Published online Nov 14, 2020. doi: 10.3748/wjg.v26.i42.6614
Peer-review started: August 12, 2020
First decision: August 22, 2020
Revised: August 29, 2020
Accepted: September 10, 2020
Article in press: September 10, 2020
Published online: November 14, 2020
Although previous studies have confirmed the feasibility of magnetic compression anastomosis (MCA), there is still a risk of long-term anastomotic stenosis. For traditional MCA devices, a large device is associated with great pressure, and eventually increased leakage.
To develop a novel MCA device to simultaneously meet the requirements of pressure and size.
Traditional nummular MCA devices of all possible sizes were used to conduct ileac anastomosis in rats. The mean (± SD) circumference of the ileum was 13.34 ± 0.12 mm. Based on short- and long-term follow-up results, we determined the appropriate pressure range and minimum size. Thereafter, we introduced a novel “fedora-type” MCA device, which entailed the use of a nummular magnet with a larger sheet metal.
With traditional MCA devices, the anastomoses experienced stenosis and even closure during the long-term follow-up when the anastomat was smaller than Φ5 mm. However, the risk of leakage increased when it was larger than Φ4 mm. On comparison of the different designs, it was found that the “fedora-type” MCA device should be composed of a Φ4-mm nummular magnet with a Φ6-mm sheet metal.
The diameter of the MCA device should be greater than 120% of the enteric diameter. The novel “fedora-type” MCA device controls the pressure and optimizes the size.
Core Tip: To address some of the deficiencies in the current magnetic compression anastomosis (MCA) model, we explored the optimal size and pressure of the MCA device for intestinal anastomosis in rats. We found that the suggested diameter of the MCA device should be larger than 120% of the enteric diameter to avoid stenosis. Further, we developed a novel “fedora-type” MCA device for the current model, using a Φ4-mm nummular magnet with a Φ6-mm sheet metal. This model safely formed anastomosis and ensured long-term anastomosis. This novel anastomat controlled pressure and optimized the size, thus meeting our stipulated requirements.