The Role of Biomaterials in Upper Digestive Tract Transoral Reconstruction

Abstract

This study aims to establish whether the use of biomaterials, particularly polydimethylsiloxane (PDMS), for surgical reconstruction of the esophagus with templates, Montgomery salivary tube, after radical oncology surgery for malignant neoplasia is an optimal choice for patients’ safety and for optimal function preservation and organ rehabilitation. Methods: Structural analysis by Raman spectrometry and biomechanical properties with dynamic mechanical analysis are performed for fatigue strength and toughness, essential factors in durability of a prosthesis in the reconstruction practice of the esophagus. Nanocomposites with silicone elastomers and nanoparticles used in implantable devices and in the reconstruction surgery are facing risks of infection and fatigue strength when required to perform a mechanical effort for long periods of time. Results: This report takes into account the effect of silver (Ag) nanoparticles on the fatigue strength using polydimethylsiloxane (PDMS) matrix, representative for silicon elastomers used in implantable devices. PDMS with 5% (wt) Ag nanoparticles of 100-150 nm during mechanical fatigue testing at shear strength loses elasticity properties after 400 loading-unloading cycles and up to 15% shear strain. The fatigue strength, toughness, maximum shear strength are the key issues in designing Montgomery salivary tube with appropriate biomechanical behavior for each patient. Conclusions: Prosthesis design needs to indulge both clinical outcome as well as design methods and research in the field of biomaterials.

Hypopharyngeal Cancer

“…As a first intraoperative stage after total circular pharyngo-laryngectomy a Montgomery tube can be placed between the pharyngostomy and the esophagostomy. In the ENT Clinic of Colțea Clinical Hospital in Bucharest, Romania, Professor Dr. Cristian Radu Popescu restored the pharyngo-esophageal continuity using a Montgomery esophageal prosthesis Figure 3 [20].…”