Fetal Surgery Stands To Advance From New Glues Inspired By Mussels

Pediatric surgeon Michael R. Harrison, M.D. and UC Berkeley engineer Phillip Messersmith, Ph.D. are collaborating on an NIH-Funded research project to improve glues used in fetal surgery procedures, notably those used to treat twin-to-twin transfusion syndrome. Dr. Harrision, widely acknolwedged as the "father of fetal surgery", is Director Emeritus of the Fetal Treatment Center and leads the research of the Harrison Lab. The full story was recently reported in UC Berkeley News.

UC Berkeley engineer Phillip Messersmith is happy to be learning lessons from a lowly mollusk, with the expectation that the knowledge gained will enable him and fellow physicians to prevent deaths among their youngest patients — those who haven’t been born yet.

Equipped with new funding from the National Institutes of Health and a partnership with a physician known as the “father of fetal surgery,” Messersmith is making better glues for medical procedures inside the body, applying what he and others before him have learned about underwater superglue-making techniques that have been developed and elaborated upon through eons of evolution by mussels, a brainless bivalve.

Fetal surgery, in which anatomical defects are repaired before birth, was unimaginable to most physicians just a few decades ago. Today, 35 years after the first lifesaving procedure, advances in diagnostic methods, surgical tools and scientific understanding have led to an ongoing expansion of the number and types of fetal surgeries, and in the number of practitioners performing them.

Among the fetal surgeries performed daily are those used to treat twin-to-twin transfusion syndrome, in which identical twins sharing an umbilical cord do not have equal access to nutrients from the mother’s blood; urinary blockages that threaten the kidneys; conditions in which lobes of the lung do not form normally; and the most severe forms of spina bifida, in which the spinal cord does not close.

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Bioengineer Philip Messersmith looked to mussels for how to design a new glue to close incisions during fetal surgery. (UC Berkeley video by Roxanne Makasdjian and Stephen McNally)

Dr. Harrison, also an investigator in the UCSF Surgical Innovations Program, has been at the forefront of advances in the field for over three decades. This effort represents yet another effort to augment the fetal surgery armamentarium.

With his new NIH grant, Messersmith has begun a collaboration with UCSF pediatric surgeon Michael Harrison. Harrison performed the first successful fetal surgery in 1981, to bypass a urethral blockage that might have led to fatal kidney damage. Harrison now is an emeritus professor managing a research lab at UCSF. He used a custom-made catheter to perform that first surgery, and to this day he maintains a research focus on improving tools and techniques used in fetal surgery.

“We have worried about this problem of fetal membranes leaking and causing pre-term labor and delivery for decades,” Harrison said. “It’s the Achilles heel of fetal surgery.”

With new adhesives created by Messersmith’s lab team, Harrison hopes to at last experience success with a strategy that he calls “pre-sealing.”