, and accelerated tissue healing process, with broad prospects for clinical application.