An experimental study on magnetic esophageal compression anastomosis in piglets

Oliver J. Muensterer, Alexander Sterlin, Christina Oetzmann von Sochaczewski, Andreas Lindner, Axel Heimann, Alexandru Balus, Jana Dickmann, Maximilian Nuber, Veeshal H. Patel, Michael A. Manfredi, Russell W. Jennings, Charles J. Smithers, Dario O. Fauza, Michael R. Harrison

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Introduction: Fashioning a patent, watertight anastomosis in patients with esophageal atresia is a challenging task in pediatric surgery, particularly when performed under tension. A reproducible suture-less alternative would decrease operative time. We evaluated magnetic esophageal compression anastomoses in a novel bypass-loop swine model. Methods: Eight-week-old piglets underwent thoracotomy to mobilize the esophagus at the carina to create a U-shaped loop. Custom-made 8 mm diameter Neodymium Magnets were inserted into the esophagus proximal and distal to the loop, then mated side-to-side at the future anastomosis site. Pigs were observed for 8 (n = 4), 10 (n = 6), and 12 (n = 2) days and then sacrificed. The magnetic compression anastomosis was evaluated macroscopically, by radiography, burst pressure testing, and histology. Results: All 12 pigs survived until the endpoint. Separation of the magnets occurred at a median of 9 days. Contrast esophagrams showed patency and no leak. All anastomoses withstood pressures well over 13 kPa without leak. Histopathology showed epithelialized circular scar tissue. Conclusion: Magnetic compression anastomoses of the esophagus using our specially-designed magnets are formed between the 8th and 10th postoperative day, are patent and mechanically resistant to supraphysiologic intraluminal pressures. These data lay the basis for a potential clinical application in patients born with esophageal atresia. Level of evidence: Not applicable (experimental animal study).

Original languageEnglish (US)
Pages (from-to)425-432
Number of pages8
JournalJournal of pediatric surgery
Volume55
Issue number3
DOIs
StatePublished - Mar 2020
Externally publishedYes

Keywords

  • Anastomosis
  • Compression
  • Esophagus
  • Magnetic
  • Pig

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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