Guangbin Zhao1, Jia Ma2, Xiaopeng Yan3, Jianhui Li4, Feng Ma3, Haohua Wang3, Yaxiong Liu5, Yi Lv6. 1. State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, 710049, Xi'an, China. Electronic address: zhaoguangbin333@163.com. 2. The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, China; National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Xi'an Jiaotong University, 710061, Xi'an, China; Department of surgical oncology, the Third Affiliated Hospital, Xi'an Jiaotong University, Shaanxi Provincial People's Hospital, 710068, Xi'an, China. Electronic address: majia1110@sina.com. 3. The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, China; National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Xi'an Jiaotong University, 710061, Xi'an, China. 4. The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, China; National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Xi'an Jiaotong University, 710061, Xi'an, China; Department of surgical oncology, the Third Affiliated Hospital, Xi'an Jiaotong University, Shaanxi Provincial People's Hospital, 710068, Xi'an, China. 5. State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, 710049, Xi'an, China. Electronic address: yaxiongliu@xjtu.edu.cn. 6. The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, China; National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Xi'an Jiaotong University, 710061, Xi'an, China. Electronic address: luyi169@126.com.
Abstract
BACKGROUND: Magnetic compression anastomosis (MCA) is a commonly used anastomosis method. MCA was widely used in tissues repair, gastroenterostomy, choledochoenterostomy, and so on. It is safer and more effective than stapler and manual surgical suturing. However, there are few detailed studies on the biomechanical characteristics and tissue transformation mechanisms of the anastomosis process. In this research, taking intestinal tissue as research object, we need to determine an optimal compressive force range to provide a biomechanical reference for the design of anastomats. METHODS: Magnets with different magnetic force groups (2.06, 3.21, 6.27, 13.3 and 19.2 N) were implanted into each dog to form intestinal tissue side-to-side anastomoses. Five dogs were euthanized on each of postoperative day 1, day 3, and day 7. Anastomoses were then harvested and compared with respect to postoperative complications, histology and tear-resistance load capacity (TRLC). RESULTS: The TRLC of anastomotic tissue formed by magnets with different magnetic forces differed markedly, but with the tissue growth, the TRLC differences between groups were decreased. Histology of anastomotic tissue showed that, in the initial stage, the anastomoses compressed by 2.06-N magnets did not form effectively, while the leakage appeared in the anastomoses compressed by 19.2-N magnets, in the rest groups, with magnetic force increasing, severity of ischemia and necrosis of compressed tissue increased and healing speed of anastomotic tissue improved. In the late stage, the influence of magnetic force for anastomotic tissue was gradually diminished. CONCLUSIONS: The magnetic force applied on the magnetic compression anastomats affects the necrosis speed of compressed tissue and the healing speed of anastomotic tissue. The optimal compressive force range for intestinal compression anastomosis is 6.27 N to 13.3 N, and the actual optimal compression pressure is 79.8 kPa - 169 kPa. LEVEL OF EVIDENCE: Magnetic compression anastomosis (MCA) is a commonly used anastomosis method. MCA was widely used in tissues repair, gastroenterostomy, choledochoenterostomy, and so on. It is safer and more effective than stapler and manual surgical suturing. However, there are few detailed studies on the biomechanical characteristics and tissue transformation mechanisms of the anastomosis process. In this research, taking intestinal tissue as research object, we need to determine an optimal compressive force range to provide a biomechanical reference for the design of anastomats.
BACKGROUND: Magnetic compression anastomosis (MCA) is a commonly used anastomosis method. MCA was widely used in tissues repair, gastroenterostomy, choledochoenterostomy, and so on. It is safer and more effective than stapler and manual surgical suturing. However, there are few detailed studies on the biomechanical characteristics and tissue transformation mechanisms of the anastomosis process. In this research, taking intestinal tissue as research object, we need to determine an optimal compressive force range to provide a biomechanical reference for the design of anastomats. METHODS: Magnets with different magnetic force groups (2.06, 3.21, 6.27, 13.3 and 19.2 N) were implanted into each dog to form intestinal tissue side-to-side anastomoses. Five dogs were euthanized on each of postoperative day 1, day 3, and day 7. Anastomoses were then harvested and compared with respect to postoperative complications, histology and tear-resistance load capacity (TRLC). RESULTS: The TRLC of anastomotic tissue formed by magnets with different magnetic forces differed markedly, but with the tissue growth, the TRLC differences between groups were decreased. Histology of anastomotic tissue showed that, in the initial stage, the anastomoses compressed by 2.06-N magnets did not form effectively, while the leakage appeared in the anastomoses compressed by 19.2-N magnets, in the rest groups, with magnetic force increasing, severity of ischemia and necrosis of compressed tissue increased and healing speed of anastomotic tissue improved. In the late stage, the influence of magnetic force for anastomotic tissue was gradually diminished. CONCLUSIONS: The magnetic force applied on the magnetic compression anastomats affects the necrosis speed of compressed tissue and the healing speed of anastomotic tissue. The optimal compressive force range for intestinal compression anastomosis is 6.27 N to 13.3 N, and the actual optimal compression pressure is 79.8 kPa - 169 kPa. LEVEL OF EVIDENCE: Magnetic compression anastomosis (MCA) is a commonly used anastomosis method. MCA was widely used in tissues repair, gastroenterostomy, choledochoenterostomy, and so on. It is safer and more effective than stapler and manual surgical suturing. However, there are few detailed studies on the biomechanical characteristics and tissue transformation mechanisms of the anastomosis process. In this research, taking intestinal tissue as research object, we need to determine an optimal compressive force range to provide a biomechanical reference for the design of anastomats.
Authors: Christen E Salyer; Jonathan Thompson; Dennis Hanseman; Tayyab Diwan; Brad M Watkins; Joshua Kuethe; Michael D Goodman Journal: Surg Endosc Date: 2021-11-12 Impact factor: 3.453