BACKGROUND
Wound closure devices for internal luminal repair have historically been limited to staples (nondegradable, commonly titanium), sutures, and/or adhesives. The urinary tract in particular is an area in which sutured repairs with bioabsorbable sutures remain the standard closure mechanism due to the risk of stones and UTIs with staples and the need for watertight repairs to avoid urine leak. In lower urinary tract reconstruction in particular, standard-of-care procedures have a 30 to 60% complication rate within 30 days post–operatively in the management of congenital and acquired conditions, such as spina bifida, bladder exstrophy, and bladder malignancies. The innovations presented here provide wound closure mechanisms for use in internal luminal repairs that will improve the feasibility of a variety of tissue repairs that occur within the body including congenital and acquired conditions.
SUMMARIES
Bio-Zipper Urethral Closure Device (UC Case No. 2019-816)
Researchers in the UCLA Department of Urology and California Nano System Institute have developed a biodegradable microneedle for operative closure and structural support of the urethra post urethral surgery. The bio-inspired, biodegradable microneedle designed by researchers at UCLA is designed to facilitate epithelial inversion, minimize urine leak, alleviate tension along the full extent of the ventral urethral closure site and prevent localized laminar flow effects. The device supports urethra structure, limiting postoperative urethral catheterization and allow the patient to resume voiding after completion of the reconstructive procedure. Lastly, the device minimize effects on vascularization from the underlying corporal bodies.
Biotape Closure Device (UC Case No. 2020-867)
Researchers in the UCLA Department of Urology and California Nano System Institute have developed a biodegradable surgical closure device with a flexible base that can be adhered to either side of an incision to draw it closed. The device can aid in performance of complex minimally invasive procedures such as bladder reconstruction, a method of bladder closure that decreases the time and learning curve required while maintaining a tension-free, watertight repair. The device can be used extraluminal or intraluminal to ‘drawstring close’ the tissue together. The device can be used during the repair of congenital and acquired conditions without requiring penetration/stapling, minimizing early postoperative complications. The device itself is biodegradable and biocompatible and can be modified to delivery vehicles or therapeutic agents to the tissue.
POTENTIAL APPLICATIONS
- Urethral tissue support
- Urethrovesical anastomosis (bladder, prostate cancer)
- Urethroplasty (urethral stricture, hypospadias)
- Neobladder or bladder reconstructive surgery
- Open or minimally invasive (bladder cancer, spina bifida/neurogenic bladder)
- Gastrointestinal system luminal repairs
- Endorectal (colorectal cancer)
- Vaginal and/or uterine repairs
- Myomectomy (fibroids), vaginal cuff repair (hysterectomy)
- Fascial, soft inner organs
- Renal or collecting system repair after partial nephrectomy (kidney cancer)
- Cardiovascular surgery
ADVANTAGES
- Nontoxic
- Biodegradable
- Tunable elasticity
- Decreases risk of kidney stones and urine leaks
- Decreases risk of infection
- Can be modified to provide timed release of materials
- Nanoparticles or drug delivery
ABOUT THE INVENTORS
Dr. Renea Sturm is pediatric urologist leading bench-to-bedside research at University of California Los Angeles. Her overarching goal is to apply basic science and technologic advancements to improve equity, quality and consistency of surgical care provision for children with urologic disorders across diverse healthcare settings. Her research focuses in surgical device development, tissue engineering and immunomodulation of the lower urinary tract. Dr. Sturm earned her undergraduate degree from Rice University and her medical doctorate from Baylor College of Medicine. She completed her urology residency training at the University of California, Davis, and her fellowship in pediatric urology at Lurie Children's Hospital of Northwestern University.
Dr. Ali Khademhosseini is the Director and CEO of the Terasaki Institute. He joined UCLA starting from Nov. 2017 and who aims to use and develop technology platforms to deliver personalized diagnostics and solutions. He received his Ph.D. in bioengineering from MIT (2005), and MASc (2001) and BASc (1999) degrees from the University of Toronto both in chemical engineering.
Together, they are working together to develop surgical devices, tissue engineering and immunomodulation to improve equity, quality and consistency of surgical care.