The novel application of an emerging device for salvage of primary repair in high-risk complex esophageal atresia

Chen, Caressa S.; Muensterer, Oliver J.; Sahlabadi, Mohammad; Lovvorn, Harold N.; Novotny, Nathan M.; Upperman, Jeffrey S.; Martinez, J. Andres; Bruzoni, Matías; Dunn, James C.Y.; Harrison, Michael R.; Fuchs, James A.; Zamora, Irving J.

doi:10.1016/j.jpedsurg.2022.05.018

Cited by 12 publications

(13 citation statements)

References 35 publications

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“…Even though magnets have recently been used successfully as therapeutic agents in pediatric surgery for neonates with high-risk complex esophageal atresia [ 8 , 9 ], they cause great concern in the infant after swallowing because, in combination with a second magnet or a metallic object, they can lead to intestinal perforation with fistula formation and a correspondingly severe course of disease.…”

Section: Discussionmentioning

confidence: 99%

Tips and Tricks—3 Use Cases of Interdisciplinary Knowledge Transfer in Minimally Invasive Pediatric Surgery

et al. 2022

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In the pediatric surgical environment, we can enrich our knowledge and improve our skills through interdisciplinary knowledge transfer in exchange with other surgical or even non-surgical disciplines. To demonstrate this, we present in this article three patient cases of method transfer enabling new techniques in minimally invasive pediatric surgery. 1. The somewhat modified application of the AeroStat rigid tip laparoscopic cholangiography catheter during the single-step laparoscopic cholecystectomy facilitates the safe intraoperative cholangiography with common bile duct flushing. 2. A magnetic rod is used during laparoscopic enterotomy to locate and retrieve ingested magnets. 3. Using a patient-specific MRI 3D model representing a syndromic high anorectal malformation improves surgical planning and parental education.

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Section: Discussionmentioning

confidence: 99%

Tips and Tricks—3 Use Cases of Interdisciplinary Knowledge Transfer in Minimally Invasive Pediatric Surgery

et al. 2022

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“…Currently, open or laparoscopic approaches to the creation of an anastomosis are performed with either surgical staplers or hand-sutured methods; however, the use of compression to create an equally robust anastomosis resistant to anastomotic leak would create an approach that could further minimize the invasiveness of this procedure by decreasing or eliminating the need for incisions. This approach also has the potential to create an anastomosis in patients that require one to restore GI tract continuity, but that have medical or anatomic comorbidities that may prohibit conventional surgical methods [ 56 ]. For example, in patients with an obstructing gastric cancer and a history of multiple intra-abdominal operations or radiation therapy, subsequent dense adhesions may prohibit a safe palliative gastrointestinal bypass.…”

Section: Core Functions Of Magnetic Surgical Devicesmentioning

confidence: 99%

“…Burst pressure is used to test anastomotic resistance to leakage with maximal observed burst pressures in MCAs consistently being > 100 mmHg, which is above the physiologic intraluminal pressure [ 53 ]. Continued research aims to optimize magnet delivery via completely endoscopic means (i.e., incisionless surgery) ( Figure 1 ) while improving anastomotic outcomes by reducing stricture rates ( Figure 2 ) [ 45 , 55 , 56 ].…”

Section: Core Functions Of Magnetic Surgical Devicesmentioning

confidence: 99%

“…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%

“…Examples of in-human use of MCA include the following: Esophago-esophageal anastomoses of two disconnected esophageal ends in children with esophageal atresia [ 49 , 51 , 52 , 54 , 55 , 56 ]; Gastroenteric or intestinal anastomoses to restore gastrointestinal (GI) tract continuity [ 35 , 42 ]; Uretero-ileal anastomoses for urinary diversions in patients with neurogenic bladders [ 42 ]; Colorectal anastomoses of disconnected colons and rectums in children with rectal atresia [ 41 ]; Intestinal anastomoses for enteral bypasses/diversions with comparable weight loss and decrease in hemoglobin A1c, fasting blood glucose, and use of medications/insulin for diabetes [ 44 , 45 ]; Stricturoplasties, or intraluminal resections of obstructing strictures, to restore GI tract continuity; Small bowel non-anastomotic strictures [ 63 ]; Anastomotic strictures after esophagectomy for esophageal cancer [ 64 ], esophageal atresia repair [ 61 , 62 ], and colon resections for colorectal cancer [ 66 ]; Bilioenteric (the bile duct to the small intestine) anastomotic ischemic strictures after liver transplant or a bile duct injury [ 57 , 58 , 59 , 60 ]. …”

Section: Core Functions Of Magnetic Surgical Devicesmentioning

confidence: 99%

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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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Side-to-side magnet anastomosis system duodeno-ileostomy with sleeve gastrectomy: early multi-center results

Gagner,

Cadiere,

Sanchez-Pernaute

et al. 2023

Surg Endosc

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Introduction Gastrointestinal anastomoses with classical sutures and/or metal staples have resulted in significant bleeding and leak rates. This multi-site study evaluated the feasibility, safety, and preliminary effectiveness of a novel linear magnetic compression anastomosis device, the Magnet System (MS), to form a side-to-side duodeno-ileostomy (DI) diversion for weight loss and type 2 diabetes (T2D) resolution. Methods In patients with class II and III obesity (body mass index [BMI, kg/m2] ≥ 35.0– ≤ 50.0 with/without T2D [HbA1C > 6.5%]), two linear MS magnets were delivered endoscopically to the duodenum and ileum with laparoscopic assistance and aligned, initiating DI; sleeve gastrectomy (SG) was added. There were no bowel incisions or retained sutures/staples. Fused magnets were expelled naturally. Adverse events (AEs) were graded by Clavien-Dindo Classification (CDC). Results Between November 22, 2021 and July 18, 2022, 24 patients (83.3% female, mean ± SEM weight 121.9 ± 3.3 kg, BMI 44.4 ± 0.8) in three centers underwent magnetic DI. Magnets were expelled at a median 48.5 days. Respective mean BMI, total weight loss, and excess weight loss at 6 months (n = 24): 32.0 ± 0.8, 28.1 ± 1.0%, and 66.2 ± 3.4%; at 12 months (n = 5), 29.3 ± 1.5, 34.0 ± 1.4%, and 80.2 ± 6.6%. Group mean respective mean HbA1C and glucose levels dropped to 1.1 ± 0.4% and 24.8 ± 6.6 mg/dL (6 months); 2.0 ± 1.1% and 53.8 ± 6.3 mg/dL (12 months). There were 0 device-related AEs, 3 procedure-related serious AEs. No anastomotic bleeding, leakage, stricture, or mortality. Conclusion In a multi-center study, side-to-side Magnet System duodeno-ileostomy with SG in adults with class III obesity appeared feasible, safe, and effective for weight loss and T2D resolution in the short term.

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The novel application of an emerging device for salvage of primary repair in high-risk complex esophageal atresia

Cited by 12 publications

References 35 publications

Tips and Tricks—3 Use Cases of Interdisciplinary Knowledge Transfer in Minimally Invasive Pediatric Surgery

Tips and Tricks—3 Use Cases of Interdisciplinary Knowledge Transfer in Minimally Invasive Pediatric Surgery

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

Side-to-side magnet anastomosis system duodeno-ileostomy with sleeve gastrectomy: early multi-center results

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