Experimental Validation of a Tissue-Joining Implant Providing Flexible Adaptation to the Thickness of the Stomach Wall

Endoscopy is gradually replacing open surgery in the gastrointestinal tract. Therefore, novel medical devices and instrumentation are required, such as flexible miniaturized mechanisms for tissue joining and manipulation. In this paper, an absorbable implant for the purpose of long-term tissue fixation is presented. An experimental validation of the implant design and functionality is introduced. The implant achieves tissue penetration and provides flexible adaptation according to the thickness of two stomach walls. This mechanism is easy as it is based on push-pull principle using unidirectional forces. The shape optimization of each implant part occurs by varying design-influencing factors. The load transmission on postmortem porcine tissue was measured in the frame of the experimental setup. The feasibility of the implant was tested, and the forces needed for the intended application quantified. The implant successfully achieves tissue penetration, load transmission, adjustment, and fixation. It is a new alternative to conventional tissue-joining mechanisms.

[1]  Blake Hannaford,et al.  Biomechanical properties of abdominal organs in vivo and postmortem under compression loads. , 2008, Journal of biomechanical engineering.

[2]  G. Raju Endoscopic Closure of Gastrointestinal Leaks , 2009, The American Journal of Gastroenterology.

[3]  A W Partin,et al.  New laparoscopic suturing device: initial clinical experience. , 1995, Urology.

[4]  Sergey V Kantsevoy,et al.  Eagle Claw II: A novel endosuture device that uses a curved needle for major arterial bleeding: a bench study. , 2005, Gastrointestinal endoscopy.

[5]  Alberto Arezzo,et al.  Endoscopic closure of gastric access in perspective NOTES: an update on techniques and technologies , 2010, Surgical Endoscopy.

[6]  Paul Swain,et al.  Endoluminal Methods for Gastrotomy Closure in Natural Orifice TransEnteric Surgery (NOTES) , 2006, Surgical innovation.

[7]  P. Uggowitzer,et al.  Microstructure and mechanical properties of microalloyed and equal channel angular extruded Mg alloys , 2008 .

[8]  P. Uggowitzer,et al.  On the in vitro and in vivo degradation performance and biological response of new biodegradable Mg-Y-Zn alloys. , 2010, Acta biomaterialia.

[9]  H. Aguib,et al.  Absorbable Biomaterials for Medical Devices: A Redesign of Endoscopic Rivets for Biological Tissue , 2008, 2008 Cairo International Biomedical Engineering Conference.

[10]  Jenny Dankelman,et al.  Slip and damage properties of jaws of laparoscopic graspers , 2004, Surgical Endoscopy.

[11]  D. Martin,et al.  Endoluminal suturing may overcome the limitations of clip closure of a gaping wide colon perforation (with videos). , 2007, Gastrointestinal Endoscopy.

[12]  H. Nagai,et al.  An abdominal wall-lift method of laparoscopic cholecystectomy without peritoneal insufflation. , 1993, Surgical laparoscopy & endoscopy.

[13]  L. Swanstrom,et al.  Developing essential tools to enable transgastric surgery , 2008, Surgical Endoscopy.

[14]  V. Egorov,et al.  Mechanical properties of the human gastrointestinal tract. , 2002, Journal of biomechanics.

[15]  W E Bolch,et al.  Individual variations in mucosa and total wall thickness in the stomach and rectum assessed via endoscopic ultrasound. , 2003, Physiological measurement.

[16]  H. Feußner,et al.  Endoluminal endosurgery: rivet application in flexible endoscopy. , 2006, Gastrointestinal endoscopy.

[17]  J. Marescaux,et al.  A new method to close the gastrotomy by using a cardiac septal occluder: long-term survival study in a porcine model. , 2007, Gastrointestinal endoscopy.

[18]  B. Miedema,et al.  Natural orifice transluminal endoscopic surgery. , 2008, Surgical endoscopy.

[19]  Tim C. Lueth,et al.  Concepts for Completely Absorbable Wound Closing Rivets and Prototype Manufacturing , 2009 .