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Joining Blood Vessels Without Sutures

Soulskill posted more than 3 years ago | from the what-can't-duct-tape-do dept.

Medicine 54

Med-trump writes "Stanford microsurgeons have used a poloxamer gel and bioadhesive, rather than a needle and thread, to join together blood vessels. The technique, published in the recent issue of Nature Medicine, may replace the 100-year-old method of reconnecting severed blood vessels with sutures. According to the authors of the study, 'ultimately, this has the potential to improve patient care by decreasing amputations, strokes and heart attacks while reducing health-care costs.'"

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Best bet? Don't get sick! (2, Funny)

Dr.Bob,DC (2076168) | more than 3 years ago | (#37242778)


So instead of having chemicals filtering into our bodies where they do incredible harm, we're to have these chemical 'glues' used directly inside our blood vessels where they can spread through to virtually every cell of our bodies?

"Better Living Through Chemistry" indeed. No thank you.

The facts are undeniable: since the advent of man-made chemicals, we have gotten less healthy as a species. Cancers, heart disease, subluxation, nerve damage, autism, allergies... the list is endless. As a sad example, take Steve Jobs. The man is a legend and has been a vegetarian/vegan for decades. How could someone with the healthiest diet known end up with cancer? Chemicals. While he ate what he thought was a good diet, I'll wager he ate non-organic foods. They're loaded with pesticides, herbicides, fungicides and other "cancer-cides".

If I or any members of my family ever have to go under the knife (unlikely as we're all healthy, but imagine an accident) I would *insist* that they use what they've used for years: natural catgut sutures.

The best solution is to avoid the surgeon's butcher knives and the BigPharma-controlled Sickness Industry:
- Get plenty of rest
- Get plenty of exercise
- Eat a vegetarian (preferably vegan) organic diet
- Get regular chiropractic adjustments to help maintain nervous system health.

Take care,
Bob.

Re:Best bet? Don't get sick! (1)

MyLongNickName (822545) | more than 3 years ago | (#37242862)

Oh boy... a real wack job has surfaced.

Re:Best bet? Don't get sick! (2, Insightful)

Doubting Sapien (2448658) | more than 3 years ago | (#37243054)

Wise up, folks. [wikipedia.org] http://en.wikipedia.org/wiki/Internet_troll [wikipedia.org] . I'm new here and even I'm sensible enough to not feed the trolls. Seriously, guys like this are not worth your time.

Re:Best bet? Don't get sick! (2, Informative)

tonywong (96839) | more than 3 years ago | (#37243738)

You must feed the trolls with Organic foods or Doc Bob will get his spine all bent out of shape.

Re:Best bet? Don't get sick! (1)

luxifr (1194789) | more than 3 years ago | (#37251112)

Wise up, folks. [wikipedia.org] http://en.wikipedia.org/wiki/Internet_troll [wikipedia.org] . I'm new here and even I'm sensible enough to not feed the trolls. Seriously, guys like this are not worth your time.

It's not as easy as you try to make it appear. It's been on ./ a few years ago, that not feeding the trolls is usually ineffective. [slashdot.org]

Re:Best bet? Don't get sick! (1)

Kral_Blbec (1201285) | more than 3 years ago | (#37242964)

Ya, lifespans are so much shorter than they were 100 years ago....

Re:Best bet? Don't get sick! (2)

Dr.Bob,DC (2076168) | more than 3 years ago | (#37242990)

Only because Chiropractic has been around since the late 19th century to offset all the toxins and subluxations we've been giving ourselves.

Re:Best bet? Don't get sick! (2, Insightful)

Anonymous Coward | more than 3 years ago | (#37243160)

I love how Chiropractic can improve the life-span of people that haven't ever been treated with it. Now there's a useful medical procedure!

Re:Best bet? Don't get sick! (1, Insightful)

Samantha Wright (1324923) | more than 3 years ago | (#37243396)

Of course it can: laughter is the best medicine.

Re:Best bet? Don't get sick! (1)

tibit (1762298) | more than 3 years ago | (#37246254)

You've nailed it. I've recently had to service a computer used by a chiropractor. The amount of quackery represented in the software installed there is beyond belief. Astrology, acupuncture "measurements", oh boy. The providers of this software surely must be making a good life for themselves. Sometimes I wish FDA had more teeth to stop it. Say what you want about the european Medical Directive, but if you want to market hardware or software that is classified as a medical device (anything directly used for treatment/diagnosis), it must have proven efficacy.

PS. I hate laws that come with a price tag attached just to view them -- many european directives include by reference national standards that cost thousands of dollars per single directive. I think this is completely broken and insane -- the U.S. has got it right: the courts have repeatedly ruled that if it's law, you can limit its distribution. Thus any code such as electrical, building, plumbing, etc. that got included in a law somewhere in the U.S. is available free of charge if you know where to look (resource.org is a good one [resource.org] ).

Re:Best bet? Don't get sick! (1)

Samantha Wright (1324923) | more than 3 years ago | (#37252838)

As long as there are stupid or vulnerable people in the world, someone, somewhere will continue preying on them. (These are generally the sort of people who don't mind the title "prophet.") While these insane attacks on the medical profession are obviously a big issue, it would really be nice if we could circumvent the problem at the source.

P.S. it is way too early in the morning for the above to be coherent or have a point

Re:Best bet? Don't get sick! (1)

tibit (1762298) | more than 3 years ago | (#37253024)

s/you can limit its distribution/you can't limit its distribution/

Re:Best bet? Don't get sick! (3, Insightful)

JoshuaZ (1134087) | more than 3 years ago | (#37243302)

If that were true then it would require that most people would have to see chiropractics. But lifespan has increased across the board even as only a small fraction of people go get chiropractic treatments.

Here's a better question: When was the last time chiropractice came up with a new treatment that helped heal a disease or problem they couldn't otherwise? Science does this all the time. Small pox and polio, once terrifying diseases, are diseases of the past. Diabetes, once a death sentence, is now manageable. Fifty years ago, childhood leukemia was a death sentence. Now, it is a horrific disease which permanently damages children, but often they live. And the death rates are still declining http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5648a1.htm [cdc.gov] . A hundred years ago, severe liver disease was a painful way to die. Now, we have liver transplants.

This is what real science and real medicine do. They improve. They work. They develop and test new treatments. And when a treatment doesn't work we throw it out. This process is slow, and comes in fits and starts. But the pattern of progress is clear. So again, what have the chiropracticts or the homeopaths or the Reiki fan done? What diseases have they cured? What insights into the nature of humans have they found? Did they find DNA? Did they unravel the genetic code? Did they discovery the many things RNA does in a cell? Instead they've stuck with hundred year old beliefs and kept parroting them.

All of these fringe beliefs have a variety of things in common: they each claim to be able to cure almost everything. The Reiki practitioner can cure any disease by manipulating the energy fields. The chiropracter can cure and prevent any disease by removing toxins" and subluxations. But that's not how the real world works. In the real world, there is no magic bullet. The human body is a wondrously complicated awesome thing. And so different diseases have different causes, not the same causes. And so different problems require different solutions. There's nothing easier when confronted with a massive collection of hard problems to convince yourself that you can solve all of them with a single trick. But that's not how the world works.

Unfortunately for you Dr. Bob, it is extremely unlikely that you will let any of this sink in. You have spent a massive amount of time and resources preaching your beliefs to the world. Humans have a tremendous amount of time admitting when they are wrong even over little things. In your case, the long amount of effort will likely make the cognitive dissonance much too severe for you to even question whether potentially part of your belief system might be wrong. And that's sad. But, you've put yourself in that position. You are the only one who can take yourself out of it.

Re:Best bet? Don't get sick! (1)

tibit (1762298) | more than 3 years ago | (#37246272)

Applause

Re:Best bet? Don't get sick! (0)

Anonymous Coward | more than 3 years ago | (#37254034)

Bravo.

I'm still laughing at the part where Botchtor Dob would insist on catgut sutures. Are there any real MD's out there that care to comment on the availability of cat-gut for sutures? Not that it'd matter, given that one advantage mentioned was this adhesives' sub-mm suturing prospects.

Oh, and Where. Are. PETA? Catgut? ORLY?! That's gotta be a nonstarter for PETA.

And if Hollywood wants to get in on the beatdown, I can't be the only one that'd eagerly watch a season of Survivor that pitted quacks like this against cranky PETA activists that got wind of the incipient 'catgut' revolution in medicine pushed by this nimrod's retro-holistic mumbojumbo. Aggressive infections from punji sticks and/or various critter bites would be a most entertaining challenge. Then we could watch them endure debilitating shits / dysentery when they fail to adequately filter water without modern tech or materials.

Medicine, science and using manmade compounds instead of frickin' catgut, incantations and incense isn't some scam, it's moving PAST bullshit like he's spewing to things that prove themselves to consistently work better.

Re:Best bet? Don't get sick! (2)

LanMan04 (790429) | more than 3 years ago | (#37244790)

If Alternative Medicine worked, it would just be called Medicine.

Re:Best bet? Don't get sick! (1)

umghhh (965931) | more than 3 years ago | (#37244122)

Well kids dying early and wars distort the picture quite some. I recall my study of church books I did while searching for roots - I found out that 200ya my folks lliving off the farms (not as owners mind me) lived into their 80ties and had kids till they died (with new wives of course). This has changed quite a lot when area got industrialized - quite often folks were brought back home from the factory before even reaching 50yoa. This trend has reversed after the second big one and My mum is almost as old as my grand ma from 200ya. Life and death are more complicated than what they seem to be. Nevertheless I would not swap penicillin for living on the farm back then.

Re:Best bet? Don't get sick! (0)

Anonymous Coward | more than 3 years ago | (#37243068)

Dr. Bob, I just want you to know that we all appreciate your posts. Please keep spreading the truth about modern medicine.

Re:Best bet? Don't get sick! (1)

SleazyRidr (1563649) | more than 3 years ago | (#37245294)

A few points:
1. Cancer, heart disease, etc. have largely arisen due to increased life expectancy, and the fact that people now live long enough to get sick with that kind of thing.
2. Your other examples of "new" diseases were likely merely undiagnosed and untreated in the past.
3. Wouldn't a cancer-cide be a good thing, coz it would kill the cancer?

Re:Best bet? Don't get sick! (1)

X0563511 (793323) | more than 3 years ago | (#37250144)

We're all happy to know the next time you lacerate yourself you'll be abstaining from treatment because it's totally evil!

Glue! (1)

Gr33nJ3ll0 (1367543) | more than 3 years ago | (#37242852)

Another human invention that's been around since the dawn of time!

Re:Glue! (0)

Anonymous Coward | more than 3 years ago | (#37243122)

Uh, yeah... just like Elmers. You should ask for that when you need heart surgery.

Smartass.

Re:Glue! (0)

Anonymous Coward | more than 3 years ago | (#37244286)

Another human invention that's been around since the dawn of time!

You mean, since the dawn of old horses.

Reducing Costs... (1)

DoomHamster (1918204) | more than 3 years ago | (#37242866)

"ultimately, this has the potential to improve patient care by decreasing amputations, strokes and heart attacks while reducing health-care costs"... For the insurance companies. What are the odds those savings will be passed on to the patients?

Re:Reducing Costs... (2)

pnewhook (788591) | more than 3 years ago | (#37243008)

For the insurance companies. What are the odds those savings will be passed on to the patients?

All you have to do is to cut the bloodsucking insurance companies out and go total socialized health care like Canada, and everyone will win.

Re:Reducing Costs... (4, Informative)

sgt scrub (869860) | more than 3 years ago | (#37243090)

Canada is a AAA rated country. They can afford to give a shit.

Re:Reducing Costs... (1)

Samantha Wright (1324923) | more than 3 years ago | (#37243434)

Yep. And we did it by letting ourselves be taxed. (And bumming off the Yanks, when circumstances necessitated it. But it's mostly about not hating strangers.)

Re:Reducing Costs... (0)

Anonymous Coward | more than 3 years ago | (#37245292)

The last part is because of the decriminalization of Marijuana.

Re:Reducing Costs... (0)

Anonymous Coward | more than 3 years ago | (#37252920)

They learned that trick by banning cigarettes. Now, with both being legal, they have fewer smokers of both. Except for William Shatner. That guy is way to funny not to be burning the twisty ones.

Re:Reducing Costs... (0)

Anonymous Coward | more than 3 years ago | (#37246804)

... 'ultimately, this has the potential to improve patient care by decreasing amputations, strokes and heart attacks while reducing health-care costs.'

In the United States, the savings will be passed on to the insurance companies, which means bigger bonuses for the executives. We can thank the sanctity of religion for the prosperity [wikimedia.org] of capitalism.

Re:Reducing Costs... (1)

umghhh (965931) | more than 3 years ago | (#37244280)

probably not quite true. Neither way has only bad or good sides. The fact that US f.d up is telling. Germany is going the same way too. I think Holland tried to change their system in such where basic coverage is for everyone and everyone living there has to have basic insurance which from what I know is bought from private companies which in turn are obliged by law to accept everybody. On top of this system is private insurance for those who can and want to have an insurance providing a bit more sophisticated services (blue pill and such). Not sure if the system works but it provides basic service for all while keeping relatively free market. I would appreciate if somebody from NL say something about details. Of course maniacs from US will not have it because that is 'communism'. Well possibly this is another sign of decline in education in US. I love how the efforts of not having general solution for the whole nation (communism) result in expensive, ineffective and widespread state run systems that do not provide what is paid for because they try to cut the costs so much..

Re:Reducing Costs... (1)

pnewhook (788591) | more than 3 years ago | (#37252166)

I have had several eye opening experience with Canadian health care. First was my dad who got a pacemaker - he was in surgery the next morning after being diagnosed and that probably saved his life. Top of the line pacemaker that apparently cost $30 for just the part in the US.

My personal experience was with our first child that was born premature. Amazing care by a team of doctors and specialists for two months in the NICU, and followup monitoring care until he is three. The only thing I had to pay for was parking. If this happened in the US I would probably had to have sold my house to pay the bill as I'm sure it would have run into the hundreds of thousands based on the care he got and the research I did on it online.

The US does have top of the line heath care but only for the two percent that can actually afford it. The rest get substandard care. Here in Canada we get the same exact care the US gets but its for everyone, and the overall costs for supplying this have been proven to be much lower than the US healthcare costs.

Re:Reducing Costs... (0)

Anonymous Coward | more than 3 years ago | (#37246284)

The odds are zero. The doctors are the only ones who profit. I have already had a glue/suture. I declined to have a stitch put into a gash in my finger. I didn't have insurance and didn't want to pay for it. I said I would use "nuskin" as it wasn't really that bad.

The doctor said, "oh I have something like that here thats better", and smeared it with their glue. Weeks later I was charged $450 for a suture. I tried to contest it, but they maintain that a glue/suture is a suture so I am supposed to pay full price.

Re:Reducing Costs... (0)

Anonymous Coward | more than 3 years ago | (#37250570)

You cannot be happy enough about the decrease of amputations, strokes and heart attacks?

Expanding the scope of existing techniques (1)

Andy Dodd (701) | more than 3 years ago | (#37242940)

This isn't exactly super-new - it's expanding the scope of an existing technique to cases where it hasn't been used before.

Using glue instead of sutures has been around for at least a decade - after getting hit in the face with a hockey pick around 1999-2000, instead of stitches the local hospital glued together the gash above my eye where the lens from my glasses pushed in. (Thank God for shatterproof polycarbonate lenses - the lens saved my eye.) The glue worked very well - not even the slightest scar remains there.

However this appears to involve applying glue with far more precision than anything done before.

Re:Expanding the scope of existing techniques (0)

Anonymous Coward | more than 3 years ago | (#37243102)

sure. this is talking about gluing together individual blood vessels though, which doesn't remotely resemble what was done to your face. this is a new technique, and it sounds like it's pretty good for everyone.

Re:Expanding the scope of existing techniques (4, Informative)

Iron Chef Unix (582472) | more than 3 years ago | (#37243118)

It's not the glue that is novel in this application, but the use of a poloxamer gel to keep the vessel shape while attaching the ends.

Imagine trying to glue together the open ends of two tube socks. It would be time consuming to line up the ends and not glue the other side together, etc. This technique is like putting a solid round canister inside the junction of the two tubes, making it very quick to line up the edges and glue them together.

In this case the canister is a cylinder of poloxamer gel that is solid when warmed above body temperature. After the connection is glued, the gel cools and liquifies, leaving a perfectly glued joint.

Re:Expanding the scope of existing techniques (1)

yog (19073) | more than 3 years ago | (#37245730)

Furthermore, we're talking about tubes less than 1mm in diameter. Actually, it's quite an achievement to recreate these connections and have them heal that well. It sounds simple, but it's not.

Re:Expanding the scope of existing techniques (1)

Pope (17780) | more than 3 years ago | (#37246040)

Furthermore, we're talking about tubes less than 1mm in diameter.

Huh. So that's what the internet was like in the 70s.

Re:Expanding the scope of existing techniques (1)

X0563511 (793323) | more than 3 years ago | (#37250150)

I imagine the ability to repair such small vessels will help a patient keep sensation in the area of an operation?

Polymer that dissolves when cooled (3, Informative)

JoshuaZ (1134087) | more than 3 years ago | (#37243048)

According to TFA a major part of this is the use of a polymer that solidifies when heated but dissolves when it cools down. It is striking that we can not only have such weird substances but can have such substances that are also reasonably ok inside humans (that is, not poisonous and not triggering an immune response). The main advantages of this method is that it is faster than the normal method and that it can be applied to much smaller blood vessels. According to TFA, suturing is extremely difficult if not outright impossible for blood vessels that are smaller than 1 milimeter wide. The basic type of polymer has been used in various forms before to deliver drugs, so while this version is a modified version, it is unlikely that any very serious problems will crop up. Overall, this will be helpful in for both planned and emergency surgeries and should help reattach limbs and digits much more effectively. Right now when a finger is removed reattachment is a difficult process that often just fails. This should change that.

Re:Polymer that dissolves when cooled (3, Insightful)

ColdWetDog (752185) | more than 3 years ago | (#37243870)

Actually, it's more than that. Microvascular work requires a lot of training and specialized equipment. IF (big IF) this pans out, then it's possible that some dumb ol ER doc (ie, me) can put together blood vessels where today we either have to ship them someplace that has the personnel and equipment (slow and expensive) or just wack off the broken bits (cheap, fast but sometimes you want the little pieces part that's left on the floor).

Cool idea. We'll see if it pans out in clinical trials (most cool ideas don't unfortunately).

Re:Polymer that dissolves when cooled (1)

timeOday (582209) | more than 3 years ago | (#37244350)

How in the heck did they make it freeze when it gets hot and melt when it cools off?

Re:Polymer that dissolves when cooled (0)

Anonymous Coward | more than 3 years ago | (#37244890)

I don't know any specifics but I could think of a substance that needs a high amount of energy to create polymers, that energy might be provided as heat and make it work. Now that substance would have a reversible polymerization so that when cooled off it would break.

Re:Polymer that dissolves when cooled (2)

reverseengineer (580922) | more than 3 years ago | (#37246506)

Poloxamers are, as the Nature Medicine abstract describes, a triblock polymer. Blocks in polymerization are created by polymerizing one monomer chemical to create a chain, and then introducing another monomer to polymerize at the still reactive end of the original chain. This can be used to create a polymer that has regions of different properties. In the case of poloxamers, the blocks on the ends are polyethylene glycol while the middle block is less-soluble polypropylene glycol. This gives the chain a hydrophobic head and two hydrophilic tails. In aqueous conditions at lower temperatures, hydrogen bonds form between water and the hydrophilic chains and help to stabilize the poloxamer in solution. At higher temperatures, the hydrogen bonds break, and hydrophobic interactions between the polypropylene glycol blocks dominate (since it no longer interacts with water, it ends up interacting with itself). These interactions favor the formation of an insoluble gel. Cool down the gel, and the hydrophilic interactions take over again and the gel dissolves.

For those that didn't read the article... (2)

Guppy (12314) | more than 3 years ago | (#37243052)

For those who didn't read the link, the problem is, "How do you glue the ends of a tiny blood vessel together without gluing the lumen of the vessel shut?" Answer is that you need a temporary plug that sits inside and joins the two ends together, while propping it open until the glue sets.

The clever part was finding a material (the polaxamer) that is solid enough to do the job, but melts away at the right speed afterwards, without toxicity.

Ingenious (1)

Anonymous Coward | more than 3 years ago | (#37243316)

"How do you glue the ends of a tiny blood vessel together without gluing the lumen of the vessel shut?" Answer is that you need a temporary plug that sits inside and joins the two ends together, while propping it open until the glue sets.

  Also, a lot of people don't know that surgeons have been gluing (larger) blood vessels together, instead of suturing with needle and thread for decades already. Cyanoacrylates (superglues) were used outside the USA in medical applications since the 1970's, and specifically, butyl cyanoacrylate was approved in 1998 by the FDA here in the US.

Re:For those that didn't read the article... (1)

tibit (1762298) | more than 3 years ago | (#37246332)

Is it possible to use a needle inserted into the vessel, that you then simply take out by poking a hole in the vessel? Perhaps the vessel can stretch so that a you won't have a big gash in it? How stretchable are small blood vessels"

Serenity (1)

sgt scrub (869860) | more than 3 years ago | (#37243062)

How long until they can suture a wound above the spinal cord with can'd foam.

Re:Serenity (1)

Doubting Sapien (2448658) | more than 3 years ago | (#37243546)

not until River Tam goes bonkers and start beating people up. Obligatory xkcd [xkcd.com] comic.

Re:Serenity (1)

ColdWetDog (752185) | more than 3 years ago | (#37243910)

How long until they can suture a wound above the spinal cord with can'd foam.

Neurons are harder to deal with than blood vessels. They're more complicated. There are more of them. They are lots smaller.

So probably not for some time.

Star Trek reference (1)

TheSync (5291) | more than 3 years ago | (#37244012)

"Oh, I'd give a lot to see the hospital. Probably...needles and...sutures. All the pain. They used to hand-cut and sew people like garments. Needles and sutures...all the terrible pain!"

-McCoy, City on the Edge of Forever

"reduce heath care costs once the patent expires" (1)

mr_mischief (456295) | more than 3 years ago | (#37245434)

ITYM "reduce heath care costs once the patent expires". Time and again, a breakthrough at a tax-supported university that's supposed to improve healthcare for all mankind becomes a privately-held patent that is used to gouge those who can afford it. Considering Stanford is a private school which accepts very little money from public sources and only for specific projects, there's even less reason for the public to even expect this will be freely available technology.

Awesome (1)

hesaigo999ca (786966) | more than 3 years ago | (#37252622)

I think it is so awesome to have some innovative way of doing things that is less intrusive to the body, and gives the same results....

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