Abstract
Abstract The goal of our research work is the development of a novel endoscopic anastomosis device for the colon. One of the main challenges in this context is the application of forces at the endoscope tip to rejoin the two bowel endings. Thus, we focus on a magnetic two-part compression implant approach. The implant halves are detached from the applicator units by means of electromagnets. In this contribution we present the results of our experiments to determine the implant design with special focus on tissue compression forces and the resultant electromagnet dimensioning to estimate size requirements of the application/detachment system. To achieve the targeted compression forces derived from literature, we used cubic N52 magnetized neodymium magnets1 with a side length of 5 mm and mild steel screws. For these magnets, we evaluated a required electromagnetic repulsion force of 4.1 N. For the electromagnetic detachment system this led to the need for 166 windings for the coils on oral side, and 146 windings for the coils at the aboral side. Based on these requirements, a colonoscope diameter (~14 mm) increase of 10.6 mm on the oral side and of 12 mm on the aboral side due to the application device must be assumed. Nevertheless, this diameter still remains within the size range of other colonoscopic tools, such as e.g., circular staplers.
Highlights
In the context of intraoperative trauma minimization, therapeutic endoscopy has become increasingly important in recent years
We investigated the correlation between the magnetic attraction force of different neodymium-iron-boron magnets and a soft magnetic counterpart with respect to an increasing distance between the components
We decided for the strongest magnet, which remains within the feasible size range for NOTES-application systems
Summary
In the context of intraoperative trauma minimization, therapeutic endoscopy has become increasingly important in recent years. Procedures performed directly in the access lumen, such as endoscopic submucosal dissection in the colon, wound closure or the ablation of colonic polyps are already common clinical practice. For the last 15 years, procedures have been developed that even allow scarless surgical procedures in the abdominal cavity, and leaving the access lumen [1]. In 2006, the Society of American Gastrointestinal and Endoscopic Surgeons (AGES) published an overview of systems to further advance the establishment of surgical endoscopic techniques. While the tissue grows together in one area of the joined intestinal endings, it becomes necrotic inside the lumen. By this means the compression implant is excreted
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