Application of Y-Z deformable magnetic ring for recanalization of transanal single-access rectal stricture.

Abstract

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 9-15min (average: 11.75 ± 1.98min). No rectal bleeding or perforation occurred during or after operation. The ring was naturally expelled 7-10days after surgery. A pressure of > 300mmHg 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.