Magnetic compression anastomosis – an insight from the past into the future
Anatole KOTLOVSKY | Oliver Muensterer
Seance of wednesday 24 april 2024 (La chirurgie viscérale magnétique)
DOI number : 10.26299/aew6-gp08/emem.2024.15.01
Abstract
Originating in the 1970s, magnetic compression anastomosis (MCA) has lately been revisited focusing on minimal invasive surgery (MIS). Aiming to encourage future MCA advancement, we outline our earlier experience with MCA from the 80’s– 90’s which comprised preclinical evaluations on animals and clinical trials in paediatric patients.
The experimental studies, including 250 MCA in gastrointestinal and urinary tracts, demonstrated the technical versatility of MCA as well as its superior bio-mechanical characteristics versus hand-sewn anastomoses. Clinical trials encompassed 98 MCA procedures in 97 children, 2 to 10 years of age, with digestive and urinary conditions, involving the following original techniques: non-operative esophageal recanalization, non-operative ileostomy undiversion, Swenson type pull-through, extravesical ureterocystoneostomy, non-operative urethral recanalization and posterior urethra reconstruction. MCA clinical success was achieved in over 85% of cases. The adverse events concerning anastomotic failure and post
-anastomotic scarring were considered to occur due to suboptimal magnetic compression.
In a view of current MCA development, we highlight the need for further research into MCA biology to ensure MCA optimal formation without adverse effects. Our proposals to design specific magnets and an auxiliary device are directed towards future standardization of MCA to be universally utilized for broad-spectrum surgical applications, especially in combination with MIS techniques.
Anatole Kotlovsky MD PhD and Oliver Muensterer MD PhD
Affiliation: Department of Pediatric Surgery, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University Medical Center, Lindwurmstrasse, 480337 Munich, Germany
The experimental studies, including 250 MCA in gastrointestinal and urinary tracts, demonstrated the technical versatility of MCA as well as its superior bio-mechanical characteristics versus hand-sewn anastomoses. Clinical trials encompassed 98 MCA procedures in 97 children, 2 to 10 years of age, with digestive and urinary conditions, involving the following original techniques: non-operative esophageal recanalization, non-operative ileostomy undiversion, Swenson type pull-through, extravesical ureterocystoneostomy, non-operative urethral recanalization and posterior urethra reconstruction. MCA clinical success was achieved in over 85% of cases. The adverse events concerning anastomotic failure and post
-anastomotic scarring were considered to occur due to suboptimal magnetic compression.
In a view of current MCA development, we highlight the need for further research into MCA biology to ensure MCA optimal formation without adverse effects. Our proposals to design specific magnets and an auxiliary device are directed towards future standardization of MCA to be universally utilized for broad-spectrum surgical applications, especially in combination with MIS techniques.
Anatole Kotlovsky MD PhD and Oliver Muensterer MD PhD
Affiliation: Department of Pediatric Surgery, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University Medical Center, Lindwurmstrasse, 480337 Munich, Germany