Preparation of Tubular Biocellulose Implants and Its Use in Surgery—A Review

This review highlights the current state regarding the preparation and characterization of tubular biocellulose materials as well as their application and application potential with a special focus on abdominal oncologic surgery. Biocellulose is a natural polymer synthesized by acetic acid bacteria from low molecular sugars and alcohols as a mechanically stable nanofiber network at the interface between the aqueous culture medium and air. This hydrogel is characterized by very high purity and biocompatibility, dimensional stability, and good surgical handling. With this property profile, biocellulose proves to be a promising candidate for the development of novel medical soft tissue implants. This requires close R&D cooperation between chemists, material scientists, biotechnologists, and surgeons. In this sense, this review spans from the natural polymer to the design of biocellulose implants and surgical suitability. It is also a concern of this article to show concretely the great need for such implants and the fields of application in oncological abdominal surgery where tubular biocellulose is or could be the focus of research. Furthermore, a critical assessment for the use of biocellulose materials concerning incidence malignancy and surgical interventions, complication rates, and current studies is emphasized. The regeneration of damaged bile ducts by the use of biocellulose implants is a first example.