Magnamosis II

Magnetic compression anastomosis for minimally invasive gastrojejunostomy and jejunojejunostomy

Kullada O. Pichakron, Eric B. Jelin, Shinjiro Hirose, Patrick F. Curran, Ramin Jamshidi, Jacob T. Stephenson, Richard Fechter, Michael Strange, Michael R. Harrison

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background Previously we demonstrated the safety and patency of a magnetic compression anastomosis (magnamosis). We present the further development of this technique, with specific focus on optimizing device design for minimally invasive magnamosis. Study Design The magnamosis device was designed to incorporate 3 features: 2 convex-concave radially symmetric halves that magnetically self-align, a central channel for immediate patency, and specially engineered radial topography of the mating surfaces to promote gradual remodeling. Each symmetrical half consists of a ring-shaped neodymium-iron-boron magnet encased in polycarbonate casing. Twenty-one young adult pigs underwent either magnetic gastrojejunostomy (n = 13) or jejunojejunostomy (n = 8). Animals were euthanized at 1, 2, 4, and 6 weeks after operation. Anastomoses were studied with contrast radiography, burst pressure, and histology. Results Gastrojejunostomy: In all animals with successful placement of magnets, anastomoses were patent by contrast fluoroscopy, well healed by histologic examination, and showed excellent burst strength. Jejunojejunostomy: All animals had uneventful clinical courses, indicating that the magnamosis with immediate patency functioned properly without device dislodgement. At sacrifice, all magnamoses were patent, well healed by histology, and had burst strengths that equaled or exceeded that of traditional stapled anastomoses. Conclusions Minimally invasive placement of a custom magnetic device in the stomach and jejunum allows intraluminal self-alignment and subsequent compression anastomosis over 3 to 10 days. The magnamosis is immediately patent and develops strength equal to or greater than that of hand-sewn or stapled anastomoses. Magnamosis is effective in the pig model, and may be a safe, effective, and minimally invasive alternative to current anastomotic strategies in humans.

Original languageEnglish (US)
Pages (from-to)42-49
Number of pages8
JournalJournal of the American College of Surgeons
Volume212
Issue number1
DOIs
StatePublished - Jan 1 2011
Externally publishedYes

Fingerprint

Gastric Bypass
polycarbonate
Magnets
Equipment and Supplies
Histology
Swine
Equipment Design
Neodymium
Boron
Fluoroscopy
Jejunum
Radiography
Young Adult
Stomach
Iron
Hand
Safety
Pressure

ASJC Scopus subject areas

  • Surgery

Cite this

Magnamosis II : Magnetic compression anastomosis for minimally invasive gastrojejunostomy and jejunojejunostomy. / Pichakron, Kullada O.; Jelin, Eric B.; Hirose, Shinjiro; Curran, Patrick F.; Jamshidi, Ramin; Stephenson, Jacob T.; Fechter, Richard; Strange, Michael; Harrison, Michael R.

In: Journal of the American College of Surgeons, Vol. 212, No. 1, 01.01.2011, p. 42-49.

Research output: Contribution to journalArticle

Pichakron, KO, Jelin, EB, Hirose, S, Curran, PF, Jamshidi, R, Stephenson, JT, Fechter, R, Strange, M & Harrison, MR 2011, 'Magnamosis II: Magnetic compression anastomosis for minimally invasive gastrojejunostomy and jejunojejunostomy', Journal of the American College of Surgeons, vol. 212, no. 1, pp. 42-49. https://doi.org/10.1016/j.jamcollsurg.2010.09.031
Pichakron, Kullada O. ; Jelin, Eric B. ; Hirose, Shinjiro ; Curran, Patrick F. ; Jamshidi, Ramin ; Stephenson, Jacob T. ; Fechter, Richard ; Strange, Michael ; Harrison, Michael R. / Magnamosis II : Magnetic compression anastomosis for minimally invasive gastrojejunostomy and jejunojejunostomy. In: Journal of the American College of Surgeons. 2011 ; Vol. 212, No. 1. pp. 42-49.
@article{97298ca373dc4f55a8ecbbd7b9c13d44,
title = "Magnamosis II: Magnetic compression anastomosis for minimally invasive gastrojejunostomy and jejunojejunostomy",
abstract = "Background Previously we demonstrated the safety and patency of a magnetic compression anastomosis (magnamosis). We present the further development of this technique, with specific focus on optimizing device design for minimally invasive magnamosis. Study Design The magnamosis device was designed to incorporate 3 features: 2 convex-concave radially symmetric halves that magnetically self-align, a central channel for immediate patency, and specially engineered radial topography of the mating surfaces to promote gradual remodeling. Each symmetrical half consists of a ring-shaped neodymium-iron-boron magnet encased in polycarbonate casing. Twenty-one young adult pigs underwent either magnetic gastrojejunostomy (n = 13) or jejunojejunostomy (n = 8). Animals were euthanized at 1, 2, 4, and 6 weeks after operation. Anastomoses were studied with contrast radiography, burst pressure, and histology. Results Gastrojejunostomy: In all animals with successful placement of magnets, anastomoses were patent by contrast fluoroscopy, well healed by histologic examination, and showed excellent burst strength. Jejunojejunostomy: All animals had uneventful clinical courses, indicating that the magnamosis with immediate patency functioned properly without device dislodgement. At sacrifice, all magnamoses were patent, well healed by histology, and had burst strengths that equaled or exceeded that of traditional stapled anastomoses. Conclusions Minimally invasive placement of a custom magnetic device in the stomach and jejunum allows intraluminal self-alignment and subsequent compression anastomosis over 3 to 10 days. The magnamosis is immediately patent and develops strength equal to or greater than that of hand-sewn or stapled anastomoses. Magnamosis is effective in the pig model, and may be a safe, effective, and minimally invasive alternative to current anastomotic strategies in humans.",
author = "Pichakron, {Kullada O.} and Jelin, {Eric B.} and Shinjiro Hirose and Curran, {Patrick F.} and Ramin Jamshidi and Stephenson, {Jacob T.} and Richard Fechter and Michael Strange and Harrison, {Michael R.}",
year = "2011",
month = "1",
day = "1",
doi = "10.1016/j.jamcollsurg.2010.09.031",
language = "English (US)",
volume = "212",
pages = "42--49",
journal = "Journal of the American College of Surgeons",
issn = "1072-7515",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Magnamosis II

T2 - Magnetic compression anastomosis for minimally invasive gastrojejunostomy and jejunojejunostomy

AU - Pichakron, Kullada O.

AU - Jelin, Eric B.

AU - Hirose, Shinjiro

AU - Curran, Patrick F.

AU - Jamshidi, Ramin

AU - Stephenson, Jacob T.

AU - Fechter, Richard

AU - Strange, Michael

AU - Harrison, Michael R.

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Background Previously we demonstrated the safety and patency of a magnetic compression anastomosis (magnamosis). We present the further development of this technique, with specific focus on optimizing device design for minimally invasive magnamosis. Study Design The magnamosis device was designed to incorporate 3 features: 2 convex-concave radially symmetric halves that magnetically self-align, a central channel for immediate patency, and specially engineered radial topography of the mating surfaces to promote gradual remodeling. Each symmetrical half consists of a ring-shaped neodymium-iron-boron magnet encased in polycarbonate casing. Twenty-one young adult pigs underwent either magnetic gastrojejunostomy (n = 13) or jejunojejunostomy (n = 8). Animals were euthanized at 1, 2, 4, and 6 weeks after operation. Anastomoses were studied with contrast radiography, burst pressure, and histology. Results Gastrojejunostomy: In all animals with successful placement of magnets, anastomoses were patent by contrast fluoroscopy, well healed by histologic examination, and showed excellent burst strength. Jejunojejunostomy: All animals had uneventful clinical courses, indicating that the magnamosis with immediate patency functioned properly without device dislodgement. At sacrifice, all magnamoses were patent, well healed by histology, and had burst strengths that equaled or exceeded that of traditional stapled anastomoses. Conclusions Minimally invasive placement of a custom magnetic device in the stomach and jejunum allows intraluminal self-alignment and subsequent compression anastomosis over 3 to 10 days. The magnamosis is immediately patent and develops strength equal to or greater than that of hand-sewn or stapled anastomoses. Magnamosis is effective in the pig model, and may be a safe, effective, and minimally invasive alternative to current anastomotic strategies in humans.

AB - Background Previously we demonstrated the safety and patency of a magnetic compression anastomosis (magnamosis). We present the further development of this technique, with specific focus on optimizing device design for minimally invasive magnamosis. Study Design The magnamosis device was designed to incorporate 3 features: 2 convex-concave radially symmetric halves that magnetically self-align, a central channel for immediate patency, and specially engineered radial topography of the mating surfaces to promote gradual remodeling. Each symmetrical half consists of a ring-shaped neodymium-iron-boron magnet encased in polycarbonate casing. Twenty-one young adult pigs underwent either magnetic gastrojejunostomy (n = 13) or jejunojejunostomy (n = 8). Animals were euthanized at 1, 2, 4, and 6 weeks after operation. Anastomoses were studied with contrast radiography, burst pressure, and histology. Results Gastrojejunostomy: In all animals with successful placement of magnets, anastomoses were patent by contrast fluoroscopy, well healed by histologic examination, and showed excellent burst strength. Jejunojejunostomy: All animals had uneventful clinical courses, indicating that the magnamosis with immediate patency functioned properly without device dislodgement. At sacrifice, all magnamoses were patent, well healed by histology, and had burst strengths that equaled or exceeded that of traditional stapled anastomoses. Conclusions Minimally invasive placement of a custom magnetic device in the stomach and jejunum allows intraluminal self-alignment and subsequent compression anastomosis over 3 to 10 days. The magnamosis is immediately patent and develops strength equal to or greater than that of hand-sewn or stapled anastomoses. Magnamosis is effective in the pig model, and may be a safe, effective, and minimally invasive alternative to current anastomotic strategies in humans.

UR - http://www.scopus.com/inward/record.url?scp=78650620991&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78650620991&partnerID=8YFLogxK

U2 - 10.1016/j.jamcollsurg.2010.09.031

DO - 10.1016/j.jamcollsurg.2010.09.031

M3 - Article

VL - 212

SP - 42

EP - 49

JO - Journal of the American College of Surgeons

JF - Journal of the American College of Surgeons

SN - 1072-7515

IS - 1

ER -