Innovative Gel Assists Clampless Vascular Surgery

LeGoo is a reverse thermosensitive polymer (poloxamer 407) used to control vascular hemostasis, limiting vessel trauma and facilitating blood vessel anastomosis by minimizing dissection. Legoo is a viscous liquid at room temperature, but turns into a firm plug at body temperature, thus maintaining the cylindrical shape of the vessel, and allowing sutures to be passed directly through the gel. Once the surgical procedure is completed, LeGoo is dissolved by applying ice to the vessel or by infusing cold saline, thus restoring blood flow; once dissolved, it cannot reform into a gel because the concentration is too low, and the diluted material passes through the microcirculation and excreted in urine.

Among the clinical benefits that LeGoo provides are transient vascular occlusion; elimination of radial pressure (unlike clamps, loops, or balloons); preservation of crush fragile or calcified vessels; a superior surgical field with minimal dissection; easier suturing through the gelatinous plug; shorter occlusion and anastomosis time; and a simple technique to rapidly restore blood flow. LeGoo is a product of Pluromed (Woburn, MA, USA), and is approved by the US Food and Drug Administration (FDA) for temporary endovascular occlusion in blood vessels up to 4 mm in diameter below the neck.

“LeGoo represents a major advancement in surgical technology because of its ability to control bleeding without clamps or snares that can injure delicate blood vessels,” said William E. Cohn, MD, director of minimally invasive surgical technology at the Texas Heart Institute (Houston, USA) and a member of Pluromed’s board of directors. “This breakthrough gives surgeons a way to temporarily stop blood flow into the surgical field which is imperative for clear visualization and accurate placement of sutures. I believe this technology will be widely adopted in cardiovascular surgery and perhaps in other fields in the future.”

Poloxamer 407 is a hydrophilic nonionic surfactant consisting of a central hydrophobic block of polypropylene glycol flanked by two hydrophilic blocks of polyethylene glycol. Most of the common uses of poloxamer 407 are related to its surfactant properties. For example, it is widely used in cosmetics for dissolving oily ingredients in water. It can also be found in multipurpose contact lens cleaning solutions, where its purpose there is to help remove lipid films from the lens. It can also be found in some mouthwashes.

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