Magnamosis III: delivery of a magnetic compression anastomosis device using minimally invasive endoscopic techniques

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• 作者：Kelly D. Gonzales^a ; ¹ ; Geoffrey Douglas^b ; ¹ ; Kullada O. Pichakron^b ; Dillon A. Kwiat^a ; Salvador Guevara Gallardo^a ; Jose Luis Encinas^a ; Shinjiro Hirose^a ; Michael R. Harrison^a ; ^{michael.harrison@ucsfmedctr.org}
• 关键词：Anastomosis ; Intestinal surgery ; Magnamosis ; Minimally invasive ; Devices
• 刊名：Journal of Pediatric Surgery
• 出版年：2012
• 期刊代码：190_00223468
• 类别：med
• 出版时间：June, 2012
• 卷：47
• 期：6
• 页码：1291-1295
• 文件大小：534 K

摘要

Purpose

Magnamosis creates a secure sutureless anastomosis through magnetic compression. In this study, we further develop and test delivery devices capable of creating a secure duodeno-colonic anastomosis using available minimally invasive endoscopic techniques.

Methods

Eight pigs underwent general anesthesia. Colonoscopy was used to deliver 1 magnetic ring to the hepatic flexure. Simultaneously, upper endoscopy delivered the other magnetic ring into the duodenum using a variety of techniques. The 2 magnetic rings were brought into magnetic proximity under laparoscopic guidance. The pigs were recovered and examined daily followed by sacrificing at 1, 2, 4, and 6 weeks.

Results

The device designed to deliver and release each magnetic ring evolved from using a guide wire and balloon devices to redesigning the magnetic ring casing with a groove to accommodate an endoscopic snare. Laparoscopic visualization assured safe magnet mating of intestinal segments. The duodeno-colonic anastomoses created with the snare yielded widely patent anastomoses. In vitro testing revealed excellent burst pressure. Histology revealed complete healing as early as 1 week.

Conclusion

We redesigned the magnamosis device to facilitate delivery by endoscopic techniques. The snare technique allows endoscopic positioning and controlled release of the magnetic rings for a secure side-to-side duodeno-colonic anastomosis.