In Vivo Evaluation of a Biodegradable Intraanastomotic Membrane in a Porcine Model

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Abstract
Abstract Background: Anastomotic leakage (AL) represents one of the most serious complications in gastrointestinal surgery, with reported incidence rates of up to 26 %. Despite advancements in surgical techniques, early detection of AL remains challenging, and no reliable real-time monitoring system is currently available. In this study, we investigated a resorbable polydioxanone (PDO) membrane as a potential substrate for future sensor integration, aiming to facilitate real-time monitoring of anastomotic healing. Methods: In eight German Landrace pigs, 34 ileal side-to-end stapler anastomoses were examined: GM1 (n = 7), GM2 (n = 10), and controls (n = 17). Membrane stability was monitored after implantation, while adhesion formation, burst pressure, and histology were assessed on postoperative day 7. Results: Both membrane geometries showed robust stability, with good anchorage of the large spokes within the anastomosis. Geometry 1 (GM1) exhibited higher burst pressure than Geometry 2 (GM2) (193 ± 43.6 vs 155 ± 65.5 mmHg, p = 0.02). Compared with controls (167 ± 42.3 mmHg), neither GM1 (p = 0.053) nor GM2 (p = 0.379) differed significantly. Adhesions occurred in all groups, without significant differences. Histological evaluations showed typical granulation tissue and fibrosis, with granulocytic inflammation more common in GM1 without affecting anastomotic stability. Conclusion: This proof-of-concept study demonstrates that the PDO membrane can be safely incorporated into stapled anastomoses without compromising anastomotic healing. The membrane provides a stable, biocompatible platform suitable for future sensor integration, supporting the development of a diagnostic intraanastomotic device.
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Authors Schafmayer, Clemens
Journal Frontiers in surgery
Year Year not found
DOI
10.3389/fsurg.2026.1746520
URL
https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2026.1746520/full
Keywords Keywords not found

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