Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China; National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
J Surg Res. 2020 Jan;245:249-256. doi: 10.1016/j.jss.2019.07.078. Epub 2019 Aug 14.
Technical improvement of gastrojejunostomy is critical in bariatric and metabolic surgery. In this study, a novel magnetic compression approach for gastrojejunostomy was evaluated.
Both cylindrical and rectangular magnets were used in rabbits, and the magnets were named according to their location. All the magnets were perorally introduced into the stomach. The position of the jejunal magnet was controlled by a connecting line. When the jejunal magnet spontaneously entered the jejunum, the gastric magnet was introduced into the stomach. An extracorporeal magnet was used to guide these two magnets together, and the magnet pair was left to create a side-to-side anastomosis. The state of the animals and extrusion time of the magnets were observed. The anastomoses were evaluated by burst pressure and histology.
Gastrojejunostomy was successfully established in all animals. Cylindrical and rectangular magnets spontaneously entered the jejunum through the pylorus within 2.4 ± 0.5 and 6.0 ± 0.8 d, respectively (P < 0.01). The cylindrical and rectangular magnet pairs fell off within 15.3 ± 0.8 and 11.9 ± 1.1 d, respectively (P < 0.01). The burst pressures were statistically similar between the two types of magnets (P > 0.05). Histological examination showed sealed anastomoses with mild inflammation of the mucosa and fibrosis within the submucosa.
The feasibility and efficacy of establishing gastrojejunostomy by guidewire introduction of magnets, which were guided together with an extracorporeal magnet, were confirmed in rabbits. In humans, with the clinical use of this procedure, surgery would be greatly simplified.
胃空肠吻合术的技术改进在减重和代谢手术中至关重要。在本研究中，评估了一种用于胃空肠吻合术的新型磁压缩方法。
在兔子中使用了圆柱形和矩形磁铁，并根据其位置对磁铁进行了命名。所有磁铁均经口进入胃中。通过连接线控制空肠磁体的位置。当空肠磁体自动进入空肠时，将胃磁体引入胃中。使用体外磁体引导这两个磁体一起移动，然后将磁体对留作侧向吻合。观察动物的状态和磁体的挤出时间。通过爆裂压力和组织学评估吻合口。
所有动物均成功建立了胃空肠吻合术。圆柱形和矩形磁铁分别在 2.4±0.5 和 6.0±0.8 天内自发通过幽门进入空肠（P<0.01）。圆柱形和矩形磁体对分别在 15.3±0.8 和 11.9±1.1 天内自行脱落（P<0.01）。两种类型的磁铁的爆裂压力在统计学上无显著差异（P>0.05）。组织学检查显示吻合口密封良好，黏膜轻度炎症，黏膜下层纤维化。
在兔子中，通过引导线引入磁体并使用体外磁体引导建立胃空肠吻合术的可行性和有效性得到了证实。在人类中，随着该程序的临床应用，手术将大大简化。
