Noninvasive gastrostomy based on magnetic compression technique: an experimental study in rat models
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1.Department of Hepatobiliary Surgery, Xi'an Jiaotong University, Xi'an 710061, China;2.National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China, Xi'an Jiaotong University, Xi'an 710061, China;3.Qide College, Xi'an Jiaotong University, Xi'an 710061, China;4.Zonglian College, Xi'an Jiaotong University, Xi'an 710061, China

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R656.6

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    Abstract:

    Background and Aims Gastrostomy is a common operation in general surgery. Traditional gastrostomy has been gradually replaced by endoscopic gastrostomy and X-ray gastrostomy due to the great surgical trauma. However, the implementation process requires the assistance of endoscopic system or X-ray machine, and the procedure is complicated. Based on the assumption of performing a noninvasive gastrostomy by magnetic compression technique, this study was conducted to verify the feasibility and safety of this assumption in rat models using a self-designed and developed magnet device for gastrostomy.Methods According to the anatomical characteristics and size of rat digestive tract, the parent and daughter magnets made from Ndfeb and suitable for rat gastrostomy were designed and produced. The magnitude of the magnetic force between the parent and daughter magnets was tested by electronic universal testing machine. In 10 SD rats, the daughter magnet was inserted into the stomach through mouth after anesthesia and the parent magnet was placed in the left upper abdomen. After the two magnets automatically latched onto each other, the attraction status was confirmed by abdominal X-ray. After operation, the rats were raised in a single cage, the survival status, time of magnet detachment, and complications during magnets retention were observed. The animals were sacrificed 2 weeks after the operation, and the gastrostomy specimens were obtained to observe the formation of the gastrostomy under naked eye and light microscope.Results Both the self-designed and produced parent and daughter magnets were cylindrical shaped and made from N42 sintered Ndfeb, with nickel plating on the surface. The diameter and height of the daughter magnet were 5 mm and 3 mm, and the diameter of the parent magnet were 6 mm and 5 mm, respectively. The mass of the daughter magnet and parent magnet were 0.410 g and 1.035 g respectively. The maximum adhesive force of the parent and daughter magnets was 4.36 N in direct contact, and the magnetic force of the magnets decreased with the increase of displacement. The daughter magnets were successfully inserted into the stomach of all the 10 rats after anesthesia. After the parent magnets were placed in the left upper abdomen of rats, the daughter and parent magnets were rapidly attracted to each other. Abdominal X-ray examination showed that the magnets stuck in right position. All rats survived after operation. During the period of retention of the parent and daughter magnets, there were no accidents such as magnetic displacement and separation of the magnets occurred, and no complications such as digestive tract obstruction and abdominal infection occurred in all experimental animals. The magnets were detached and the gastrostomy channel was established 10 to 13 days after operation. Two weeks after the operation, the adhesion between stomach and abdominal wall around the fistula stoma was firmly healed, and there was no exudation and adhesion in the abdominal cavity. The specimens of the fistula stoma were obtained, naked-eye observation found that the fistula stoma was well formed, and the tissue structure of the fistula was clear under HE and Masson staining and light microscope.Conclusion The magnet device for gastrostomy based on magnetic compression technique is cleverly designed, easy to process and low cost. The establishment of non-invasive gastrostomy in rats by this method is simple, safe and feasible, and the tissues of each layer of the fistula can heal well. The next step is to carry out experiments in large animals that are more similar to human anatomy to verify its feasibility and evaluate the long-term effects of the fistula formation. Clinical trials of this technique are expected in the future after optimization of the design of magnets and the operating procedure.

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ZHANG Miaomiao, JI Lin, GAI Jingci, LEI Fengping, LIU Peinan, WANG Yirui, LAN Ting, ZHANG Hanzhi, LI Heng, LU Yi, YAN Xiaopeng. Noninvasive gastrostomy based on magnetic compression technique: an experimental study in rat models[J]. Chin J Gen Surg,2021,30(10):1175-1183.
DOI:10.7659/j. issn.1005-6947.2021.10.007

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History
  • Received:February 04,2021
  • Revised:September 23,2021
  • Adopted:
  • Online: November 02,2021
  • Published: