Low-cost, Non-electronic Enzyme Responsive Macromolecular Sensor for the Early Detection of Anastomotic Leaks

Project descpription:

Anastomotic leak (AL) is one of the most serious and life-threatening complications following gastrointestinal surgery, contributing to prolonged hospital stays, reoperations, and mortality rates exceeding 20%. Early diagnosis is critical to improving patient outcomes, yet current detection strategies—based on periodic monitoring of vital signs, inflammatory markers, and imaging—often delay intervention due to their limited specificity and sensitivity. This project addresses this urgent clinical need through the clinical validation and refinement of a novel, enzyme-responsive sensor developed by the research team at Empa/ETH/UZH. The
sensor provides a simple, naked-eye color change in response to elevated levels of digestive enzymes in surgical drain fluid—a biochemical hallmark of early AL. The technology enables real-time, bedside monitoring without the need for electronics, specialized equipment, or laboratory infrastructure. With production costs below 1 CHF per unit, it offers a scalable and affordable solution that could be readily adopted in both high-resource and low-resource settings. Following promising in vitro performance and a small-scale pilot study using collected drain fluids (achieving 100% predictive accuracy in 32 clinical samples), the sensor will now be tested observationally in a larger, prospective cohort at Kantonsspital Baden (KSB). The study will be conducted in close collaboration between the Empa engineering team and KSB’s surgical department. This hospital–research partnership enables continuous feedback loops: structured input from clinicians will inform iterative improvements to the sensor’s sensitivity, usability, and integration into existing surgical workflows, while researchers will rapidly adapt and refine the design based on real-world experience. The project benefits from an integrated clinic–lab collaboration to drive translational impact. It not only offers a great opportunity for Dr. Kalt for surgically relevant research, it also accelerates the development of a clinically viable diagnostic tool and lays the groundwork for broader adoption. Expected outcomes include a validated sensor ready for scale-up, and a strengthened foundation for follow-on multi-center trials. Ultimately, this initiative aims to improve patient outcomes, reduce healthcare costs, and demonstrate a successful model for hospital–research cooperation—delivering equitable, high-impact innovation from bench to bedside.

About Fabian Kalt:

Dr. med. Fabian Kalt is Chief Resident at Kantonsspital Baden since 2025. He previously worked at Spital Muri as well as the University Hospital in Zürich. Dr. Fabian Kalt is a surgical resident with a strong academic and clinical background in
visceral and transplant surgery. He has actively contributed to several peer-reviewed publications across a broad spectrum of surgical disciplines, including thoracic, colorectal, and head and neck surgery. His scholarly work spans clinical research, systematic reviews, and outcome analyses, reflecting a solid commitment to evidence-based surgical practice.