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The next step? Use of tissue fusion technology to perform the serial transverse enteroplasty--proof of principle.
J Pediatr Surg. 2012 May; 47(5):938-43.JP

Abstract

BACKGROUND

Serial transverse enteroplasty (STEP) is an established procedure for intestinal lengthening and tapering. A gastrointestinal linear stapler is used to taper the bowel sequentially. We report preliminary experience with tissue fusion technology to perform STEP in a porcine model.

METHODS

Four weaned male pigs (mean age, 4 ± 0 weeks; mean weight, 6.8 ± 0.1 kg) first underwent a 60-cm reversed intestinal segment followed by a STEP 4 to 6 weeks later. The LigaSure Impact (Covidien, Valleylab, Tyco Healthcare Group LP, Boulder, CO) was used to perform the procedure. Animals were fed on postoperative day 2 and terminated 1 week later. Morphometric data were collected, and intestinal tissue was obtained for histology.

RESULTS

Mean bowel caliber of 5.1 ± 0.5 cm was tapered to 1.8 ± 0.3 cm post-STEP with a mean increase in the length of the dilated segment of 82% ± 20%. All animals tolerated enteral feeding, and all survived to termination on day 7. Histologic evaluation revealed the zone of tissue fusion to be 7.1 ± 1.5 mm. Masson trichrome, hematoxylin and eosin, and polarized picrosirius red stains demonstrated that the fusion zone was well healed with overlying granulation tissue.

CONCLUSION

This is the first report of the successful application of radiofrequency energy to perform the STEP procedure in animals. Although further evaluation is required, tissue fusion devices may eventually provide an alternative to the linear stapler for the STEP procedure.

Authors+Show Affiliations

Division of General Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

22595577

Citation

Suri, Megha, et al. "The Next Step? Use of Tissue Fusion Technology to Perform the Serial Transverse Enteroplasty--proof of Principle." Journal of Pediatric Surgery, vol. 47, no. 5, 2012, pp. 938-43.
Suri M, Dicken B, Nation PN, et al. The next step? Use of tissue fusion technology to perform the serial transverse enteroplasty--proof of principle. J Pediatr Surg. 2012;47(5):938-43.
Suri, M., Dicken, B., Nation, P. N., Wizzard, P., Turner, J. M., & Wales, P. W. (2012). The next step? Use of tissue fusion technology to perform the serial transverse enteroplasty--proof of principle. Journal of Pediatric Surgery, 47(5), 938-43. https://doi.org/10.1016/j.jpedsurg.2012.01.048
Suri M, et al. The Next Step? Use of Tissue Fusion Technology to Perform the Serial Transverse Enteroplasty--proof of Principle. J Pediatr Surg. 2012;47(5):938-43. PubMed PMID: 22595577.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The next step? Use of tissue fusion technology to perform the serial transverse enteroplasty--proof of principle. AU - Suri,Megha, AU - Dicken,Bryan, AU - Nation,Patrick N, AU - Wizzard,Pamela, AU - Turner,Justine M, AU - Wales,Paul W, PY - 2012/01/16/received PY - 2012/01/26/accepted PY - 2012/5/19/entrez PY - 2012/5/19/pubmed PY - 2012/9/25/medline SP - 938 EP - 43 JF - Journal of pediatric surgery JO - J Pediatr Surg VL - 47 IS - 5 N2 - BACKGROUND: Serial transverse enteroplasty (STEP) is an established procedure for intestinal lengthening and tapering. A gastrointestinal linear stapler is used to taper the bowel sequentially. We report preliminary experience with tissue fusion technology to perform STEP in a porcine model. METHODS: Four weaned male pigs (mean age, 4 ± 0 weeks; mean weight, 6.8 ± 0.1 kg) first underwent a 60-cm reversed intestinal segment followed by a STEP 4 to 6 weeks later. The LigaSure Impact (Covidien, Valleylab, Tyco Healthcare Group LP, Boulder, CO) was used to perform the procedure. Animals were fed on postoperative day 2 and terminated 1 week later. Morphometric data were collected, and intestinal tissue was obtained for histology. RESULTS: Mean bowel caliber of 5.1 ± 0.5 cm was tapered to 1.8 ± 0.3 cm post-STEP with a mean increase in the length of the dilated segment of 82% ± 20%. All animals tolerated enteral feeding, and all survived to termination on day 7. Histologic evaluation revealed the zone of tissue fusion to be 7.1 ± 1.5 mm. Masson trichrome, hematoxylin and eosin, and polarized picrosirius red stains demonstrated that the fusion zone was well healed with overlying granulation tissue. CONCLUSION: This is the first report of the successful application of radiofrequency energy to perform the STEP procedure in animals. Although further evaluation is required, tissue fusion devices may eventually provide an alternative to the linear stapler for the STEP procedure. SN - 1531-5037 UR - https://www.unboundmedicine.com/medline/citation/22595577/The_next_step_Use_of_tissue_fusion_technology_to_perform_the_serial_transverse_enteroplasty__proof_of_principle_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3468(12)00117-0 DB - PRIME DP - Unbound Medicine ER -