Basic Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 14, 2020; 26(42): 6614-6625
Published online Nov 14, 2020. doi: 10.3748/wjg.v26.i42.6614
Fedora-type magnetic compression anastomosis device for intestinal anastomosis
Huan Chen, Tao Ma, Yue Wang, Hao-Yang Zhu, Zhe Feng, Rong-Qian Wu, Yi Lv, Ding-Hui Dong
Huan Chen, Tao Ma, Yue Wang, Hao-Yang Zhu, Zhe Feng, Rong-Qian Wu, Yi Lv, Ding-Hui Dong, National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Huan Chen, Tao Ma, Yue Wang, Zhe Feng, Rong-Qian Wu, Yi Lv, Ding-Hui Dong, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Author contributions: All authors helped to perform the research; Dong DH and Lv Y conceived and designed the experiments; Chen H and Dong DH contributed to performing the animal experiment; Chen H, Feng Z, and Wang Y collected and analyzed the data; Chen H, Zhu HY, Ma T, and Wu RQ contributed to manuscript writing; Dong DH and Lv Y contributed to critical revision of the manuscript; all authors read and approved the final manuscript.
Supported by the National Natural Science Foundation of China (to Lv Y), No. 81470896.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Xi'an Jiaotong University (Permit Number: XJTU1AF2015LSL-046).
Institutional animal care and use committee statement: All experimental protocols were approved by the Committee on the Ethics of Animal Experiments of Xi'an Jiaotong University (Permit Number: XJTULAC2020-1281).
Conflict-of-interest statement: All authors declare no conflicts of interest related to this article.
Data sharing statement: No additional data are available.
ARRIVE guidelines statement: The authors have read the ARRIVE guidelines, and the manuscript was prepared and revised according to the ARRIVE guidelines.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ding-Hui Dong, MD, PhD, Surgeon, Teacher, National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, No. 76 West Yanta Road, Xi’an 710061, Shaanxi Province, China. dongdinghui0510@163.com
Received: August 12, 2020
Peer-review started: August 12, 2020
First decision: August 22, 2020
Revised: August 29, 2020
Accepted: September 10, 2020
Article in press: September 10, 2020
Published online: November 14, 2020
Processing time: 92 Days and 20.3 Hours
Abstract
BACKGROUND

Although previous studies have confirmed the feasibility of magnetic compression anastomosis (MCA), there is still a risk of long-term anastomotic stenosis. For traditional MCA devices, a large device is associated with great pressure, and eventually increased leakage.

AIM

To develop a novel MCA device to simultaneously meet the requirements of pressure and size.

METHODS

Traditional nummular MCA devices of all possible sizes were used to conduct ileac anastomosis in rats. The mean (± SD) circumference of the ileum was 13.34 ± 0.12 mm. Based on short- and long-term follow-up results, we determined the appropriate pressure range and minimum size. Thereafter, we introduced a novel “fedora-type” MCA device, which entailed the use of a nummular magnet with a larger sheet metal.

RESULTS

With traditional MCA devices, the anastomoses experienced stenosis and even closure during the long-term follow-up when the anastomat was smaller than Φ5 mm. However, the risk of leakage increased when it was larger than Φ4 mm. On comparison of the different designs, it was found that the “fedora-type” MCA device should be composed of a Φ4-mm nummular magnet with a Φ6-mm sheet metal.

CONCLUSION

The diameter of the MCA device should be greater than 120% of the enteric diameter. The novel “fedora-type” MCA device controls the pressure and optimizes the size.

Keywords: Magnetic compression anastomosis; Anastomotic stenosis; Size of anastomat; Compression pressure; Fedora-type magnetic compression anastomosis device

Core Tip: To address some of the deficiencies in the current magnetic compression anastomosis (MCA) model, we explored the optimal size and pressure of the MCA device for intestinal anastomosis in rats. We found that the suggested diameter of the MCA device should be larger than 120% of the enteric diameter to avoid stenosis. Further, we developed a novel “fedora-type” MCA device for the current model, using a Φ4-mm nummular magnet with a Φ6-mm sheet metal. This model safely formed anastomosis and ensured long-term anastomosis. This novel anastomat controlled pressure and optimized the size, thus meeting our stipulated requirements.