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Uniform and Complete Irreversible Electroporation on Gastric Mucosa Enabled by Sintered Silver Hydrogel
Zhuoqun Li1,2,3, Shenshen Lei4, Quanpeng Li4
1Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China.
Abstract:
Irreversible electroporation is a promising nonthermal ablation for gastric mucosa, but nonconformal contact between the electrode and the rough surface of the gastric mucosa causes an inhomogeneous distribution of the high-voltage electric field. Here, we enhanced gap filling and substantially reduced distortion of the delivered high-voltage electric field by fabricating a soft, highly conductive sintered silver hydrogel as the bioelectronic tissue interface, thereby achieving uniform and complete irreversible electroporation. The sintering reaction was initiated by Cl- and H+, which can work synergistically to partially eliminate the insulating surfactant on silver flakes, facilitating a sintering reaction through the dynamic redeposition of silver nanoparticles on silver flakes. Via a room-temperature sintering process, the conductivity of the hydrogel was promoted from below 1 to >104 S/m at a low silver flake loading (4 vol%), and the mechanical property was still kept at a low Young's modulus (91 kPa), even after swelling from digestive juices. In vitro experiments demonstrated that ablation uniformity improved by up to 86%, with the ablation area increasing by 30% to 52% and a maximum depth of 5.39 mm. Preclinical validation using porcine models demonstrated uniform, complete gastric mucosal ablation, reaching a depth of 2.50 mm, extending through the muscularis mucosae and leaving no residual cells. This sintered silver hydrogel-enhanced irreversible electroporation addresses key challenges and reinforces its potential as a reliable, advanced treatment for gastrointestinal lesions.