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Our first experiences with endoscopic gastroentric anastomosis using magnets

Szülőkategória: KUTATÁSI TÉMÁK
06. 10. 10
Módosítás: 01 december 2016

Attila Jónás, Peter Lukovich, Balázs Kádár, Sadat Mehdi, Pál Bata, Krisztina Tari, Peter Kupcsulik

Magyar Gasztroenterológiai Társaság 48. Nagygyűlése 2006. Szeged

1 st. Department of Surgery, Semmelweis University of Medicine , Budapest

 

 

 

Background: Many malignancies (especially pancreatic cancer) can cause the gastric outlet obstruction. Surgical gastrointestinal bypass need narcosis and associate high stress and risk for patients with poor general conditions. Endoscopic insertion of self-examble metal stent is less invasive, but often cause complications like ulceration, migration, occlusion, and malignant overgrowth. In the last years some studies examined a new minimal invasive technique which using magnets to create gastroenteric anastomosis.

Material and Method: Our study examined the technical executable of endoscopic gastroenteric anastomosis using magnets (EGAM). A biosynthetic model was developed to imitate the upper digestive tract. The model combined synthetic materials with biogenic specimens taken from slaughtered domestic pigs. The procedure was performed with endoscopic and fluoroscopic guidance. To eliminate the high X-ray absorption and contrast differences the model was put into water. Two coated rare-earth magnets (Br: 1200Gauss, D: 10mm) with central hole were inserted by guide wire and duodenal probe. The first magnet was pushed to the first jejunal loop, the second one was placed in the stomach. The gastric magnet was manoeuvred using endoscope. When magnets reach good position, them were pushed down from the guide wires to let them mate.

Result: The biosynthetic model was usable to training endoscopy without sacrificed animals. The magnets were mated across gastric and jejunal walls successfully. The pressure between the magnets results a sterile inflammation witch makes adhesion between the bowels and the anastomosis develops after 7-10 days.

Conclusion: The technique could be made with standard upper entoscope and instruments. EGAM may be potentially useful for managing gastric outlet obstruction.