Vanishing Act: New Dissolving Stent Could End Second Surgeries for Liver Transplant Patients

BENGALURU – In a significant leap for surgical recovery, researchers at the Indian Institute of Science (IISc) have partnered with renowned transplant surgeon Dr. Sonal Asthana to develop a first-of-its-kind biodegradable biliary stent. Known as the “Asthana Stent,” the device is designed to support the bile duct during the critical healing weeks following a liver transplant before naturally dissolving in the body.

The innovation, which recently transitioned from a laboratory prototype to a commercial venture through an exclusive licensing deal, promises to eliminate the need for a second, invasive surgery to remove traditional plastic stents. For thousands of patients undergoing complex abdominal surgeries, this “Made in India” breakthrough could mean fewer complications, lower costs, and a smoother path to recovery.

The Hidden Hurdle in Liver Transplants

Liver transplantation is a life-saving miracle for those with end-stage organ failure, but the surgery’s success often hinges on a tiny, tube-like structure: the bile duct. During surgery, the donor’s bile duct is connected to the recipient’s, a process called anastomosis.

However, this site is notoriously prone to complications. Between 11% and 40% of patients experience “biliary complications,” such as leaks or narrowings (strictures) at the connection point. To prevent these, surgeons currently insert plastic or metal stents to keep the duct open while it heals.

The catch? These stents don’t stay forever.

• External stents protrude through the skin, requiring months of meticulous care and carrying a high risk of infection.

• Internal plastic stents must be removed via an endoscopic procedure (ERCP) or a second surgery roughly 4 to 6 weeks later.

“This repeat intervention not only adds to the patient’s emotional and financial burden but also carries inherent procedural risks like bleeding or perforation,” the research team noted in their summary.

Engineering a “Self-Erasing” Solution

The Asthana Stent addresses this dilemma using polydioxanone (PDS), a biodegradable polymer that has been the gold standard in absorbable surgical sutures for decades.

Developed under the leadership of Prof. Kaushik Chatterjee at IISc’s Department of Materials Engineering, the stent is a marvel of bioengineering. The team, including researchers Thaseeb Rehman and Saswat Choudhury, engineered the device to maintain its structural integrity for approximately six weeks—the precise window required for a bile duct to heal.

Key Technical Features:

• Strength: Laboratory tests confirmed the stent can withstand over 16 Newtons of pressure, far exceeding the physiological forces exerted by the human bile duct.

• Stability: The design incorporates surface ridges and “Velcro-like” hooks to ensure the stent stays in place and does not migrate—a common failure in earlier stent designs.

• Visibility: The device includes tiny radiopaque markers, allowing doctors to track its position and degradation progress using standard X-rays.

Unlike permanent metal stents used in cardiac care, which can cause chronic inflammation or “restenosis” (re-narrowing), the PDS material is fully absorbed by the body, leaving no residue behind.

Expert Perspectives: A Shift in the Standard of Care

Dr. Sonal Asthana, a lead surgeon at Aster CMI Hospital with nearly three decades of experience in multi-organ transplants, spearheaded the clinical vision for the project.

“Traditional stents solve one problem but create another—the need for removal,” the development team stated, reflecting Dr. Asthana’s observations from years of clinical practice. “Our stent disappears on its own, simplifying the entire recovery process.”

Independent experts are watching the development with cautious optimism. Dr. Praveen Kammar, a Mumbai-based gastroenterologist, notes that while traditional plastic stents can sometimes become blocked by thickened bile, biodegradable options could potentially mitigate these risks.

“If these devices prove reliable in human subjects, they could significantly reduce the incidence of post-transplant infections and the logistical nightmare of scheduling follow-up removals in overstretched hospital systems,” Dr. Kammar observed.

The Path from Lab to Bedside

The technology has already secured an Indian patent and has been licensed to Advanced Medtech Solutions Private Limited, a Gujarat-based firm. Supported by the Indian Council of Medical Research (ICMR), the stent is now moving toward the rigorous approval process required by the Central Drugs Standard Control Organisation (CDSCO).

This development mirrors a global trend toward “bioresorbable” medical tech. While dissolving stents have been used in the heart and the windpipe (trachea), the biliary system has remained a challenge due to the harsh, acidic environment of human bile. The IISc team’s success in simulating these conditions in the lab marks a major milestone.

Public Health and the Bottom Line

The implications for public health are substantial. India performs over 2,000 liver transplants annually, a number that continues to grow.

1. Cost Reduction: Eliminating a second surgery could save patients and healthcare providers thousands of rupees per case.

2. Resource Management: Freeing up endoscopy suites and operating rooms from “routine” stent removals allows hospitals to treat more critical patients.

3. Patient Safety: Every invasive procedure carries a risk of hospital-acquired infection. By reducing the number of procedures from two to one, the cumulative risk to the patient drops significantly.

Limitations and Future Outlook

Despite the excitement, the Asthana Stent is not yet available in operating rooms. It remains in the pre-clinical phase, meaning it has yet to undergo large-scale human clinical trials.

Critics and analysts point out that “real-world” bile flow can vary significantly between patients, which might affect how quickly the polymer degrades. There is also the question of whether the breakdown products of the PDS material could cause localized irritation in a small subset of patients, though its long history in stitches suggests a high safety profile.

“Lab strength is encouraging, but clinical trials will reveal the real-world performance,” noted one medtech analyst. “We need to see how it handles the complex chemistry of a healing liver over several months.”

What This Means for You

For patients currently scheduled for liver or biliary surgery, the Asthana Stent represents the future rather than the immediate present. However, its development highlights the importance of discussing stent management with your surgical team.

If you or a loved one is undergoing a transplant, ask your surgeon:

• What type of stent will be used?

• Will a second procedure be required for its removal?

• What are the signs of stent-related complications, such as jaundice or fever?

As India’s medtech sector continues to innovate, the goal of “one-and-done” surgery is moving closer to reality, promising a future where the only thing a patient has to focus on is their new lease on life.

Reference Section

Study & Technical Citations:

• IISc Research Team: Rehman, T., Choudhury, S., & Chatterjee, K. (2025-2026). Development of a Biodegradable Polydioxanone Biliary Stent for Liver Transplantation. Indian Institute of Science, Department of Materials Engineering.

Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.