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1.
Surg Endosc ; 37(2): 1005-1012, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36085384

RESUMO

BACKGROUND: There have been no prospective randomized controlled clinical trials evaluating the advantages of the magnetic anchor technique (MAT) used in reduced-port laparoscopic cholecystectomy (LC). The present study evaluated a novel magnetic anchor device designed by the authors. METHODS: Between April 2019 and June 2020, 60 patients with gallbladder diseases participated in a single-center, prospective, randomized controlled clinical trial. The patients were randomly apportioned to undergo either 2-port LC assisted by the novel MAT (MAT-2P-LC, experimental group) or conventional 3-port LC (3P-LC, control). The groups were compared regarding operative time, postoperative complications, surgical incision pain score (Wong-Baker), and other indicators. The patients were followed for 2 years. RESULTS: The test and control groups were comparable in age, gender, body mass index, and primary disease. No patient in the MAT-2P-LC group was converted to 3P-LC. No patients were converted to laparotomy. On the first postoperative day, the Wong-Baker pain score of the experimental group (1.60 ± 0.67) was significantly lower than that of the control (2.20 ± 0.76; P = 0.002). The groups were statistically similar regarding intraoperative blood loss; operative time; time to leave bed; hospital stay; postoperative pain scores at 1 and 4 weeks; and complications. CONCLUSIONS: This rigorous clinical trial shows that the novel MAT used to assist reduced-port LC significantly reduced postoperative pain, but has no obvious advantages in other terms. Clinical Trails.gov. number, ChiCTR1800019464.


Assuntos
Colecistectomia Laparoscópica , Doenças da Vesícula Biliar , Humanos , Colecistectomia Laparoscópica/métodos , Doenças da Vesícula Biliar/cirurgia , Dor Pós-Operatória/cirurgia , Complicações Pós-Operatórias/cirurgia , Duração da Cirurgia , Tempo de Internação , Fenômenos Magnéticos
2.
J Surg Res ; 276: 283-290, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35405414

RESUMO

INTRODUCTION: The magnetic compression technique (MCT) is used for the anastomosis of hollow organs by the means of suction between magnets. The MCT is useful for establishing digestive tract anastomoses in rats, for example, end-to-side small intestinal anastomosis and colonic anastomosis. We aim to determine the feasibility of MCT-based esophageal anastomosis in rats. METHODS: Twenty-four Sprague-Dawley albino rats (230-250 g) were randomly divided into an MCT group and a control group (hand-sewn esophageal anastomosis). The time required to construct the anastomosis, postoperative complications, and survival rate was compared between the two groups. At 2 wk postoperatively, the animals were sacrificed to assess the burst pressure and histological features of the anastomoses. RESULTS: The mean anastomosis time was significantly lower for MCT (11.17 ± 1.64 min) than for the hand-sewn technique (27.42 ± 2.23 min; P < 0.001). The survival rate was slightly higher in the MCT group (91.67%) than in the control group (66.67%, P = 0.317). The magnets were discharged from the body after 8.33 ± 0.89 d (range, 7-10 d). No anastomotic leakage or stenosis occurred in the MCT group. Three rats developed anastomotic stenosis and two rats developed anastomotic leakage in the control group. The burst pressures were similar in the two groups. An histological examination showed that compared with the control group, the MCT group had better alignment of the tissue layers and less inflammation. CONCLUSIONS: The MCT is a simple and feasible technique for esophageal anastomosis in rats and has the potential for clinical application.


Assuntos
Anastomose Cirúrgica , Procedimentos Cirúrgicos do Sistema Digestório , Esôfago , Imãs , Anastomose Cirúrgica/efeitos adversos , Anastomose Cirúrgica/instrumentação , Anastomose Cirúrgica/métodos , Fístula Anastomótica/etiologia , Fístula Anastomótica/prevenção & controle , Animais , Constrição Patológica/etiologia , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Procedimentos Cirúrgicos do Sistema Digestório/instrumentação , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Esôfago/cirurgia , Fenômenos Magnéticos , Ratos , Ratos Sprague-Dawley , Técnicas de Sutura
3.
Surg Endosc ; 36(11): 8170-8177, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35501603

RESUMO

BACKGROUND: Being one of the core techniques of magnetic surgery, magnetic compression technique (MCT) has been used for digestive tract anastomosis reconstruction in experimental studies. This study verified the feasibility of gastroenteric anastomosis through natural orifice using MCT in rats. METHODS: The parent and daughter magnets were designed and manufactured for oral and anal insertion in 20 Sprague-Dawley rats. After anesthesia, the parent magnet was inserted into the colon spleen area through the anus, and the daughter magnet was inserted into the stomach through the mouth. Then the two magnets were positioned to attract each other and bind together. The position of the two magnets was monitored using X-ray. The time required for the formation of the anastomosis and expulsion of the magnets were recorded. 2 weeks later, the animal was sacrificed and the anastomotic specimen was obtained which was observed under naked eye and microscope. RESULTS: The gastroenteric anastomosis was successfully performed via natural orifices in 18 out of 20 rats. The mean time to construct the anastomosis was 3.78 ± 0.88 min. X-ray examination showed that the magnets were in the appropriate position in 17 rats. The magnets were excreted in 9.47 ± 1.62 days after surgery. The gross and microscopic examination of the specimen showed that the anastomoses were patent and the mucosa at the anastomotic was smooth. The mean bursting pressure of the anastomosis was 136.94 ± 6.79 mmHg. CONCLUSION: It is feasible to perform gastroenteric anastomosis through natural orifices by MCT.


Assuntos
Magnetismo , Imãs , Ratos , Animais , Ratos Sprague-Dawley , Anastomose Cirúrgica/métodos , Fenômenos Magnéticos
4.
Surg Endosc ; 36(5): 3653-3662, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35080676

RESUMO

BACKGROUND: Dissecting lymph nodes along the left recurrent laryngeal nerve (LRLN) is the most challenging step in thoracoscopic-assisted esophagectomy. To retract the proximal esophagus in the existing lymphadenectomy methods, either a special trocar is required to insert and take out endoscopic instruments or thoracic punctures are needed to externally retract the esophageal loop. Therefore, advanced skills for esophageal traction are important to facilitate the LRLN lymphadenectomy and to reduce the incidence of trauma to the chest wall. Herein, we present the magnetic anchoring and traction technique, a novel method for LRLN lymphadenectomy during thoracoscopic esophagectomy. METHODS: The magnetic anchoring traction system was successfully used to retract the upper thoracic esophagus and to help expose the upper mediastinum in 10 cases of thoracoscopic-assisted esophagectomy. When the external magnet was moved outside of body, the internal magnet was coupled with a magnetic force to pull the proximal esophagus to the appropriate direction, which helped to expose the LRLN and adjacent lymph nodes. The lymph nodes adjacent to the LRLN could then be dissected completely without any damage to the nerve. RESULTS: In all surgeries, the LRLN and adjacent lymph nodes were well visualized, and the number of trocars used to pass endoscopic instruments for retraction of the proximal esophagus or the number of thoracic punctures for external traction of the esophagus during the surgery were reduced. CONCLUSIONS: In thoracoscopic-assisted esophagectomy, the magnetic anchoring and traction technique can improve the exposure of the LRLN, facilitate LRLN lymphadenectomy, and reduce chest wall trauma.


Assuntos
Neoplasias Esofágicas , Nervo Laríngeo Recorrente , Neoplasias Esofágicas/cirurgia , Esofagectomia/métodos , Humanos , Excisão de Linfonodo/métodos , Fenômenos Magnéticos , Mediastino/patologia , Nervo Laríngeo Recorrente/patologia , Estudos Retrospectivos , Tração
5.
Hepatobiliary Pancreat Dis Int ; 21(4): 340-346, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35022144

RESUMO

BACKGROUND: Although laparoscopic technology has achieved rapid development in the surgical field, it has not been applied to liver transplantation, primarily because of difficulties associated with laparoscopic vascular anastomosis. In this study, we introduced a new magnetic-assisted vascular anastomosis technique and explored its application in laparoscopic liver transplantation in pigs. METHODS: Two sets of magnetic vascular anastomosis rings (MVARs) with different diameters were developed. One set was used for anastomosis of the suprahepatic vena cava (SHVC) and the other set was used for anastomosis of the infrahepatic vena cava (IHVC) and portal vein (PV). Six laparoscopic orthotopic liver transplantations were performed in pigs. Donor liver was obtained via open surgery. Hepatectomy was performed in the recipients through laparoscopic surgery. Anastomosis of the SHVC was performed using hand-assisted magnetic anastomosis, and the anastomosis of the IHVC and PV was performed by magnetic anastomosis with or without hand assistance. RESULTS: Liver transplants were successfully performed in five of the six cases. Postoperative ultrasonographic examination showed that the portal inflow was smooth. However, PV bending and blood flow obstruction occurred in one case because the MVARs were attached to each other. The durations of loading of MVAR in the laparoscope group and manual assistance group for IHVC and PV were 13 ± 5 vs. 5 ± 1 min (P < 0.01) and 10 ± 2 vs. 4 ± 1 min (P < 0.05), respectively. The durations of MVAR anastomosis in the laparoscope group and manual assistance group for IHVC and PV were 5 ± 1 vs. 1 ± 1 min (P < 0.01), and 5 ± 1 vs. 1 ± 1 min (P < 0.01), respectively. The anhepatic phase was 43 ± 4 min in the laparoscope group and 23 ± 2 min in the manual assistance group (P < 0.01). CONCLUSIONS: Our study showed that magnetic-assisted laparoscopic liver transplantation can be successfully carried out in pigs.


Assuntos
Laparoscopia , Transplante de Fígado , Anastomose Cirúrgica/métodos , Animais , Humanos , Transplante de Fígado/métodos , Doadores Vivos , Fenômenos Magnéticos , Veia Porta/diagnóstico por imagem , Veia Porta/cirurgia , Suínos , Veia Cava Inferior/cirurgia
6.
Zhongguo Yi Liao Qi Xie Za Zhi ; 45(6): 612-615, 2021 Nov 30.
Artigo em Zh | MEDLINE | ID: mdl-34862772

RESUMO

Based on the principle of magnetic anastomosis technique, the design of magnetic anastomosis system for endoscopic tissue clamping is proposed. The system includes a semi-ring magnet, a special structure transparent cap and a detachable push rod. With the help of the existing digestive endoscopy and endoscopic tissue gripper, the endoscopic close clamping and anastomosis of the bleeding or perforated tissue can be completed. After the anastomosis, the magnet falls off and is discharged through the digestive tract. Animal experiments showed that the system was easy to use, the fistula was clamped firmly, the magnet was discharged for 7~21 days, and there was no magnet retention and digestive tract obstruction. Further safety verification, optimization of endoscopic operation, the system can be used in clinical trial.


Assuntos
Magnetismo , Imãs , Anastomose Cirúrgica , Animais , Constrição , Endoscopia Gastrointestinal
7.
J Surg Res ; 245: 249-256, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31421370

RESUMO

BACKGROUND: Technical improvement of gastrojejunostomy is critical in bariatric and metabolic surgery. In this study, a novel magnetic compression approach for gastrojejunostomy was evaluated. MATERIALS AND METHODS: Both cylindrical and rectangular magnets were used in rabbits, and the magnets were named according to their location. All the magnets were perorally introduced into the stomach. The position of the jejunal magnet was controlled by a connecting line. When the jejunal magnet spontaneously entered the jejunum, the gastric magnet was introduced into the stomach. An extracorporeal magnet was used to guide these two magnets together, and the magnet pair was left to create a side-to-side anastomosis. The state of the animals and extrusion time of the magnets were observed. The anastomoses were evaluated by burst pressure and histology. RESULTS: Gastrojejunostomy was successfully established in all animals. Cylindrical and rectangular magnets spontaneously entered the jejunum through the pylorus within 2.4 ± 0.5 and 6.0 ± 0.8 d, respectively (P < 0.01). The cylindrical and rectangular magnet pairs fell off within 15.3 ± 0.8 and 11.9 ± 1.1 d, respectively (P < 0.01). The burst pressures were statistically similar between the two types of magnets (P > 0.05). Histological examination showed sealed anastomoses with mild inflammation of the mucosa and fibrosis within the submucosa. CONCLUSIONS: The feasibility and efficacy of establishing gastrojejunostomy by guidewire introduction of magnets, which were guided together with an extracorporeal magnet, were confirmed in rabbits. In humans, with the clinical use of this procedure, surgery would be greatly simplified.


Assuntos
Derivação Gástrica/instrumentação , Gastrostomia/instrumentação , Jejunostomia/instrumentação , Imãs , Animais , Desenho de Equipamento , Estudos de Viabilidade , Feminino , Derivação Gástrica/efeitos adversos , Derivação Gástrica/métodos , Gastrostomia/efeitos adversos , Gastrostomia/métodos , Jejunostomia/efeitos adversos , Jejunostomia/métodos , Masculino , Modelos Animais , Pressão , Coelhos
8.
Cell Physiol Biochem ; 52(3): 382-396, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30845378

RESUMO

BACKGROUND/AIMS: Breast cancer is clinically classified into three main subtypes: estrogen receptor-positive (ER+) breast cancer, human epidermal growth factor receptor 2-positive (HER2+) breast cancer, and triple-negative breast cancer (TNBC). Without specific targeted therapies, patients with TNBC have poorer prognosis compared with those with ER+ and HER2+ breast cancer. Protein kinase D (PRKD) family members play crucial roles in cancer progression. CRT0066101, a PRKD inhibitor, has been reported to have anticancer activity in many cancer types. Nevertheless, the role and mechanism of CRT0066101 in TNBC have not been well investigated. METHODS: The expression level of PRKDs was analyzed in breast cancer samples and breast cancer cell lines. The effects of inhibiting PRKD activity with CRT0066101 on TNBC cell proliferation, cell cycle, apoptosis, and tumor growth were studied by Cell Counting Kit8 assay, cell cycle assay, propidium iodide/annexin-V assay, and a xenograft mouse model, respectively. To uncover the molecular mechanism of CRT0066101 in TNBC, comparative phosphoproteomic analysis using iTRAQ was employed. RESULTS: We found that PRKD2 and PRKD3 were preferentially expressed in breast cancers. Immunohistochemistry confirmed the overexpression of PRKD2 and PRKD3 in TNBC. CRT0066101, which inhibited the activity of PRKDs, dramatically inhibited proliferation, increased apoptosis and the G1-phase population of TNBC cells in vitro, and reduced breast tumor volume in vivo. Comparative phosphoproteomic analysis between breast cancer cells with and without CRT0066101 treatment revealed that the anti-breast cancer effects involved regulation of a complex network containing multiple enriched pathways and several hub-nodes contributing to multiple cancer-related processes, thus explaining the described effects of CRT0066101 on TNBC in vitro and in vivo. Finally, we validated several targets of PRKD inhibition by treatment with CRT0066101 and small interfering RNAs against PRKD2 and PRKD3 (siPRKD2 and siPRKD3), including p-MYC(T58/ S62), p-MAPK1/3(T202/Y204), p-AKT(S473), p-YAP(S127), and p-CDC2(T14). CONCLUSION: PRKD inhibitor CRT0066101 exhibits anti-TNBC effects via modulating a phosphor-signaling network and inhibiting the phosphorylation of many cancer-driving factors, including MYC, MAPK1/3, AKT, YAP, and CDC2, providing insight into the important roles as well as the molecular mechanism of CRT0066101 as an effective drug for TNBC.


Assuntos
Apoptose/efeitos dos fármacos , Pirimidinas/farmacologia , Animais , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Feminino , Pontos de Checagem da Fase G1 do Ciclo Celular/efeitos dos fármacos , Humanos , Camundongos , Camundongos Nus , Fosfopeptídeos/análise , Proteína Quinase C/antagonistas & inibidores , Proteína Quinase C/genética , Proteína Quinase C/metabolismo , Proteômica , Proteínas Proto-Oncogênicas c-akt/genética , Proteínas Proto-Oncogênicas c-akt/metabolismo , Proteínas Proto-Oncogênicas c-myc/genética , Proteínas Proto-Oncogênicas c-myc/metabolismo , Pirimidinas/metabolismo , Pirimidinas/uso terapêutico , Interferência de RNA , RNA Interferente Pequeno/metabolismo , Neoplasias de Mama Triplo Negativas/tratamento farmacológico , Neoplasias de Mama Triplo Negativas/metabolismo , Neoplasias de Mama Triplo Negativas/patologia
9.
Zhongguo Yi Liao Qi Xie Za Zhi ; 43(5): 334-336, 2019 Sep 30.
Artigo em Zh | MEDLINE | ID: mdl-31625329

RESUMO

Laparoscopic surgery based on magnetic anchor technique has great potential for further minimally invasive surgery and good surgical field exposure, in which the internal grasper is the key factor. In this paper, an internal grasper based on magnetic anchor laparoscopic surgery is designed, which consists of three parts:target magnet, connection module and tissue forceps. The magnetic shield shell is used to wrap the magnetic core in the target magnet, which not only can increase the magnetic force in the working area, but also reduce the magnetic interference between the instruments, and the connecting module can flexibly adjust the length of the internal grasper. The special structure of tissue gripper can effectively reduce deputy injury and facilitate the replacement of clamp position. It has many advantages, such as ingenious design, easy processing, simple operation and wide range of application, which greatly increased its clinical application value.


Assuntos
Laparoscopia , Instrumentos Cirúrgicos , Desenho de Equipamento , Magnetismo , Imãs
10.
Zhongguo Yi Liao Qi Xie Za Zhi ; 43(1): 17-20, 2019 Jan 30.
Artigo em Zh | MEDLINE | ID: mdl-30770684

RESUMO

A motion unit for sucking robot with a stable motion, convenient operation and process simulation is introduced. The key parameters and process data of the sucking operation were obtained from the clinical work, which provided the basis for the design of the sucking robot motion unit. According to the points of sucking action, robotic thumb, forefinger and metacarpophalangeal joints were used to grip the suction tube, and the servo and arm structure were used to simulate the motion of the wrist and elbow to complete the rotation and push of the sputum suction tube. The feasibility is verified through the advanced sputum suction training model. The movement unit is stable in movement, and can smoothly complete the clamping, feeding, back off protection and rotating tube removal of the sputum suction tube, so as to achieve effective sputum suction.


Assuntos
Intubação Intratraqueal , Robótica , Cateterismo , Sucção
11.
World J Surg ; 42(12): 4039-4045, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-29947988

RESUMO

BACKGROUND: Magnetic compression anastomosis (magnamosis, MCA) has been verified safe and effective by us and others in animal bilioenteric anastomosis (BEA). The objective of the present study was to introduce clinical application of magnetic compression bilioenteric anastomosis (MC-BEA) with a unique device in series of patients. METHODS: Patients with obstructive jaundice with an indication of BEA were prospectively enrolled from 2012 to 2015. After dissection of bile ducts, the mother ring and drainage tube were placed in the proximal bile duct and the purse-string suture was tightened over the drainage tube. The drainage tube was introduced into the jejunal lumen at the anastomotic site and used to guide the daughter ring to assemble with the mother ring. All the patients were routinely followed up for magnets discharge or any complications associated. RESULTS: Forty-one patients were included. Thirty-four (82.9%) patients had a malignant primary disease, while seven (17.1%) had benign disease. The median time for MC-BEA was 10.5 min (interquartile range [IQR] 8.3-13.0 min). No perioperative morbidity or mortality associated with MC-BEA was observed. The median time for a patent bilioenteric anastomosis formation was 19.0 days (IQR 14.5-23.0 days), and the magnets were discharged with a median postoperative duration of 35.0 days (IQR 28.0-43.0 days). With a median follow-up of 547.5 days (range 223-1042 days), no patients had biliary fistula, while two (4.9%) developed anastomotic stricture at 4 months and 14 months after surgery, and underwent reoperation for reconstruction of BEA. CONCLUSIONS: MCA is a safe, effective, and time-saving modality for biliojejunostomy.


Assuntos
Anastomose Cirúrgica/métodos , Ductos Biliares/cirurgia , Icterícia Obstrutiva/cirurgia , Jejunostomia/métodos , Imãs , Idoso , Anastomose Cirúrgica/efeitos adversos , Drenagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
12.
Zhongguo Yi Liao Qi Xie Za Zhi ; 42(1): 11-13, 2018 Jan 30.
Artigo em Zh | MEDLINE | ID: mdl-29862737

RESUMO

A biliary contrast agents pushing device, including a syringe pushing system and a remote controller is introduced. The syringe pushing system comprises an injector card slot, a support platform and an injection bolus fader. A 20 mL syringe can be fitted on the syringe pushing system and kept with the ground about 30 degree. This system can perform air bubble pumping back and contrast agents bolus injection as well as speed adjustment. Remote controller is an infrared remote control which can start and stop the syringe pushing system. With this device, the remote controlled cholangiography technology can be achieved, which can not only protect doctors from X-ray radiation but also improve the traditional T-tube cholangiography and the contrast effect, reduce postoperative complications in patients as well. The application of this device will improve the current diagnosis and treatment system, the device will benefit the majority of doctors and patients.


Assuntos
Meios de Contraste/administração & dosagem , Seringas , Humanos , Injeções , Complicações Pós-Operatórias
13.
Surg Endosc ; 31(1): 274-280, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27177955

RESUMO

BACKGROUND: Laparoendoscopic single-site surgery and natural orifice transluminal endoscopic surgery attempt to reduce transabdominal port sites. These require all instruments to pass through a single access point, leading to instruments collide or work at unfamiliar angles. Thus, we designed an internal grasper under magnetic anchoring guide system (MAGS) platform and investigated its utility and operability. METHODS: We measured the configuration for magnetic force decay over distance using a standardized, ex vivo laboratory testing apparatus. An electronic balance was used to measure the force of the gallbladder pull in ten patients with gallbladder stones. One pig (11 mm abdominal wall thickness) underwent a compressed trial of MAGS platform. The device was left in place for 20 min before tissue sections were harvested, and histologic assessment was performed. The utility and operability were investigated in four pigs (38-280 kg weight). RESULTS: The magnetic attraction force decayed exponentially over distance; the force of pulling gallbladder was 7.46 ± 0.54 N. This pairing of components allowed for coupling to a theoretical distance of 10 mm. No gross tissue damage was observed. H-E stain showed no necrosis in all specimens. One failed due to wall thickness of 45 mm. Others showed the critical view, triangulation of instruments was obtained, and instrument collision or "sword fighting" was reduced. CONCLUSIONS: The MAGS platform overcomes limitations such as collisions and lack of triangulation, reduces transabdominal port sites, and is easy to operate. However, our internal grasper requires the abdominal wall thickness below 10 mm.


Assuntos
Laparoscopia , Magnetismo/instrumentação , Animais , Desenho de Equipamento , Modelos Animais , Instrumentos Cirúrgicos , Suínos
14.
Int Urogynecol J ; 28(2): 241-247, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27530520

RESUMO

INTRODUCTION AND HYPOTHESIS: Rectovaginal fistula (RVF) is an abnormal epithelium-lined connection between the rectum and vagina. The primary effective treatment is surgical repair, but recurrence remains a challenge. Magnetic compression anastomosis (MCA), an alternative to suturing, has been developed to generate an anastomosis between various hollow viscera. We hypothesized that the MCA approach could be used to treat RVF. METHOD: We designed a novel MCA device for RVF treatment and evaluated the magnetic compression procedure in a RVF pig model in comparison with the traditional suturing procedure. Following satisfactory outcomes, we also applied the MCA procedure to a human patient with recurrent RVF. The MCA device was designed based on the anatomical characteristics of the pig vagina and previous literature. The pig RVF model were established surgically (n = 12), and compression and control groups were each treated. The data were analyzed by one-way analysis of variance. RESULTS: qqExcept in one animal in each group, the RVF site was smooth and healing was complete. Histological analysis confirmed complete healing of the RVF with high histological continuity to neighboring tissues. The compression procedure applied to our patient with RVF was successful. The patient recovered quickly without complications, and RVF did not recur during a 15-month follow-up. CONCLUSIONS: From this preliminary investigation, MCA using our novel device appears to be a safe, simple, and effective nonsurgical procedure for the treatment of RVF.


Assuntos
Imãs , Fístula Retovaginal/terapia , Procedimentos Cirúrgicos sem Sutura/instrumentação , Adulto , Canal Anal/cirurgia , Análise de Variância , Animais , Estudos de Casos e Controles , Desenho de Equipamento , Feminino , Humanos , Modelos Animais , Recidiva , Procedimentos Cirúrgicos sem Sutura/métodos , Suturas/efeitos adversos , Suínos , Resultado do Tratamento , Vagina/cirurgia , Cicatrização
16.
J Surg Res ; 200(2): 508-13, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26500185

RESUMO

BACKGROUND: Poloxamer 407 (P407) is a thermosensitive polymer that can gelatinize at body temperature and dissolve below critical temperature. The aim of this study was to evaluate an optimized procedure for hepatectomy, in which the target liver section was stained with methylene blue, and the blood inflow was occluded with P407. METHODS: Twelve dogs were randomized into two equal groups. The conventional group (CG) underwent unstained liver resection with the hemi-Pringle maneuver for blood control. After angiography, the optimized group (OG) was cannulated to the target lobar hepatic artery via the femoral artery and to the target segmental portal vein via a branch of the splenic vein. The artery was then occluded with P407, whereas the vein was administered methylene blue and P407 sequentially before excision along the stained border. Blood specimens and necropsy were acquired periodically. RESULTS: The stained resection margins were clearly visualized and were accompanied by negligible blood loss. The occlusion duration was significantly reduced from 24.5 ± 2.3 min in the conventional group to 18.5 ± 4.9 min in the OG (P < 0.05). The aspartate aminotransferase and alanine aminotransferase levels were less elevated in the OG postoperatively. No significant evidence of pathology was detected in either group. CONCLUSIONS: This optimized procedure represents an easy, time-saving and effective approach for stained anatomic hepatectomy with temporary intravascular blood occlusion.


Assuntos
Perda Sanguínea Cirúrgica/prevenção & controle , Procedimentos Médicos e Cirúrgicos sem Sangue/métodos , Embolização Terapêutica/métodos , Hemostasia Cirúrgica/métodos , Hemostáticos/uso terapêutico , Hepatectomia/métodos , Poloxâmero/uso terapêutico , Animais , Corantes , Cães , Masculino , Azul de Metileno , Distribuição Aleatória , Resultado do Tratamento
17.
Sci Rep ; 14(1): 1865, 2024 01 22.
Artigo em Inglês | MEDLINE | ID: mdl-38253773

RESUMO

Magnetic compression anastomosis has been reported to have remarkable clinical outcomes. Here, we tested the applicability of a Y-Z deformable magnetic ring (DMR) for non-surgical manipulation of rectal stenosis (RS) in a beagle dog model under a transanal single-access condition. RS was modeled in 8 beagle dogs using partial ligation with silk thread. Under X-ray guidance, the Y-Z DMR was positioned at the proximal and distal ends of the RS, and the magnetic ring was bent into an "O" shape, such that the two rings were magnetically attracted. Operation time, complications during or after operation, and discharge time of the magnetic rings were recorded. The anastomosis bursting pressure was measured two weeks after removing the rings, and its formation was assessed through gross and histological examination. Partial ligation with a silk thread successfully established the canine RS model. After Y-Z DMR installation, the magnetic ring was successfully reconfigured from an "S" to an "O" shape. Strong attraction existed between the rings. The operation time was 9-15 min (average: 11.75 ± 1.98 min). No rectal bleeding or perforation occurred during or after operation. The ring was naturally expelled 7-10 days after surgery. A pressure of > 300 mmHg was recorded at the point of anastomosis rupture. The rectal anastomosis appeared to have healed properly on the surface, which was confirmed histologically, signifying the success of this procedure. A Y-Z DMR facilitated the successful recanalization of transanal single-channel RS without needing surgery in an animal model.


Assuntos
Fenômenos Magnéticos , Seda , Animais , Cães , Constrição Patológica/cirurgia , Fenômenos Físicos , Anastomose Cirúrgica
18.
J Vis Exp ; (204)2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38407239

RESUMO

Liver transplantation is the primary treatment for end-stage liver disease. However, the shortage and inadequate quality of donor organs necessitate the development of alternative therapies. Bioartificial livers (BALs) utilizing decellularized liver matrix (DLM) have emerged as promising solutions. However, sourcing suitable DLMs remains challenging. The use of a decellularized spleen matrix (DSM) has been explored as a foundation for BALs, offering a readily available alternative. In this study, rat spleens were harvested and decellularized using a combination of freeze-thaw cycles and perfusion with decellularization reagents. The protocol preserved the microstructures and components of the extracellular matrix (ECM) within the DSM. The complete decellularization process took approximately 11 h, resulting in an intact ECM within the DSM. Histological analysis confirmed the removal of cellular components while retaining the ECM's structure and composition. The presented protocol provides a comprehensive method for obtaining DSM, offering potential applications in liver tissue engineering and cell therapy. These findings contribute to the development of alternative approaches for the treatment of end-stage liver disease.


Assuntos
Doença Hepática Terminal , Baço , Animais , Ratos , Terapia Baseada em Transplante de Células e Tecidos , Matriz Extracelular
19.
Sci Rep ; 14(1): 10602, 2024 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-38719935

RESUMO

Although the application of magnetic compression anastomosis is becoming increasingly widespread, the magnets used in earlier studies were mostly in the shape of a whole ring. Hence, a deformable self-assembled magnetic anastomosis ring (DSAMAR) was designed in this study for gastrointestinal anastomosis. Furthermore, its feasibility was studied using a beagle model. The designed DSAMAR comprised 10 trapezoidal magnetic units. Twelve beagles were used as animal models, and DSAMARs were inserted into the stomach and colon through the mouth and anus, respectively, via endoscopy to achieve gastrocolic magnamosis. Surgical time, number of failed deformations, survival rate of the animals, and the time of magnet discharge were documented. A month later, specimens of the anastomosis were obtained and observed with the naked eye as well as microscopically. In the gastrocolic anastomosis of the 12 beagles, the procedure took 65-120 min. Although a deformation failure occurred during the operation in one of the beagles, it was successful after repositioning. The anastomosis was formed after the magnet fell off 12-18 days after the operation. Naked eye and microscopic observations revealed that the anastomotic specimens obtained 1 month later were well-formed, smooth, and flat. DSAMAR is thus feasible for gastrointestinal anastomosis under full endoscopy via the natural orifice.


Assuntos
Anastomose Cirúrgica , Estudos de Viabilidade , Animais , Cães , Anastomose Cirúrgica/métodos , Estômago/cirurgia , Imãs , Magnetismo , Cirurgia Endoscópica por Orifício Natural/métodos , Cirurgia Endoscópica por Orifício Natural/instrumentação , Colo/cirurgia , Masculino
20.
Sci Rep ; 14(1): 12462, 2024 05 30.
Artigo em Inglês | MEDLINE | ID: mdl-38816430

RESUMO

Various surgical methods have so far been developed for treating rectovaginal fistula (RVF), each with its own advantages and disadvantages. The lack of standardized animal models of RVF is a major reason for the failure to establish a unified and effective surgical method for the treatment of RVF. This study aimed to explore the feasibility of an RVF animal model by magnetic compression and compare it with the traditional modeling method. Thirty-two female Japanese white rabbits were randomly divided into four groups: A, B, C, and D, based on how the rectovaginal septum was treated. The operation time, intraoperative blood loss, and model success rate of each group were determined. The experimental animals were euthanized 2 weeks after the operation. Their rectovaginal septum specimens were obtained. RVF was observed by the naked eye. The fistula size was measured. Histological changes of fistula were observed by hematoxylin and eosin and Masson staining. All rabbits completed the RVF model and survived 2 weeks after the operation. Groups A and B had no bleeding, while groups C and D had < 0.5 mL of bleeding. The magnet detached in 4-6 days in group A, while it remained in place for 2 weeks after surgery in group B. Only one group D rabbit had a plastic hose for 2 weeks after surgery. The RVFs of groups A and C healed by themselves. In group B, the fistula was well formed. In group D, fistula healing was observed in three animals and the diameter of the fistulas was only 2.82-4.64 mm in the other four animals. Groups B and D had a scar on the inner surface of fistulas. Our study shows that the magnetic compression technique based on the T-shaped magnet is a highly useful method to establishing a continuous and stable RVF model in rabbits.


Assuntos
Modelos Animais de Doenças , Fístula Retovaginal , Animais , Coelhos , Feminino , Fístula Retovaginal/cirurgia , Fístula Retovaginal/patologia
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