一种创新的输尿管回肠吻合方法——基于兔模型的磁吻合

An innovative method of uretero-ileal anastomosis: magnetic anastomosis based on rabbit models

摘要

目的 使用实验兔动物模型，探讨磁吻合技术用于输尿管回肠吻合的可行性。方法 以6只实验兔为模型，剪开左侧输尿管下段，将子磁体置入到输尿管中段，结扎远端输尿管。打开回肠肠壁，经此置入母磁体，调整子、母磁体位置使其端端相吸，缝合关闭回肠肠壁切口。记录手术操作时间、术中出血量、术后并发症及磁体排出时间。术后2周行左侧输尿管造影，观察吻合口通畅情况，获取输尿管回肠吻合口标本，肉眼及光镜观察吻合口形成情况。结果 6只实验兔顺利实施了输尿管回肠磁吻合手术。手术操作时间28～39 min，平均（32.50±3.94）min，术中出血量均＜5 mL。实验兔术后恢复良好，未见外科手术相关并发症发生，所有动物均存活至实验观察终点。术后磁体排出时间9～13 d，平均（10.83±1.72）d。大体标本肉眼可见吻合口通畅，组织学观察见吻合口黏膜连续、光滑平整，吻合口形成良好。结论 磁吻合用于输尿管回肠吻合操作简单、吻合口形成良好，具有可行性，后续有望应用于临床患者。

Abstract

Objective To investigate the feasibility of magnetic anastomosis for uretero-ileal anastomosis using experimental rabbit models. Methods Six experimental rabbits were used as the models. The lower part of the left ureter was cut with scissors, the daughter magnet (DM) was placed in the middle of the ureter, and the distal end of the ureter was ligated. After that, the ileum wall was opened, the parent magnet (PM) was inserted through it, the positions of the PM and DM were adjusted so that their ends were attracted to each other, and then ileum wall incision was sutured. The operation time, intraoperative blood loss, postoperative complications and magnet discharge time were recorded. Two weeks after operation, left ureterography was performed to obtain the specimens of the uretero-ileal anastomosis, and to observe the patency of the anastomosis. The formation of the anastomosis was observed with naked eyes and light microscope. Results Uretero-ileal magnetic anastomosis was performed successfully in 6 experimental rabbits. The operation time was 28-39 (32.50±3.94) min, and the intraoperative blood loss was less than 5 mL. The rabbits recovered well after operation, and no complications were observed. All animals survived to the end point of observation. The disconnection time of magnet after operation was 9-13 (10.83±1.72) days. The gross specimen showed that the anastomosis was patent. The histological observation showed that the mucosa of the anastomosis was continuous and smooth, and the anastomosis was well formed. Conclusion Magnetic anastomosis is feasible for uretero-ileal anastomosis with simple operation and good anastomosis formation. After further experimental verification, this technique is expected to be used in clinical practice.

关键词

磁压榨技术 / 磁外科 / 输尿管回肠吻合 / 磁吻合 / 磁体

Key words

magnetic compression technique / magnetic surgery / uretero-ileal anastomosis / magnetic anastomosis / magnet

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基金资助

陕西省重点研发计划项目(2024SF-YBXM-447)

西安交通大学第一附属医院科研发展基金项目(2022MS-07)

陕西省医工融合高端医疗装备共性技术研发平台项目(2023GXJS-01)