Cholangiojejunostomy Using a Novel Magnamosis Device: Initial Clinical Results

Abstract

Background Cholangiojejunostomy (CJ) is a popular operation; however, no specific anastomotic device is available. A novel magnamosis device for CJ was developed in 2017; here, we evaluated the feasibility and safety of the device. Methods Between January 2017 and December 2019, 23 patients who underwent CJ using a novel magnamosis device were enrolled. For the CJ: the parent magnet was placed in the proximal duct, and the purse-string suture was tightened over the rod of the parent magnet. The magnamosis device was introduced into the jejunum, and the mandrel penetrated the jejunum at the anastomotic site, before insertion into the rod of the parent magnet. After rotating the knob, the distance between two magnets was shortened enough to achieve coupling. Results Sixteen patients (69.6%) underwent open CJ, while 7 (30.4%) underwent laparoscopic CJ; 21 patients (91.3%) underwent choledochojejunostomy, and 2 (8.7%) underwent right or left hepatic duct jejunostomy. The mean time for completion of CJ was 9.2±2.5 min; it was significantly shorter for open CJ than for the laparoscopic way (8±1.2 min vs. 11.8±2.5 min, P\0.05). Only one patient (4.3%) suffered bile leakage after operation and was cured by conservative treatment. The magnets were discharged with a postoperative duration of 66.7±47.2 days, with a 100% expulsion rate. After a median follow-up of 15 months, only one patient (4.3%) developed inflammatory anastomotic stricture. Conclusion The novel magnamosis device is a simple, safe, and effective modality for CJ.

Feasibility experiment of a novel deformable self-assembled magnetic anastomosis ring (DSAMAR) for gastrointestinal anastomosis through a natural orifice

“…The underlying principle of MCA is that the compressed tissue between two magnets undergoes ischemia, necrosis, and shedding, whereas the adjacent tissue undergoes adhesion, repair, and healing 10 . Presently, the application of MCA in the digestive tract includes esophageal anastomosis 11 , gastrointestinal anastomosis 12 , cholangiojejunostomy 13 , intestinal anastomosis 14 , and colonic anastomosis 15 . These findings from these investigations have established that MCA of the digestive tract is safe and reliable.…”

Clinical diagnostic advances in intestinal anastomotic techniques: Hand suturing, stapling, and compression devices

“…Although the system has been used to create side-to-side colorectal anastomoses, failures due to magnetic-ring detachment have been reported. Additionally, mild-to-moderate stenoses were observed in some cases, although these decreased in severity over time[ 24 ].…”