A pancreas phantom to advance surgery: a unique project by Humanitas University and Politecnico di Milano

A collaboration between Humanitas University, Istituto Clinico Humanitas and Politecnico di Milano has led to the creation of a laboratory where engineers and surgeons are working side by side to create something highly innovative and unique worldwide: a biomechanical and functional characterisation of the pancreas tissue, in order to fully understand its features and create a physical model (phantom), made of an innovative material, on which students can be trained.

The project stems from a need originating from professionals in the operating theatre. “The number of pancreas operations is small compared to those on other organs, such as the intestine or breast. This type of surgery requires specific skills and is characterised by technical difficulties and several complications,” explains Prof. Alessandro Zerbi    Professor of General Surgery at Humanitas University and Head of the Pancreatic Surgery Operating Unit at Humanitas.

“Over the years, technological advances in general surgery have been studied and promoted for more frequent kinds of operations. New tools and materials have been designed targeting other organs and then adapted to the pancreas. The pancreas, for example, produces pancreatic juice which is very corrosive and after surgery could erode the sutures and leak, creating a risk of bleeding or infection. For this reason, the number of post-operative complications is higher than with other kinds of operations.

This is why surgeons need support from technology to develop specific tools for the pancreas. “When the Humanitas-Politecnico collaboration was born as part of the MEDTEC degree course, we held meetings between professors from both universities. I raised these issues and found great interest and support from colleagues,” Professor Zerbi continues.

The first step is to gain further knowledge about the pancreas tissue by studying its mechanical properties such as elastic modulus and mechanical strength with an engineering approach. The second step is to build an artificial tissue as similar as possible to the pancreatic tissue, to be used as a model to characterise new tools, such as glues and surgical threads, suitable to the characteristics of the pancreas.

“The goal is to recreate pancreatic tissue with synthetic materials and then build a physical simulator that replicates the characteristics of the organ, to allow surgeons to practice on it. This is a unique experiment. There are no pancreas phantoms and there are only few studies on the mechanical characterisation of the organ,’ stresses Prof. Maria Laura Costantino    president of the MEDTEC School, lecturer in Industrial Bioengineering and head of the Artificial Organs Laboratory, ‘Giulio Natta’ Department of Chemistry, Materials and Chemical Engineering (CMC-PoliMI)) at the Politecnico di Milano.

Once we develop the right artificial material, it can become a tool for the students to practice and train; trainees and young surgeons will be able to use this tool to learn how to operate, dissect or suture a pancreas. In the laboratory, located on the Humanitas premises, surgeons and engineers are already at work: Dr Giovanni Capretti and Gennaro Nappo, assistant surgeons at Humanitas, engineer Francesco De Gaetano, Professor Francesco Cellesi from the Department of Chemistry and Professor Serena Graziosi from the Department of Mechanics at the Politecnico.

“We are analysing small portions of pancreatic tissue, using a brand new machine (Bioindenter “UNHT3 Bio” by Anton Parr) that allows us to obtain the complete mechanical characterisation of the tissue”, continues Prof. Costantino. Luckily the laboratory is located in a hospital. “This means that the tissues taken from the operating theatre are transferred to the laboratory in real time and can be analysed immediately. This adds an important and unique value to this research,” explains Professor Zerbi.

The researchers aim to be able to characterise the tissues within the first six months of work and then to start the design phase with specially designed innovative materials. “In parallel with the development of the phantom, we will identify innovative materials from which we can make suture threads, different from those used today for the pancreas which do not fully meet the requirements,” Costantino concludes. “The aim of this research, which will also be carried out in the Politecnico’s CMC Department laboratory, is also to create new means using innovative materials”.