Nanothermometry-enabled intelligent laser tissue soldering

Abstract

While often life-saving, surgical resectioning of diseased tissues puts patients at risk for post-operative complications. Sutures and staples are well-accepted and routinely used to reconnect tissues, however, their mechanical mismatch with biological soft tissue and invasiveness contribute to wound healing complications, infections, and post-operative fluid leakage. In principle, laser tissue soldering offers an attractive, minimally-invasive alternative for seamless soft tissue fusion. However, despite encouraging experimental observations, including accelerated healing and lowered infection risk, critical issues related to temperature monitoring and control during soldering and associated complications have prevented their clinical exploitation to date. Here, we introduce intelligent laser tissue soldering (iSoldering) with integrated nanothermometry as a promising yet unexplored approach to overcoming the critical shortcomings of laser tissue soldering. We demonstrate that adding thermoplasmonic and nanothermometry nanoparticles to proteinaceous solders enables heat confinement and non-invasive temperature monitoring and control, offering a route to high-performance, leak-tight tissue sealing even at deep tissue sites. The resulting tissue seals exhibit excellent mechanical properties and resistance to chemically-aggressive digestive fluids, including gastrointestinal juice. The iSolder can be readily cut and shaped by surgeons to optimally fit the tissue defect and can even be applied using infrared light from a medically approved light source, hence fulfilling key prerequisites for application in the operating theatre. Overall, iSoldering enables reproducible and well-controlled high-performance tissue sealing, offering new prospects for its clinical exploitation in diverse fields ranging from cardiovascular to visceral and plastic surgery.TeaserIntelligent solders containing nanothermometers and thermoplasmonics offer new route to high-performance tissue sealing.

Robotic Laser Tissue Soldering for Damage-free Soft Tissue Fusion Guided by Fluorescent Nanothermometry

“…In this work, we introduce a new minimally invasive wound closure technique for (robotic) MIS, based on controlled laser tissue soldering guided by fluorescent nanothermometers able to create seamless water-tight sealing. Nanothermometers have recently been successfully integrated into proteinaceous solders,( 29 ) and offer non-invasive temperature measurements. The proteinaceous solder material can further be supplemented with nanoabsorbers, including gold nanorods or titanium nitride nanoparticles( 29 ) for optimal differential heating.…”

“…Nanothermometers have recently been successfully integrated into proteinaceous solders,( 29 ) and offer non-invasive temperature measurements. The proteinaceous solder material can further be supplemented with nanoabsorbers, including gold nanorods or titanium nitride nanoparticles( 29 ) for optimal differential heating. As a critical step towards more accurate and less invasive soldering, we demonstrate automatic temperature control and smart laser power modulation for high-performance laser tissue soldering in (robotic) MIS, enabled by an intelligent solder paste that contains NIR-fluorescent nanothermometers and nanoabsorbers.…”