1. Magnetic compression anastomosis gastrojejunostomy: feasibility and efficacy of a novel device in a swine model.
- Author
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Gagner M, Krinke T, Lapointe-Gagner M, and Buchwald JN
- Subjects
- Animals, Swine, Magnets, Anastomosis, Surgical instrumentation, Anastomosis, Surgical methods, Wound Healing physiology, Laparoscopy methods, Laparoscopy instrumentation, Female, Models, Animal, Magnetics instrumentation, Gastric Bypass methods, Gastric Bypass instrumentation, Feasibility Studies
- Abstract
Background: Means of addressing technical challenges in forming gastrojejunostomy (GJ) anastomoses and maintaining their patency are sought., Objectives: Evaluation of preclinical feasibility and healing efficacy of a novel linear magnetic compression anastomosis (MCA) device to form a patent GJ versus sutured jejunal enterotomy (JE) sites in swine., Setting: Single-center veterinary testing facility., Methods: Feasibility of 3 prototype sizes (4, 6, and 8 cm) of a metal MCA device (MCAD) to form a patent GJ was evaluated over 6 weeks. A distal magnet was laparoscopically inserted in the jejunum, a proximal magnet was placed gastroscopically in the stomach; magnets were aligned to gradually form an anastomosis, self-detached, and be expelled. At necropsy, MCAs were assessed for patency and compared with JE tissues to evaluate wound healing., Results: MCADs aligned at the GJ location without complications. In 5/6 MCAD pairs, dislodgement occurred between 7 and 26 days; expulsion 13-31 days; 1 MCAD pair was retained in the stomach. At necropsy, all pigs were healthy, gaining a mean 15.0 kg. Anastomoses were not adequately patent in 2/4 pigs receiving the 4-cm or 6-cm MCADs because their linear length was too small. But, anastomoses of both pigs receiving the 8-cm MCADs maintained full patency. Minimal inflammation and fibrosis were seen in MCA specimens versus sutured enterotomies., Conclusions: A novel linear MCA device was feasible and effectively created a patent GJ anastomosis in swine with minimal inflammation and fibrosis. The MCAD may be appropriate for clinical evaluation., (Copyright © 2024 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)
- Published
- 2024
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