A Robust Bio-Supportive Hydrogel Patch for Full-Thickness Repair of Gastroesophageal Defects

Surgical repair of gastroesophageal (GE) defects is a formidable clinical challenge, plagued by high leakage, fistula recurrence and life-threatening complications due to gastric acid exposure and persistent mechanical stress. To address this unmet need, we developed a robust bio-supportive (RBS) hydrogel patch for immediate fluid-tight closure and full-thickness tissue regeneration. Fabricated from highly crystalline polyvinyl alcohol (PVA) hydrogel, the RBS patch has a double-disc architecture, inherent porous network and weakly bound water. The double-disc design ensures effective sealing and deformation resistance; high crystallinity confers adequate mechanical strength and long-term acid/enzyme resistance. Moreover, its porous microstructure and weakly bound water synergistically promote cellular adhesion, migration and tissue infiltration for functional repair. In rat and rabbit models, the RBS patch achieved remarkable healing of gastric perforations (GP), esophageal perforations (EP) and tracheoesophageal fistulas (TEF), with intact mucosal, submucosal and muscular layers regeneration. Its efficacy and safety were further validated in beagle dog models, highlighting clinical translation potential. This RBS patch serves as a versatile bio-supportive technology for GE defects and a promising platform for tissue repair in dynamic physiological environments.