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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Novel deformable self-assembled magnetic anastomosis ring for endoscopic treatment of colonic stenosis via natural orifice
Miao-Miao Zhang, Guang-Bin Zhao, Han-Zhi Zhang, Shu-Qin Xu, Ai-Hua Shi, Jian-Qi Mao, Jing-Ci Gai, Yu-Han Zhang, Jia Ma, Yun Li, Yi Lyu, Xiao-Peng Yan
Miao-Miao Zhang, Shu-Qin Xu, Yun Li, Yi Lyu, Xiao-Peng Yan, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
Miao-Miao Zhang, Shu-Qin Xu, Ai-Hua Shi, Yi Lyu, Xiao-Peng Yan, 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
Guang-Bin Zhao, State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an 710054, Shaanxi Province, China
Han-Zhi Zhang, Jing-Ci Gai, Yu-Han Zhang, Qide College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
Jian-Qi Mao, Zonglian College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
Jia Ma, Department of Surgical Oncology, Shaanxi Provincial People's Hospital, Xi'an 710068, Shaanxi Province, China
Author contributions: Lyu Y and Yan XP designed and coordinated the study; Zhang MM, Zhao GB, Zhang HZ, Xu SQ, Mao JQ, Zhang YH, Ma J, Li Y, Yan XP performed the research and acquired the data; Zhang MM, Zhao GB, Zhang HZ analyzed the data; Shi AH, Zhao GB, Zhang MM tested and analyzed the magnetic test; Zhang MM, Zhao GB, and Yan XP wrote the manuscript; Yan XP and Lyu Y conceived of the study and contributed to the study design, the interpretation of the results, and the critical revision of the manuscript; all authors read and approved the final manuscript.
Supported by the Institutional Foundation of The First Affiliated Hospital of Xi’an Jiaotong University, No. 2022MS-07; the Key Research & Development Program-Social Development of Shaanxi Province of China, No. 2023-YBSF-247.
Institutional review board statement: The experimental protocol was approved by the Committee for Ethics of Animal Experiments of Xi’an Jiaotong University (No. 2022-1451).
Institutional animal care and use committee statement: The study protocol and all experimental procedures were carried out strictly in accordance with the Guidelines for Care and Use of Experimental Animals issued by the Xi’an Jiaotong University Medical Center. This experimental study was approved by the Experimental Ethics Committee of Xi’an Jiaotong University (No. 2022-1451).
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The authors declare that the data supporting the findings of this study are available within the article or from the corresponding authors upon request.
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:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Xiao-Peng Yan, MD, PhD, Associate Research Scientist, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 West Yanta Road, Xi'an 710061, Shaanxi Province, China.
yanxiaopeng9966@163.com
Received: June 14, 2023
Peer-review started: June 14, 2023
First decision: August 5, 2023
Revised: August 7, 2023
Accepted: August 15, 2023
Article in press: August 15, 2023
Published online: September 7, 2023
Processing time: 78 Days and 17.8 Hours
BACKGROUND
Although endoscope-assisted magnetic compression anastomosis has already been reported for colonic anastomosis, there is no report on a single-approach operation using the natural orifice.
AIM
To design a deformable self-assembled magnetic anastomosis ring (DSAMAR) for colonic anastomosis for use in single-approach operation and evaluate its feasibility and safety through animal experiments.
METHODS
The animal model for colonic stenosis was prepared by partial colonic ligation in eight beagles. The magnetic compression anastomosis of their colonic stricture was performed by endoscopically assisted transanal implantation of the DSAMAR. The anastomotic specimen, obtained 2 wk after the operation, was observed by both the naked eye and a light microscope.
RESULTS
The DSAMAR was successfully inserted into the proximal end of colon stenosis through the anus. The DSAMAR of seven dogs was successfully transformed into rings, while that of the remaining dog was removed after the first deformation failed. The rings were successfully retransformed after optimization. All animals underwent colonic anastomosis using the DSAMAR. No device-related or procedure-related adverse events were observed. The colostomy specimens of the experimental dogs were obtained 2 wk after the operation. Both gross and histological observations showed good anastomotic healing.
CONCLUSION
The DSAMAR is a safe and feasible option for the treatment of colon stenosis. Its specific deformation and self-assembly capability maximize the applicability of the minimally invasive treatment.
Core Tip: By combining magnetic compression anastomosis with endoscopic technology, we could design a deformable self-assembled magnetic anastomosis ring (DSAMAR) to perform magnetic compression anastomosis with only a single channel. We then verified the feasibility of magnetic compression anastomosis for the recanalization of colonic stenosis through animal experiments. The results showed that minimally invasive treatment of colonic stenosis can be achieved using the DSAMAR.
