Small but mighty: Minimally Invasive Surgery demands new materials.

The first minimally invasive surgery (MIS), an endoscopy, dates back hundreds of years. Uptake has accelerated more recently, though, and has grown fast across a wide range of surgeries in the last few decades. In orthopedics, MIS is now widely used for arthroscopies and even full joint replacement for not just knees, but hips, wrists, shoulders, and elbows. From gastroenterology to cardiothoracic and heart surgery, pediatric to urogynecology, MIS has surged.

The benefits of MIS are well recognized by medical professionals and the public alike. Smaller incisions mean less pain, fewer complications, less scarring, and shorter hospital stays and recoveries. They also mean a lower total cost of care. Given a choice, few would want a larger wound that requires more recovery time, but realizing the benefits afforded by MIS depends on a successful surgery. That will depend in part at least on high-quality medical devices produced with materials whose properties are designed to maximize the benefits of MIS procedures.

Form and Function
The rise of MIS poses challenges for medical device companies. Smaller incisions require more precise instruments and smaller medical devices to facilitate surgery. At the same time, requirements for high strength with low stretch, superior flex and bending fatigue performance remain necessary. This is applicable to both Class 2 devices, such as a catheter, and Class 3, such as part of a heart valve. In orthopedics, shrinking incisions do not diminish the need for strong materials.

As with traditional surgery, the qualities and properties of the medical devices can have a significant impact. One striking example is the rising use of colored sutures – another trend we’ve seen in recent years. Colored fibers in sutures can create patterned combinations to aid in visibility and suture management in more complex surgeries. Working within the confines of the smaller incisions of MIS that can be particularly valuable, helping promote faster, more effective, and potentially safer surgery.

Materials Matter
Medical devices are critically important, and the history of suture materials is even longer than that of MIS: From silk and catgut used over three and half millennia ago right up to the present day, to the synthetic materials of the last half-century.

Spectra® MG BIO is an Ultra-High Molecular Weight Polyethylene (UHMWPE) fiber that is fifteen times stronger than steel and three times stronger than polyester while still being ultra-lightweight. This enables strong sutures with a small diameter/footprint. It also provides superior resistance to chemicals, fatigue and abrasion compared to conventional polyethylene. Earlier this year, Spectra® MG BIO technology received ISO 13485 certification, the highest management standard for the medical device industry.

Spectra® MG BIO is now available as a blue-hued fiber. This new offering provides a high-strength, lightweight, non-absorbable, biocompatible – and highly visible – UHMWPE fiber, ideal for use in orthopedic sutures or other medical applications where stark visual contrast can aide in making the procedure more effective.

Such developments don’t just support the increasing preference for and prevalence of MIS; such lighter, stronger, high-performance materials will also be critical to supporting the emerging trends in corrective surgeries – from robotics that reduce procedure durations to smart implants that flag dangerous bacterial presence. UHMWPE will play a crucial role in all of these.