Diana Michele, Wall James, Perretta Silvana, Dallemagne Bernard, Gonzales Kelly D, Harrison Michael R, Agnus Vincent, Soler Luc, Nicolau Stephan, Marescaux Jacques
IRCAD/EITS, Hôpitaux Universitaires, Strasbourg, France.
Surg Innov. 2011 Dec;18(4):317-20. doi: 10.1177/1553350611409761. Epub 2011 Jul 7.
This study aimed to assess the feasibility of a totally endoscopic enteral bypass using a self-orienting, dual ring, magnetic anastomosis system (MAGNAMOSIS) guided by a magnetic tracking system (3D METRIS).
In an anesthetized pig, 2 endoscopes were advanced, one each into the stomach and the colon. Both endoscopes were equipped with a MAGNAMOSIS ring secured with an endoscopic snare and a 3D METRIS within one working channel. The whole procedure was followed laparoscopically. The tracking system guided tips of endoscopes to a "rendez-vous" location between the colon and stomach.
MAGNAMOSIS magnets automatically joined in the correct configuration when guided to within 2 cm of each other. At necropsy, magnetic rings were secure without entrapment of excess bowel or mesentery.
An endoscopic enteral bypass with magnetic anastomosis and magnetic tracking device was feasible. More accurate tracking and advanced techniques could enable endoscopic bypasses at multiple sites in the gastrointestinal tract.
本研究旨在评估在磁跟踪系统(3D METRIS)引导下,使用自定向双环磁性吻合系统(MAGNAMOSIS)进行完全内镜下肠内旁路手术的可行性。
在一只麻醉的猪身上,插入2根内镜,一根进入胃,另一根进入结肠。两根内镜的一个工作通道内均装有通过内镜圈套固定的MAGNAMOSIS环和一个3D METRIS。整个操作过程通过腹腔镜进行监测。跟踪系统将内镜尖端引导至结肠和胃之间的“会合”位置。
当MAGNAMOSIS磁体被引导至彼此相距2厘米以内时,它们会自动以正确的构型连接在一起。尸检时,磁性环固定良好,没有夹住过多的肠管或肠系膜。
采用磁性吻合和磁跟踪装置进行内镜下肠内旁路手术是可行的。更精确的跟踪和先进技术可实现胃肠道多个部位的内镜旁路手术。