The use of cyanoacrylate in surgical anastomosis: An alternative to microsurgery

Abstract

To present anastomosis with cyanoacrylate as a cheap, simple, fast, and available technique for anastomosis in urological, vascular, gynecological, and general surgical procedures. This method may in the future be a good alternative to microsurgery, particularly in centers where facilities are unavailable and the financial implication is unbearable for the patient. Cyanoacrylate is an adhesive or glue that is available in different chemical forms ranging from ethylcyanoacrylate (superglue) to Isobutylcyanoacrylate and octylcyanoacrylate (dermerbond), which is in clinical use. Anastomosis with cyanoacrylate requires the application of stay sutures, a luminal stent and the subsequent application of the adhesive. The adhesives with lower molecular weights produce a rigid and patent region of anastomosis, while the higher molecular compounds produce a consistency close to the normal tissue. This technique presents a surgical method that is socially, culturally, and ethically acceptable, which is affordable to a larger majority of patients in our subregion. Cyanoacrylate anastomosis may in the future present a fast, convenient, simple, and affordable option in the treatment of patients requiring anastomosis. In our subregion where the socio-cultural, psychological, and economic burden of failed anastomosis is high, associated with the low per capital income, this may be a novel option for the management of urogynecological, vascular, neurosurgical, and general surgical procedures requiring either microscopic or macroscopic anastomosis.

Adhesive and sealant interfaces for general surgery applications

“…The development and clinical evaluation of these materials for general surgery was delayed because of safety issues; however, in the last decade a lot of efforts were devoted to cyanoacrylate applications other than cutaneous. An important use of cyanoacrylate formulations is for hemostatic purpose like in anastomotic connections where there is a high risk of bleeding complication . Cyanoacrylates possess several advantages for tissue approximation and their applications include wound closure or small Pfannenstiel incisional cuts performed during clean abdominal surgery .…”

“…A commercial 2‐octyl cyanoacrylate (Dermabond Advanced™, Ethicon, Johnson, and Johnson Medical) was shown to reduce the rate of postoperative pancreatic fistula after pancreaticoduodenectomy . The use of cyanoacrylate in surgical anastomosis for general surgery has been proposed as an alternative to microsurgery particularly in centers where facilities are unavailable and the financial implication is unbearable for the patient …”

Behaviour of the Biological Adhesives TachoSil®, GelitaSpon®, and a New Elastic Cyanoacrylate (Adhflex®) in Experimental Renal Trauma and Wound Healing

“…An important use of CyA formulations is haemostasis [8] as in anastomotic connections, where there is a high risk of bleeding complications [9,10]. We hypothesized that this characteristic could make CyA suitable for the treatment of haemorrhagic traumatic injuries to solid organs.…”

Cytocompatibility and mechanical properties of surgical sealants for cardiovascular applications

“…Generally, surgical sealants fall into one of three categories: natural polymer-based sealants (fibrin-, collagen-, and albumin-based), synthetic polymer-based sealants (polyurethane-, polyethylene glycol (PEG)-, and polyester-based), and cyanoacrylate sealants [10]. Cyanoacrylate sealants were not examined in the present study because of their high stiffness, low elasticity, and high toxicity in areas with significant moisture, making them a poor candidate for cardiovascular hemostasis [10, 11]. Since the clinical utility of surgical sealants for cardiovascular application depends on their polymerization time, cytocompatibility, burst pressure strength, elasticity, and degradation time, these characteristics were systematically assessed for two natural polymer-based sealants, BioGlue® and PreveLeak®, and two synthetic polymer sealants, Tridyne™ VS, and Coseal®.…”