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Spring-mediated distraction enterogenesis in-continuity.

Nhan Huynh1, Joshua D Rouch1, Andrew Scott1

  • 1Department of Surgery, Division of Pediatric Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, 90095, USA.

Journal of Pediatric Surgery
|October 4, 2016
PubMed
Summary
This summary is machine-generated.

In-continuity spring placement successfully lengthened jejunum in pigs, offering a new approach for short bowel syndrome (SBS) treatment. This study demonstrates the feasibility of spring-mediated intestinal lengthening without obstruction.

Keywords:
Biodegradable lengthening deviceBowel lengtheningDistraction enterogenesisMechanical enterogenesisShort bowel syndromeSpring lengthening device

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Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Biomaterials Engineering

Background:

  • Short bowel syndrome (SBS) presents challenges due to intestinal length loss and repeated surgeries.
  • Distraction enterogenesis is a novel treatment for SBS, but its clinical application is hindered by surgical complexities.
  • The feasibility of in-continuity intestinal lengthening using spring devices remains unexplored.

Purpose of the Study:

  • To evaluate the safety and efficacy of in-continuity, spring-mediated intestinal lengthening.
  • To demonstrate the potential of self-expanding endoluminal springs for distraction enterogenesis.
  • To establish proof-of-concept for a less invasive approach to intestinal lengthening in SBS.

Main Methods:

  • Juvenile mini-Yucatan pigs received in-continuity placement of polycaprolactone (PCL) degradable springs in the jejunum.
  • Springs were anchored using full-thickness sutures or a high-friction surface.
  • Bowel length and spring presence were assessed at 1-4 weeks post-implantation.

Main Results:

  • Animals tolerated the in-continuity lengthening procedure without bowel obstruction for up to 29 days.
  • Jejunum length increased by 1.47-fold ±0.11 with spring placement.
  • Histological analysis revealed increased crypt depth and muscularis thickness in lengthened jejunum.

Conclusions:

  • Self-expanding endoluminal springs placed in continuity can safely lengthen the intestine in a porcine model.
  • This study provides the first evidence for the safety and efficacy of endoluminal devices in distraction enterogenesis.
  • In-continuity spring lengthening is a feasible technique with therapeutic potential for SBS.