Using external magnet guidance and endoscopically placed magnets to create suture-free gastro-enteral anastomoses
ABSTRACT To facilitate endolumenal and natural orifice procedures, this study evaluated a novel technique using external and endoscopically placed magnets to create suture-free gastroenteral anastomoses.
Seven anesthetized adult swine underwent endoscopic placement of magnets into the small bowel and stomach. Using external magnets, the endoscopically placed internal magnets were brought into opposition under endoscopic view. After 1-2 weeks, the pigs were killed and analyzed. At laparotomy and under sterile conditions, peritoneal cultures were obtained. The anastomoses were evaluated endoscopically and tested using an air insufflation test. Finally, the anastomoses were resected and evaluated microscopically.
The average operative time for endoscopic placement of the magnets was 34.3 +/- 14.8 min. Successful placement and creation of anastomoses occurred in six of the pigs. One pig did not form an anastomosis because the magnets were too large to pass through the pylorus at the time of attempted magnet placement. Six swine experienced uncomplicated postoperative courses. One pig's postoperative course involved constipation for several days, requiring additional fluids and fiber supplementation. The findings at endoscopy showed that the magnets were adhered to the anastomosis, which were easily freed, or within the stomach. The air insufflation test results were negative for all the pigs. At laparotomy, there was no evidence of infection, abscess, or leak, but two peritoneal culture results were positive with scant growth of Staphylococcus aureus and coagulase-negative staphylococcus, presumably contaminants. Microscopically, the anastomoses illustrated granulation and fibrous connective tissue without evidence of infection or leak.
Endoscopically placed magnets with external magnet guidance is a feasible and novel approach to creating patent gastroenteral anastomoses without abdominal incisions or sutures.
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ABSTRACT: Magnetic compression anastomoses (magnamosis) have been previously described for gastrointestinal, biliary, urinary, and vascular anastomoses. Objectives. Herein, the authors report the creation of a magnetic compression colostomy (magnacolostomy) using a simple technique in rats. Animals were randomized into two groups (n = 8, each): a magnetic colostomy (MC) group and a control surgical tube colostomy (SC) group. In the MC group, the first magnetic ball (3 mm) was rectally introduced into the rat colon. The second magnetic ball (4 mm) was placed subcutaneously into the left quadrant, and the two magnetic balls strongly coupled. On postoperative day 20 for the MC group and postoperative day 10 in the SC group, the rats were sacrificed and the colostomies evaluated macroscopically, histopathologically, and for mechanical burst testing. From the macroscopic evaluation, two rats failed to form the colostomy canal due to colostomy catheter and magnetic ball removal. In the remaining rats, evidence of complications were not observed. Two rats in the MC group displayed mild adhesion and all rats in the SC group displayed moderate adhesion. No significant differences between the burst pressures were observed. However, a significant difference (p < 0.001) between the procedure times of the MC (4.13 +/- 1.00 minutes) and SC groups (14.25 +/- 2.05 minutes) was evident. Magnacolostomy is an easy and effective procedure in the rat model and presents a safe, minimally invasive alternative to current tube colostomy procedures such as antegrade continence enemas, percutaneous endoscopic, and colostomy/cecostomy in humans.21(3):301-5.
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ABSTRACT: Objective To assese the healing of stoma after magnetic anastomosis for the reconstruction of biliary-enteric continuity under severe inflammation. Methods Acute bile duct injury was constructed as a bile peritonitis model in mongrel dogs (n=32). Magnetic anastomosis (group A, n=16) and traditional suture anastomosis (group B, n=16) were performed to reconstruct the biliary-enteric continuity in one stage. Half of the dogs in each group were euthanized on the 30th postoperative day, and the other half on the 90th postoperative day to harvest the stoma region. The healing conditions of the stoma after the 2 anastomotic approaches were observed with naked eyes, under light microscope and scanning electron microscope. Results The stoma leakage rate (50% versus 0% on the 30th postoperative day, 37.5% versus 12.5% on the 90th postoperative day, both P<0.05) and stenosis degree (13.9%±0.3% versus 7.1%±0.3% on the 30th postoperative day, 17.2%±0.4% versus 9.4%±0.4% on the 90th postoperative day, both P<0.01) were significantly higher in group B than in group A. Compared with traditional manual anastomoses, the histological analysis under light and electron microscope showed a more continuous stoma with more regular epithelium proliferation and collagen arrangement, less inflammation in group A. Conclusions Magnetic anastomosis stent ensures better healing of the stoma even under the circumstance of severe inflammation.Chinese Medical Sciences Journal 06/2014; 29(2):91–97. DOI:10.1016/S1001-9294(14)60034-1
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ABSTRACT: Potato virus Y (PVY) is a virus of economic importance worldwide with a wide host range. The virus displays a diversity of strains at a biological, serological and molecular level. The aim of this study was to identify the different strains of PVY infecting pepper (Capsicum annuum L.), potato (Solanum tuberosum L.) and tomato (Lycopersicon esculentum Mill.) in the province of KwaZulu-Natal (KZN) in the Republic of South Africa (RSA). Plant material showing PVY-like symptoms were sampled from small-scale and commercial farms. PVY isolates were detected using double-antibody sandwich enzyme-linked immunosorbent assay (DAS ELISA) and reverse transcription-polymerase chain reaction (RT-PCR). All PVY infected samples were further tested with strain-specific antibodies and primers. PVYO was the only strain found in all the tomato and pepper infected samples; while a diversity of strains comprising PVYN, PVYNTN and PVYNWilga, with mixed infections in some cases, was found in the potato infected samples. These results confirm the diversity of PVY in KZN as is the case wherever the virus occurs around the world.Crop Protection 11/2011; 30(11):1404-1408. DOI:10.1016/j.cropro.2011.07.006 · 1.54 Impact Factor