Development of a Novel Treatment Device for Upper Gastrointestinal Complications

Abstract

One of the major upper gastrointestinal (UGI) complications that affect approximately 1 in 10 Australians is gastro-oesophageal reflux disease (GORD). GORD is when stomach acid frequently passes back up into the oesophagus and damages the oesophageal wall. Research has shown that frequent exposure of acid can increase the risk of adenocarcinoma in the oesophagus, where in Western populations the incidence is increasing. The survival rate for patients with oesophageal adenocarcinoma is low. This thesis proposed to develop a device with the potential to treat GORD and in turn reduce the risk of adenocarcinoma formation. The proposed device is made up of two main components, an anti-reflux valve and a novel device attachment system that uses LED light activation to adhere to tissue. Various tests were conducted such as tensile test, SEM imaging, pressure tests and cell cultures. These tests were performed to determine the device’s potential. The results showed that after 10 minutes of LED light activation the adhesive lap shear strength on porcine tissue was 7.50 kPa. The device showed it could support cell attachment and proliferation. Various valve designs were investigated, with the best valve able to prevent pressure up to 6 kPa, close to the natural pressure exerted by the lower oesophageal sphincter. Deployment of the device in porcine oesophagus using a standard medical endoscope was promising, but further optimisation is required. The significance of this research showed that a light activated adhesive system was possible using standard LED lighting, achieving strengths superior to fibrin glue while being safe and capable of tissue integration. The other key outcome was silicone anti-reflux valves were made from 3D-printed moulds capable of replicating the resistance of natural oesophagus. The final device shows promise and with future development could become a new treatment option for long-term sufferers of GORD. One of the major upper gastrointestinal (UGI) complications that affect approximately 1 in 10 Australians is gastro-oesophageal reflux disease (GORD). GORD is when stomach acid frequently passes back up into the oesophagus and damages the oesophageal wall. Research has shown that frequent exposure of acid can increase the risk of adenocarcinoma in the oesophagus, where in Western populations the incidence is increasing. The survival rate for patients with oesophageal adenocarcinoma is low. This thesis proposed to develop a device with the potential to treat GORD and in turn reduce the risk of adenocarcinoma formation. The proposed device is made up of two main components, an anti-reflux valve and a novel device attachment system that uses LED light activation to adhere to tissue. Various tests were conducted such as tensile test, SEM imaging, pressure tests and cell cultures. These tests were performed to determine the device’s potential. The results showed that after 10 minutes of LED light activation the adhesive lap shear strength on porcine tissue was 7.50 kPa. The device showed it could support cell attachment and proliferation. Various valve designs were investigated, with the best valve able to prevent pressure up to 6 kPa, close to the natural pressure exerted bOne of the major upper gastrointestinal (UGI) complications that affect approximately 1 in 10 Australians is gastro-oesophageal reflux disease (GORD). GORD is when stomach acid frequently passes back up into the oesophagus and damages the oesophageal wall. Research has shown that frequent exposure of acid can increase the risk of adenocarcinoma in the oesophagus, where in Western populations the incidence is increasing. The survival rate for patients with oesophageal adenocarcinoma is low. This thesis proposed to develop a device with the potential to treat GORD and in turn reduce the risk of adenocarcinoma formation. The proposed device is made up of two main components, an anti-reflux valve and a novel device attachment system that uses LED light activation to adhere to tissue. Various tests were conducted such as tensile test, SEM imaging, pressure tests and cell cultures. These tests were performed to determine the device’s potential. The results showed that after 10 minutes of LED light activation the adhesive lap shear strength on porcine tissue was 7.50 kPa. The device showed it could support cell attachment and proliferation. Various valve designs were investigated, with the best valve able to prevent pressure up to 6 kPa, close to the natural pressure exerted by the lower oesophageal sphincter. Deployment of the device in porcine oesophagus using a standard medical endoscope was promising, but further optimisation is required. The significance of this research showed that a light activated adhesive system was possible using standard LED lighting, achieving strengths superior to fibrin glue while being safe and capable of tissue integration. The other key outcome was silicone anti-reflux valves were made from 3D-printed moulds capable of replicating the resistance of natural oesophagus. The final device shows promise and with future development could become a new treatment option for long-term sufferers of GORD. y the lower oesophageal sphincter. Deployment of the device in porcine oesophagus using a standard medical endoscope was promising, but further optimisation is required. The significance of this research showed that a light activated adhesive system was possible using standard LED lighting, achieving strengths superior to fibrin glue while being safe and capable of tissue integration. The other key outcome was silicone anti-reflux valves were made from 3D-printed moulds capable of replicating the resistance of natural oesophagus. The final device shows promise and with future development could become a new treatment option for long-term sufferers of GORD.