Crystal clear surgery using self-assembling molecules that act as a bio barrier in the brain and spinal cord

Abstract

The surgical field is often obscured with blood and debris during an operation. In addition, clearing debris from the surgical field usually requires irrigating the site with saline. Saline is only a temporary solution and needs to be continuously applied to maintain a clear surgical field. This poses several issues: 1) Any contamination in existence will easily spread; 2) a small opening will require alternating between irrigation and operating and 3) during neural operations movement of liquid can result in a massive infection leading to post-operative complications. Here we show that a self-assembling peptide (SAP) nanofiber scaffold can provide a transparent cover for the surgical field. This optically clear liquid allows operation through the resultant gel while at the same time creating a bio barrier. Using SAP for biological confinement can reduce post operative complications in open surgical procedures. Surgery was performed using this material on 218 adult Syrian hamsters and rats in the brain, spinal cord, arteries and veins. Several examples of neurosurgical procedures using the material will be presented, showing how in vivo biological confinement may change the face of neural surgery and allow for reconstructive neurosurgery.