| Magnamosis: magnetic compression anastomosis with comparison to suture and staple techniques. | |
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MedLine Citation:
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PMID: 19159747 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: An ideal anastomosis between hollow viscera should be easily performed, strong, and operator independent. We hypothesized that transluminal attraction between magnets in the intestine could be harnessed to create an intestinal compression anastomosis (magnamosis) with these characteristics. We further hypothesized that variation of attraction force and geometry of compression would affect the quality of the intestinal anastomosis. METHODS: We designed a self-orienting device composed of 2 neodymium-iron-boron magnets affixed to polytetrafluoroethylene moldings. Two topologies were evaluated: one designed with 'uniform' compression and the other with 'gradient' compression. Sixteen young adult pigs (Sus scrofa) underwent laparotomy with creation of a magnetic side-to-side anastomosis: 8 with the uniform device and 8 with the gradient device. Each also had a stapled anastomosis, and 5 had an additional hand-sutured anastomosis. Animals were euthanized at 1, 2, and 3 weeks after operation, then anastomoses were compared on the basis of gross appearance, histology, functional radiography, and mechanical integrity. RESULTS: All magnetic devices formed patent anastomoses without leak. One stapled anastomosis resulted in a contained leak. Mechanical integrity of magnetic anastomoses was not statistically significantly different from staple or suture counterparts, and there was a trend toward greater strength with magnetic anastomoses. Comparison between device types revealed the gradient device trended toward greater strength and earlier patency (67% vs 33% at 1 week). There was no evidence of stenosis, and histologic examination demonstrated tissue remodeling with mucosal and serosal apposition across the magnamoses. CONCLUSIONS: The magnetic compression anastomosis (magnamosis) device is a safe and effective means of sutureless full-thickness intestinal anastomosis with serosal apposition in a pig model. Gradient compression is superior to uniform compression. This technique is compatible with endoscopic and natural orifice approaches. |
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Authors:
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Ramin Jamshidi; Jacob T Stephenson; Jared G Clay; Kullada O Pichakron; Michael R Harrison |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of pediatric surgery Volume: 44 ISSN: 1531-5037 ISO Abbreviation: J. Pediatr. Surg. Publication Date: 2009 Jan |
Date Detail:
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Created Date: 2009-01-22 Completed Date: 2009-05-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0052631 Medline TA: J Pediatr Surg Country: United States |
Other Details:
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Languages: eng Pagination: 222-8 Citation Subset: IM |
Affiliation:
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Department of Surgery, University of California San Francisco, CA 94143-0570, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anastomosis, Surgical
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instrumentation*,
methods* Animals Equipment Design Intestines / surgery* Magnetics* Surgical Stapling Suture Techniques Swine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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