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Magnetic pancreaticobiliary stents and retrieval system: obviating the need for repeat endoscopy (with video)
Marvin Ryou1, Padraig Cantillon-Murphy, Sohail N Shaikh
1Division of Gastroenterology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Background:
Plastic stents are routinely placed in the pancreaticobiliary system to facilitate drainage. A second endoscopy is often required for stent removal. We have developed magnetic pancreaticobiliary stents that can be removed by using an external hand-held magnet, thereby obviating the need for a second endoscopy.
Objective:
To develop and test magnetic pancreaticobiliary stents and retrieval system in ex-vivo and in-vivo porcine models.
Setting:
Animal laboratory.
Design:
Benchtop and animal study.
Animals:
5 pigs.
Interventions:
Design: Computer simulations determined both the optimal design of cylindrical magnets attached to the distal aspect of existing plastic stents and the optimal design of the external hand-held magnet. Benchtop ex-vivo experiments measured magnetic force to validate the design. In-vivo analysis: In 5 Yorkshire pigs, magnetic stents were deployed into the common bile duct by using a conventional duodenoscope. An external hand-held magnet was applied for stent removal. Stent insertion and removal times were recorded.
Main Outcome Measurements:
Technical feasibility.
Results:
Magnetic stents of varying lengths and calibers were successfully created. In ex-vivo testing, the capture distance was 10.0 cm. During in-vivo testing, the magnetic stents were inserted and removed easily. The mean insertion and removal times were 3.2 minutes and 33 seconds, respectively.
Limitations:
Animal study, small numbers.
Conclusions:
Magnetic pancreaticobiliary stents and associated retrieval system were successfully designed and tested in the acute porcine model. An external, noninvasive means of stent removal potentially obviates the need for a second endoscopy, which could represent a major gain both for patients and in health care savings.
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