大鼠肝下下腔静脉端端磁吻合技术探究

王新颖; 杨丽斐; 任璐; 万永; 吕毅; 王善佩; 卢强

doi:10.3969/j.issn.1674-7445.2022.04.011

大鼠肝下下腔静脉端端磁吻合技术探究

doi: 10.3969/j.issn.1674-7445.2022.04.011

710061 西安，西安交通大学第一附属医院精准外科与再生医学国家地方联合工程研究中心（王新颖、杨丽斐、吕毅、王善佩、卢强），涉外病房（任璐），老年外科（万永、卢强）

基金项目:

陕西省重点研发计划高校联合项目-重点项目 2021GXLH-Z-047

陕西省自然科学基础研究计划资助项目 2020JQ-528

详细信息

作者简介:

通讯作者:
卢强，男，1990年生，博士，住院医师，研究方向为磁外科技术基础研究及临床应用，Email：thesurgeon@163.com

中图分类号: R617, R622+.4
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出版历程
- 收稿日期: 2022-04-07
- 网络出版日期: 2022-07-14
- 刊出日期: 2022-07-15

Study of end-to-end magnetic anastomosis technique of infrahepatic inferior vena cava in rats

National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China

More Information

Corresponding author: Lu Qiang, Email: thesurgeon@163.com

摘要

摘要: 目的研制一种适用于大鼠肝下下腔静脉的磁性吻合装置并验证其可行性及安全性。方法根据大鼠下腔静脉解剖特点，设计并加工了一种适用于大鼠肝下下腔静脉端端吻合的磁性装置，该装置分为内环和外环两个部分，内环为具有镀层的钕铁硼磁环，外环由聚醚醚酮经3D打印制成，其上均匀分布10个细孔，其中5个细孔用于加载细针，另外5个细孔在吻合时与对侧吻合环的细针相互嵌合。将外环上均匀加载细针后与内环粘接在一起组成磁性吻合环，将两侧血管断端穿过吻合环后外翻固定至细针上，再将两侧磁性吻合环相吸便完成血管吻合。选取20只SD大鼠利用磁性吻合装置进行肝下下腔静脉端端磁吻合，分析大鼠术中血管阻断时间、术后存活情况、术后吻合口通畅情况和术后吻合口大体观及组织学检查情况。结果所有大鼠均顺利完成大鼠肝下下腔静脉端端磁吻合，血管阻断时间为4~6 min。其中1只大鼠在术后10 d死亡，其余大鼠均存活至术后2个月。存活大鼠术后1 d、3 d、1个月及2个月血管吻合口通畅率分别为100%、100%、95%及95%。术后2个月时血管吻合装置未发现明显移位、成角，血管吻合环未发现明显腐蚀、裂解迹象，周围组织未见明显增生及水肿，两侧血管断端已完全愈合，吻合口未见明显狭窄及血栓形成。组织学检查发现吻合口两侧血管管壁连续性良好，吻合口内面可见内皮细胞覆盖，未见血栓及纤维组织附着。结论利用本研究设计的磁性吻合装置施行大鼠肝下下腔静脉端端磁吻合是安全可行的。
- 磁吻合技术 /
- 大鼠下腔静脉 /
- 端端吻合 /
- 血管吻合 /
- 钕铁硼磁环 /
- 聚醚醚酮环 /
- 吻合口狭窄 /
- 血栓
Abstract: Objective To develop a magnetic anastomosis device for infrahepatic inferior vena cava and verify its feasibility and safety in rat models. Methods According to the anatomical characteristics of rat inferior vena cava, a magnetic device suitable for end-to-end anastomosis of infrahepatic inferior vena cava was designed and manufactured. The device consisted of the inner and outer rings. The inner ring was a coated neodymium-iron-boron magnetic ring, and the outer ring was made of polyetheretherketone by 3D printing. Ten fine holes are evenly distributed on the outer ring, of which 5 fine holes were used to load the fine needles, and the other 5 fine holes were mutually connected with the fine needles of the contralateral anastomosis ring during anastomosis. The outer ring was uniformly loaded with fine needles and then bonded with the inner ring to form a magnetic anastomosis complex. Bilateral ends of vessels passed through the anastomosis ring and were fixed to the fine needles, and then end-to-end vascular anastomosis was performed by mutual attraction of two magnetic anastomosis rings. Twenty SD rats were selected and received end-to-end anastomosis of infrahepatic inferior vena cava with magnetic anastomosis device. The time of vascular occlusion, postoperative survival, postoperative anastomotic patency, gross observation and histological examination of anastomotic stoma were analyzed. Results All rats successfully completed end-to-end magnetic anastomosis of the infrahepatic inferior vena cava, and the time of vascular occlusion was 4~6 min. One rat died at 10 d after operation, and the other rats survived within postoperative 2 months. The patency rates of anastomotic stoma in surviving rats at postoperative 1 d, 3 d, 1 month and 2 months were 100%, 100%, 95% and 95%, respectively. At 2 months after operation, no obvious displacement and angulation of the anastomosis device were seen. No signs of corrosion and cracking of the anastomosis rings were observed. No evident hyperplasia and edema of surrounding tissues were noted. Bilateral ends of vessels were completely healed, and no obvious stenosis or thrombosis was found at the anastomotic stoma. Histological examination showed high continuity of bilateral vascular walls of anastomotic stoma, the inner surface of anastomotic stoma was covered by endothelial cells, and no thrombus or fibrous tissue was attached. Conclusions It is safe and feasible to utilize the self-designed magnetic anastomosis device to perform end-to-end magnetic anastomosis of infrahepatic inferior vena cava in rat models.
- Magnetic anastomosis technique /
- Rat inferior vena cava /
- End-to-end anastomosis /
- Vascular anastomosis /
- Neodymium-iron-boron magnetic ring /
- Polyetherketone ring /
- Anastomotic stenosis /
- Thrombus

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图 1 适用于大鼠肝下下腔静脉端端吻合的磁性吻合装置

注：A图为外环，其上均匀分布针孔用于加载细针；B图为内环与加载细针的外环粘接制成的磁性吻合装置。

Figure 1. Magnetic anastomosis device for end-to-end anastomosis of the infrahepatic inferior vena cava in rats

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图 2 大鼠下腔静脉端端磁吻合的实验步骤

注：A图为安装磁性吻合装置；B图为吻合结束；C图为术后吻合口造影。

Figure 2. Experimental procedure of end-to-end magnetic anastomosis of the inferior vena cava in rats

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图 3 术后吻合口大体观及组织学检查

注：A图为术后吻合口大体观；B图为术后吻合口通畅；C图为吻合口局部无血栓及纤维组织附着；D图为吻合口组织学检查(免疫荧光，×10)。

Figure 3. Gross view and histological examination of postoperative anastomotic stoma

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