Title : Easily injectable, organic solvent free self assembled hydrogel platform for endoscope mediated gastrointestinal polypectomy
Abstract:
Endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) are widely employed for removing small, flat gastrointestinal (GI) lesions, but their success depends on creating a durable submucosal cushion. Conventional injectables such as saline and hypertonic dextrose dissipate rapidly, while polymeric agents like gelatin and alginate suffer from poor injectability. Here, we report a novel amphiphilic polyglycerol stearate-based hydrogel (PGSH) that addresses these limitations by enabling smooth catheter injection, shear-thinning behavior, and long-lasting submucosal elevation. PGSH encapsulates hydrophilic drugs (e.g., streptomycin) and supports both enzymatic and non-enzymatic controlled release. Ex vivo studies in goat GI tissue confirmed clog-free injection and stable cushion formation, while blood assays revealed rapid hemostasis with preserved hemocompatibility. In vivo murine studies demonstrated biocompatibility, non-toxicity, and absence of cytokine overexpression, with the hydrogel forming cushions of clinically relevant height. Importantly, porcine ESD trials validated safe injection and effective polyp resection. Collectively, PGSH represents a promising next-generation submucosal lifting agent with drug delivery capability, offering significant potential to improve outcomes in early GI polyp management.
