A Perioperative Hydrogel Platform for Integrated Endoscopic Submucosal Dissection Management.

Area of Science:

• Biomaterials Science
• Gastroenterology
• Minimally Invasive Surgery

Background:

• Endoscopic submucosal dissection (ESD) faces challenges with conventional submucosal cushions and postoperative care.
• Existing methods lack sustained therapeutic support and efficient mucosal elevation.

Purpose of the Study:

• To develop a multifunctional hydrogel for perioperative management of ESD.
• To address limitations of current submucosal agents and improve ESD outcomes.

Main Methods:

• A hydrogel was synthesized using carboxymethyl chitosan and oxidized dextran via Schiff base reactions.
• Methylene blue was incorporated for visualization, and Bupivacaine-loaded mesoporous silica nanoparticles (BUP@MSNs) were integrated for sustained analgesia.
• In situ gelation, injectability, self-healing, tissue adhesion, antioxidant, and antibacterial properties were evaluated.

Main Results:

• The hydrogel formed a stable submucosal cushion, enhancing ESD efficiency and safety with immediate wound sealing.
• It demonstrated excellent injectability, self-healing, tissue adhesion, and potent antioxidant/antibacterial activities.
• Sustained postoperative analgesia exceeding 48 hours was achieved, with favorable in vitro and in vivo biocompatibility.

Conclusions:

• The developed hydrogel offers integrated mucosal elevation, sustained analgesia, and wound protection for ESD.
• It represents a clinically operable and cost-effective solution for gastrointestinal endoscopic therapies.
• This multifunctional hydrogel significantly improves perioperative management and patient outcomes in ESD.