Magnetic compression anastomosis for reconstruction of digestive tract after total gastrectomy in beagle model

Figure 1 Magnets. A: Esophagojejunal magnetic anastomosis ring; B: Jejunojejunal magnetic anastomosis ring.

Figure 2 Schematic diagram of the surgical procedure. A: Schematic diagram of total gastrectomy; B: Digestive tract is reconstructed in the control group; C: Parent and daughter magnetic rings for end-to-side jejunal anastomosis are placed; D: Jejunojejunal end-to-side magnetic anastomosis is established; E: Parent and daughter magnetic rings for esophagojejunal end-to-end anastomosis are placed; F: Esophagojejunal end-to-end magnetic anastomosis is established; G: Jejunojejunal end-to-side anastomosis is established, and the magnet is detached from the anastomosis; H: Esophagojejunal end-to-end anastomosis is established, and the magnet is detached from the anastomosis. a': The esophageal stump; b': The proximal jejunal stump; c': The distal jejunal stump; d': The distal jejunum; EJ-MAR: Esophagojejunal magnetic anastomosis ring; JJ-MAR: Jejunojejunal magnetic anastomosis ring.

Figure 3 Surgical procedure. A: Insert the parent ring of jejunojejunal magnetic anastomosis ring (JJ-MAR); B: Parent and daughter ring of JJ-MAR attract each other; C: Insert the parent of esophagojejunal magnetic anastomosis ring (EJ-MAR); D: Parent and daughter ring of EJ-MAR attract each other; E: Jejunojejunal anastomosis is performed end-to-side with manual sutures; F: Esophagojejunal anastomosis is performed with an end-to-end manual suture; EJ-MAR: Esophagojejunal magnetic anastomosis ring; JJ-MAR: Jejunojejunal magnetic anastomosis ring.

Figure 4 Esophagojejunal magnetic anastomosis ring and jejunojejunal magnetic anastomosis ring are monitored by X-ray. A: Instant X-ray showed all anastomats coupled well and retained at the right place; B: Position and state of the esophagojejunal magnetic anastomosis ring; C: Position and state of the jejunojejunal magnetic anastomosis ring. EJ-MAR: Esophagojejunal magnetic anastomosis ring; JJ-MAR: Jejunojejunal magnetic anastomosis ring.

Figure 5 Gross specimens of anastomosis in the study group. A: Serosal surface of esophagojejunal anastomosis; B: Serosal surface of jejunojejunal anastomosis; C: Mucosal surface of esophagojejunal anastomosis; D: Mucosal surface of jejunojejunal anastomosis.

Figure 6 Gross specimens of anastomosis in the control group. A: Serosal surface of esophagojejunal anastomosis; B: Serosal surface of jejunojejunal anastomosis; C: Mucosal surface of esophagojejunal anastomosis. D: Mucosal surface of jejunojejunal anastomosis.

Figure 7 Histological specimens of anastomosis. A and B: Esophagojejunal anastomosis in the study group; C and D: Jejunojejunal anastomosis in the study group; E and F: Esophagojejunal anastomosis in the control group; G and H: Jejunojejunal anastomosis in the control group. HE: Hematoxylin & eosin.