# Fabrication of an NIR-II fluorescence-visible indocyanine green-BioGlue for precision surgical adhesion with intraoperative leakage prevention

## TL;DR

A new bioadhesive called ICG-BioGlue is developed to prevent leakage during surgery and can be tracked using near-infrared fluorescence for better precision and safety.

## Contribution

The development of a NIR-II fluorescence-visible ICG-BioGlue adhesive that prevents intraoperative leakage and enables real-time visualization.

## Key findings

- ICG-BioGlue adhesive achieves nearly 100% fluorescence labeling efficiency and maintains stable NIR-II fluorescence for up to 3 months.
- The adhesive allows real-time visualization of wound adhesion in surgeries like aortic dissection and liver/kidney hemostasis, preventing leakage.
- The adhesive can be effectively imaged and removed if it causes compression symptoms after surgery.

## Abstract

Bioadhesives are being increasingly used in clinical practice, but pose significant health risks due to their uncontrollable intraoperative leakage. Nevertheless, there is currently a critical lack of effective solutions. Herein, we propose a second near-infrared window (NIR-II) fluorescence-visible indocyanine green (ICG)-BioGlue adhesive for precision surgical adhesion with intraoperative leakage prevention. The fabricated ICG-BioGlue adhesive based on the non-covalent interaction exhibits nearly 100% fluorescence labeling efficiency and maintains long-term stable NIR-II fluorescence for up to 3 months. During surgery, ICG-BioGlue adhesive enables real-time visualization of wound adhesion in various fields such as aortic dissection adhesion and liver or kidney wound hemostasis, preventing leakage into surrounding tissues. Moreover, the stable fluorescence of ICG-BioGlue adhesive allows effective imaging-guided removal of long-term adhesive fragments in the body when they cause compression symptoms after surgery. Considering it consists solely of Food and Drug Administration-approved drugs ICG and BioGlue, with a straightforward synthesis method and versatile applicability, ICG-BioGlue adhesive holds excellent potential for clinical translation. Our study provides a leakage-preventing strategy to enhance biosafety and promote the widespread application of bioadhesives in clinical settings.