Three-dimensionally printed surface features to anchor endoluminal spring for distraction enterogenesis

Area of Science:

• Gastroenterology
• Biomedical Engineering
• Surgical Innovation

Background:

• Short bowel syndrome (SBS) treatment often requires complex surgical interventions.
• Current endoluminal devices for enterogenesis face challenges with premature device migration.
• Developing sutureless, endoluminal devices is crucial for improving SBS management.

Purpose of the Study:

• To modify and evaluate a novel endoluminal spring device designed to prevent premature migration in a porcine model.
• To assess the efficacy of bidirectional hooked surface features in anchoring the device within the intestine.
• To investigate the potential for sutureless, endoscopic placement of enterogenesis devices.

Main Methods:

• Three-dimensionally printed springs with smooth and bidirectional hooked surfaces were implanted in two porcine models (Roux-en-y and in-continuity).
• Spring migration was monitored weekly via radiographs over 2 to 4 weeks.
• Histological analysis examined changes in jejunal architecture, including crypt depth and muscularis thickness.

Main Results:

• Smooth surface springs migrated within 1 to 3 weeks in both models.
• Bidirectional hooked springs remained anchored without migration for up to 4 weeks.
• Histology revealed increased crypt depth and muscularis thickness in the jejunum, indicating enterogenesis.

Conclusions:

• Bidirectional hooked features effectively prevent premature endoluminal spring migration.
• Sutureless, endoluminal spring anchors are feasible for promoting intestinal growth.
• This technology holds promise for endoscopic treatment of short bowel syndrome.