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PLoS One. 2018 Jul 12;13(7):e0200529. doi: 10.1371/journal.pone.0200529. eCollection 2018.

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

Author information

1
Department of Surgery, Division of Pediatric Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States of America.
2
Department of Surgery, Division of Pediatric Surgery, School of Medicine, Stanford University, Stanford, California, United States of America.
3
School of Engineering, Department of Bioengineering, University of California, Los Angeles, Los Angeles, California, United States of America.
4
Department of Bioengineering, School of Medicine, Stanford University, Stanford, California, United States of America.

Abstract

Spring-mediated distraction enterogenesis has been studied as a novel treatment for short bowel syndrome (SBS). Previous approaches are limited by multiple surgeries to restore intestinal continuity. Purely endoluminal devices require a period of intestinal attachment for enterogenesis. The purpose of this study is to modify the device to prevent premature spring migration in a porcine model. Two models were created in juvenile mini-Yucatan pigs for the placement of three-dimensionally printed springs. (1) Two Roux-en-y jejunojenostomies with two Roux limbs were made. A spring with bidirectional hooked surface features was placed in one Roux limb and a spring with smooth surface was placed in the other Roux limb. (2) The in-continuity model had both hooked and smooth surface springs placed directly in intestinal continuity. Spring location was evaluated by weekly radiographs, and the intestine was retrieved after 2 to 4 weeks. Springs with smooth surfaces migrated between 1 to 3 weeks after placement in both porcine models. Springs with bidirectional hooked surface features were anchored to the intestine for up to 4 weeks without migration. Histologically, the jejunal architecture showed significantly increased crypt depth and muscularis thickness compared to normal jejunum. Bidirectional features printed on springs prevented the premature migration of endoluminal springs. These novel spring anchors allowed for their endoluminal placement without any sutures. This approach may lead to the endoscopic placement of the device for patients with SBS.

PMID:
30001433
PMCID:
PMC6042758
DOI:
10.1371/journal.pone.0200529
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

This study was partly funded by Sun West Company. There are no patents, products in development or marketed products to declare. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.

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