An experimental study on long term outcomes after magnetic esophageal compression anastomosis in piglets

Sterlin, Alexander; Mahler, Sara; Lindner, Andreas; Dickmann, Jana; Heimann, Axel; Sahlabadi, Mohammad; Aribindi, Vamsi; Harrison, Michael R.; Muensterer, Oliver J.

doi:10.1016/j.jpedsurg.2021.09.032

Cited by 16 publications

(6 citation statements)

References 21 publications

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“…Our research has focused on magnet size and geometry, with the aim of optimizing the devices to create a robust anastomosis and reduce post-interventional stricture rates [ 14 , 15 , 16 ]. The newly designed magnets were validated in an experimental animal model, which demonstrated highly favorable short- and long-term outcomes [ 14 , 16 ]. Furthermore, the first in-human experience was published in 2021 with promising results [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Esophageal Magnetic Compression Anastomosis in Esophageal Atresia Repair: A PRISMA-Compliant Systematic Review and Comparison with a Novel Approach

Harrison¹,

König

Chen

et al. 2022

Children

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The use of magnet compression to endoscopically create an esophageal anastomosis is an intriguing approach to esophageal atresia repair, but published cases with an existing available device have demonstrated mixed success. One major shortcoming has been the formation of subsequent severe, recalcitrant strictures after primary repair. To address the limitations of the existing device, we recently introduced and reported success with specially designed bi-radial magnets that exhibit a novel geometry and unique tissue compression profile. The aim of this study is to compare the outcomes using our novel device (novel group, NG) with those of previous reports which utilized the historical device (historic group, HG) in a PRISMA-compliant systematic review. Seven studies were eligible for further analysis. Additionally, one of our previously unreported cases was included in the analysis. Esophageal pouch approximation prior to primary repair was performed more frequently in the NG than in the HG (100% NG vs. 21% HG; p = 0.003). There was no difference in the overall postoperative appearance of postoperative stricture (95% HG vs. 100% NG; p = 0.64). The number of postoperative dilatations trended lower in the NG (mean 4.25 NG vs. 9.5 HG; p = 0.051). In summary, magnetic compression anastomosis adds a new promising treatment option for patients with complex esophageal atresia. Prior approximation of pouches and a novel magnet design have the potential to lower the rate of stricture formation.

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Section: Introductionmentioning

confidence: 99%

Esophageal Magnetic Compression Anastomosis in Esophageal Atresia Repair: A PRISMA-Compliant Systematic Review and Comparison with a Novel Approach

Harrison¹,

König

Chen

et al. 2022

Children

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“…Recently, other groups have been reviving MCA for use in various pediatric surgical indications [ 13 ], including esophageal atresia repair [ 11 , 12 , 27 ], rectal atresia [ 9 ], duodenal stenosis [ 10 ], vascular anastomosis [ 28 ], and for re-cannulation of the hypopharynx [ 29 ]. Several experimental studies have been conducted in swine [ 30 , 31 ], rabbits, and dogs [ 32 ]. The studies confirm the above findings from decades ago and also seem to suggest that magnets can be used for creating the anastomosis, but that simultaneous approximation of pouches or structures under tension will lead to increased rates of anastomotic stricture [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Magnetic Compression Anastomosis–Past Experience and Current Proposals for Further Development in Pediatric Minimally Invasive Surgery

Kotlovsky,

Muensterer,

Nikolaev

et al. 2023

Children

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Originating in the 1970s, magnetic compression anastomosis (MCA) has lately been revisited with a focus on minimal invasive surgery (MIS). The aim of this report is to reappraise our earlier experience with MCA with the intention of facilitating future MCA advancement. A retrospective review was conducted regarding preclinical experiments and clinical trials at a single institution from 1980 to 1995. The reviewed information was compiled and appraised to generate proposals for future MCA use. The experimental studies, including 250 MCA cases in gastrointestinal and urinary tract animal models, demonstrated the technical versatility of MCA as well as the superior biomechanical characteristics in comparison to hand-sewn anastomoses. Clinical trials encompassed 87 MCA procedures in 86 children, 2 to 10 years of age, involving the following techniques: non-operative esophageal recanalization (n = 15), non-operative ileostomy undiversion (n = 46), Swenson pull-through (n = 10), non-operative urethral recanalization (n = 5), and extravesical ureterocystoneostomy (n = 11). Clinical MCA was found to be successful in over 87% of cases. MCA limitations concerning anastomotic failure and scarring were thought to be mostly due to inadequate magnetic compression. Based on our historic experience, we propose further research on the technical aspects of MCA, along with the biological aspects of anastomotic tissue remodeling. Magnets should be designed and manufactured for a wide spectrum of pediatric surgical indications, particularly in combination with novel MIS techniques.

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“…Thus, the MCA devices currently used for EA repair utilize paired magnets that are placed into apposing pouches—one via the mouth and one via the stomach—and mated to create a completely endoscopic anastomosis. While the widespread adoption of this technique has been limited by early experience, observing the prohibitive rates of anastomotic strictures [ 54 ], newer devices with wider mating surfaces and unique mating geometries aim to solve this problem [ 53 , 55 , 56 , 118 ] ( Figure 2 ).…”

Section: Core Functions Of Magnetic Surgical Devicesmentioning

confidence: 99%

The Evolving Use of Magnets in Surgery: Biomedical Considerations and a Review of Their Current Applications

2023

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The novel use of magnetic force to optimize modern surgical techniques originated in the 1970s. Since then, magnets have been utilized as an adjunct or alternative to a wide array of existing surgical procedures, ranging from gastrointestinal to vascular surgery. As the use of magnets in surgery continues to grow, the body of knowledge on magnetic surgical devices from preclinical development to clinical implementation has expanded significantly; however, the current magnetic surgical devices can be organized based on their core function: serving as a guidance system, creating a new connection, recreating a physiologic function, or utilization of an internal–external paired magnet system. The purpose of this article is to discuss the biomedical considerations during magnetic device development and review the current surgical applications of magnetic devices.

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An experimental study on long term outcomes after magnetic esophageal compression anastomosis in piglets

Cited by 16 publications

References 21 publications

Esophageal Magnetic Compression Anastomosis in Esophageal Atresia Repair: A PRISMA-Compliant Systematic Review and Comparison with a Novel Approach

Esophageal Magnetic Compression Anastomosis in Esophageal Atresia Repair: A PRISMA-Compliant Systematic Review and Comparison with a Novel Approach

Magnetic Compression Anastomosis–Past Experience and Current Proposals for Further Development in Pediatric Minimally Invasive Surgery

The Evolving Use of Magnets in Surgery: Biomedical Considerations and a Review of Their Current Applications

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