Inventions and Innovations Related to Better Results in Intestinal Anastomosis: a Patent Review

Objective: To evaluate new techniques and improvements in surgical instruments related to intestinal anastomosis procedures. Methods: A search was conducted on the free database of patents from the National Institute of Industrial Patent Office (INPI) and The United States Patent and Trademark Office (USPTO). Were analyzed all occurrences between 2012 and 2016 related to experimental surgery and intestinal anastomosis. The requests for patents were examined individually and the data collected was the nationality of the applicant, if was physical (PP) or legal (LP) person and if was innovation or invention. At the end, a comparative analysis between the two institutions was performed. Results: In INPI was found only 5 occurrences. All of them were deposited by legal entity and were inventions. In addition, only one was a national request. In USPTO database, 65 occurrences met the inclusion criteria. Of these, 48 were national applications and only 5 were filed by physical person. Conclusion: More requests were found in US database, predominating national trustee and greater solicitation to inventions than Brazilian database. The main applications for patents are invention of surgical instruments, the development of new biological glues and improvement of mechanical sutures. Keywords: patents, gastroenterology, surgical anastomosis.

A novel method for generating 3D constructs with branched vascular networks using multi-materials bioprinting and direct surgical anastomosis

Vessels pervade almost all body tissues, and significantly influence the pathophysiology of human body. Previous attempts to establish multi-scale vascular connection and function in 3D model tissues using bioprinting have had limited success due to the incoordination between cell-laden materials and stability of the perfusion channel. Here, we report a methodology to fabricate centimetre-scale vascularized soft tissue with high viability and accuracy using multi-materials bioprinting involving inks with low viscosity and a customized multistage-temperature-control printer. The tissue formed was perfused with branched vasculature with well-formed 3D capillary network and lumen, which would potentially supply the cellular components with sufficient nutrients in the matrix. Furthermore, the same methodology was applied for generating liver-like tissue with the objective to fabricate and mimic a mature and functional liver tissue, with increased functionality in terms of synthesis of liver specific proteins after in vitro perfusion and in vivo subperitoneal transplantation in mice. Moreover, to establish immediate blood perfusion, an elastic layer was printed wrapping sacrificial ink to support the direct surgical anastomosis of the carotid artery to the jugular vein. Our findings highlight the support extended by vasculature network in soft hydrogels which helps to sustain the thick and dense cellularization in engineered tissues.

Clues to echocardiographic diagnosis of isolation of right subclavian artery in a patient with DiGeorge syndrome and its transcatheter management with its associated anomalies

Isolated subclavian artery is a rare anomaly. A second steal due to a patent arterial duct further reduces arm perfusion. Surgical anastomosis of the isolated vessel to aorta normalises arm perfusion. Simple echocardiographic clues aid in the diagnosis. An associated moderate sized ventricular septal defect was non-surgically closed along with catheter closure of the duct resulting in improved arm perfusion.