Magnetic Compression Anastomosis (Magnamosis) for Functional Undiversion of Ileostomy in Pediatric Patients

Toselli, Luzia; Martinez-Ferro, Marcelo; Cervio, Guillermo; Kwiat, Dillon; Imamura-Ching, Jill; Graves, Claire E.; Gaston, Brandon; Harrison, Michael R.

doi:10.1089/lap.2017.0300

Cited by 21 publications

(11 citation statements)

References 7 publications

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“…Magnetic compression anastomosis (MCA) was developed as a low-invasive, alternative treatment for enteric or biliary obstruction [4-8], which has been shown to consistently create histologically well-formed anastomoses with strength equal to or greater than that of hand-sewn or stapled anastomoses in animal studies [9-12]. Thus, favorable, clinical results in surgically assisted, minimally invasive gastro-enteric or entero-enteric MCA have been reported [6, 13]. However, whether the technique should be applied in the clinical setting is controversial due to the potential for severe postoperative complications, including anastomotic leakage and damage to unintended tissue between the mated magnets, which has been reported in several cases [4].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Gastrojejunostomy for Superior Mesenteric Artery Syndrome Using Magnetic Compression Anastomosis

et al. 2019

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An 89-year-old woman who was bedridden suffered repeated vomiting due to superior mesenteric artery syndrome (SMAS). We performed gastrojejunostomy via the magnetic compression anastomosis (MCA) technique because her situation was not improved by conservative therapy and because the operative risk was high. We prepared two neodymium magnets: a flat plate-shaped magnet (15 × 3 mm) and a ring-shaped magnet of the same size. The ring-shaped magnet which passed through a guidewire was pushed to the duodenum by an endoscope over the guidewire. The duodenal stricture was balloon-dilated in front of the magnet, and the magnet was pushed all together beyond the stricture and placed at the duodenojejunal junction. Subsequently, the flat plate-shaped magnet was delivered endoscopically to the stomach using a biopsy forceps. The magnets were attracted towards each other transmurally after one more flat plate-shaped magnet was added to the gastric-side magnet. Completion of gastrojejunostomy was confirmed while retrieving the magnets 10 days after starting compression. She has been asymptomatic for 1 month since anastomosis. Endoscopic gastrojejunostomy using MCA was an effective, low-invasive treatment for SMAS.

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Section: Introductionmentioning

confidence: 99%

Endoscopic Gastrojejunostomy for Superior Mesenteric Artery Syndrome Using Magnetic Compression Anastomosis

et al. 2019

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“…MCA was previously reported for treating benign biliary strictures, [ 4 ] as magnetic connectors for coronary surgery, [ 5 ] and for the functional undiversion of ileostomyin pediatric patients. [ 6 ] At present, MCA for the treatment of EA patients is restricted to gross type A (without TEF) and anastomotic stenosis without thoracotomy. [ 7 ] In the present case, the newborn patient was confirmed to have LGEA with an approximately 3-cm gap.…”

Section: Discussionmentioning

confidence: 99%

Magnetic compression for anastomosis in treating an infant born with long-gap oesophageal atresia

Liu

Fang

et al. 2020

Medicine

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Rationale: Neonatal long-gap esophageal atresia (LGEA) with tracheoesophageal fistula (TEF) is an uncommon but serious congenital malformation of the esophagus in newborns, and it remains challenging for pediatric surgeons. Magnetic compress has been shown to be effective for the treatment of LGEA in children and adults. However, the implementation of this unique technique for neonatal LGEA has not been evaluated. Patient concerns: A female infant was born at 37 weeks of gestation. Prenatal ultrasound imaging revealed signs of esophageal atresia, including the absence of the gastric bubble and polyhydramnios. Diagnoses: A diagnosis of LGEA with TEF was confirmed at birth by contrast X-ray. Interventions: She was treated with magnetic compression anastomosis (MCA) following an esophago-esophagostomy. Two magnetic rings were customized, and the MCA was conducted during the same stage surgery of ligating the TEF. Under the magnetic force, the 2 magnet rings pulled along the gastric tube to achieve anastomosis. The postoperative permanent suction of these 2 pouches was instituted, and spontaneous growth was awaited. Magnet removal was performed at 36 days, and enteral nutrition was continued via a gastric tube for 4 weeks at post-operation. Outcomes: The upper gastrointestinal contrast confirmed the anastomotic patency perfectly after 3 months. The patient was followed up for 18 months, and exhibited durable esophageal patency without dysphagia. Lessons: These results suggest that MCA is feasible and effective for treating LGEA in infants.

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“…Tight compression by a pair of magnets causes ischemia, necrosis and exfoliation of the interposed tissue, and simultaneous remodeling of the surrounding tissues, which finally creates recanalization of the narrowed lumen or a new anastomosis. 11,12,[19][20][21][22][23][24] Of note, the compressive force between the two magnets increases continuously as the interposed tissue gets thinner and thinner. [26][27][28] Therefore, such tight compression of the two magnets largely reduces the risk of anastomotic leakage.…”

Section: Discussionmentioning

confidence: 99%

“…Magnetic anastomosis has been attempted in continuous connection between bowel and bowel, [10][11][12] vessels and vessels, [13][14][15] biliary and gastrointestinal tracts, [16][17][18] as well as in recanalization of the biliary stricture, [19][20][21][22][23][24] and bilioenteric anastomotic stricture. 12,14 Because of the encouraging and broad perspective of magnetic anastomosis in clinical medicine, a new word "magnamosis" has been recommended by Dr Michael Harrison, one of the leading scientists in this field. 11,12 However, there is no consensus of materials selection, manufacturing, and design of magnets, and the potential application of magnets remains largely unknown and thus is still being explored.…”

Section: Introductionmentioning

confidence: 99%

“…12,14 Because of the encouraging and broad perspective of magnetic anastomosis in clinical medicine, a new word "magnamosis" has been recommended by Dr Michael Harrison, one of the leading scientists in this field. 11,12 However, there is no consensus of materials selection, manufacturing, and design of magnets, and the potential application of magnets remains largely unknown and thus is still being explored. During the past 15 years, we have designed different types of magnets and attempted these magnets in vascular, intestine, and biliary anastomosis in preclinical studies.…”

Section: Introductionmentioning

confidence: 99%

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Magnetic compression anastomosis for biliojejunostomy and pancreaticojejunostomy in Whipple's procedure: An initial clinical study

Liu

Xiang

et al. 2018

J of Gastro and Hepatol

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Background and Aim Magnetic anastomosis has been attempted in biliary and intestinal reconstruction. The objective of the current study was to introduce an initial clinical use of magnetic compression anastomosis for pancreaticojejunostomy and biliojejunostomy in Whipple's procedure. Methods Patients with peri‐ampullary carcinoma and dilated bile and pancreatic ducts were prospectively enrolled from 2016 to 2017. After pancreaticoduodenectomy, an appropriate mother magnet and drainage tube was placed in the proximal bile duct and pancreatic duct. The daughter magnets were introduced to mate with the mother magnets at the anastomotic sites. A close postoperative surveillance and routine cholangiopancreaticography via the drainage tube were performed. Results One female and three male patients with a median age of 69 years (range, 57–77) were included. The diameter of the common bile ducts and pancreatic ducts ranged from 8 to 15 mm, and 7 to 10 mm, respectively. The median time duration for biliojejunostomy and pancreaticojejunostomy was 7 (range, 5–8 min) min and 9 (range, 8–10 min) min, respectively. The median time of biliojejunostomy and pancreaticojejunostomy formation was 17 (range, 15–21 days) days and 11 (range, 10–18 days), respectively. With a median follow up of 313 days, one patient developed biliary anastomotic stricture at 11 months after surgery, and underwent stent placement via percutaneous transhepatic drainage sinus, and recovered well. Conclusions Magnetic anastomosis is safe, effective, and simple for both biliojejunostomy and pancreaticojejunostomy in Whipple's procedure.

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Magnetic Compression Anastomosis (Magnamosis) for Functional Undiversion of Ileostomy in Pediatric Patients

Abstract: We conclude that the magnamosis undiversion procedure is a safe, minimally invasive way to gradually refunctionalize the excluded distal bowel after previous diverting ostomy.

Cited by 21 publications

References 7 publications

Endoscopic Gastrojejunostomy for Superior Mesenteric Artery Syndrome Using Magnetic Compression Anastomosis

Endoscopic Gastrojejunostomy for Superior Mesenteric Artery Syndrome Using Magnetic Compression Anastomosis

Magnetic compression for anastomosis in treating an infant born with long-gap oesophageal atresia

Magnetic compression anastomosis for biliojejunostomy and pancreaticojejunostomy in Whipple's procedure: An initial clinical study

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