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A novel double-balloon catheter device for fully endoluminal intestinal lengthening

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Abstract

Objective

Distraction enterogenesis may provide a novel therapy for short bowel syndrome (SBS). Previously described methods have relied upon isolated intestinal segments or transmural fixation. Our objective was to develop a novel, fully endoluminal device, permitting placement and removal through an enteral stoma or orifice.

Methods

A flexible device was designed consisting of two latex balloons mounted on coaxial catheters. The inner catheter allowed longitudinal force transmission from an external spring. Yorkshire pigs underwent jejunal Roux limb creation with device placement via jejunostomy. Balloons were inflated to 52 mmHg without significant reduction in bowel perfusion as measured by laser Doppler. The device was explanted after 7 days.

Results

Distracted bowel achieved an increase in length of 26.1 ± 6.1 % vs nondistracted fed bowel. As the device resided in unfed bowel, a 66.7 ± 14.5 % increase vs unfed bowel was noted. These corresponded to a gain of 6.3 ± 2.3 cm (0.9 ± 0.3 cm/day) and 12.9 ± 7.6 cm (1.8 ± 1.1 cm/day), respectively. Attachment sites demonstrated occasional epithelial sloughing with no balloon-associated perforation.

Conclusion

A novel double-balloon catheter device allows for fully endoluminal distraction enterogenesis. This approach may allow development of clinically applicable technology for the treatment of patients with SBS.

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Acknowledgments

Gail Rising, DVM, Amber Yanovich, LVT, and Janet Wolforth, LVT provided veterinary care and their contributions are appreciated. This research was supported by NIH 2R44DK085765-02, FDA P50 Pediatric Device Consortia Grant 2-P50-FD-003787-03, and a Hartwell Biomedical Research Award.

Conflict of interest

The authors declare no conflicts of interest relevant to this work.

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Authors and Affiliations

  1. Section of Pediatric Surgery, Department of Surgery, University of Michigan, Mott Children’s Hospital F3970, Ann Arbor, MI, 48109-0245, USA

    Farokh R. Demehri, Jennifer J. Freeman, Yumi Fukatsu & Daniel H. Teitelbaum

  2. MC3, Inc., Ann Arbor, MI, USA

    Philip M. Wong

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  1. Farokh R. Demehri
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  2. Philip M. Wong
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  3. Jennifer J. Freeman
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  4. Yumi Fukatsu
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Correspondence to Daniel H. Teitelbaum.

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Demehri, F.R., Wong, P.M., Freeman, J.J. et al. A novel double-balloon catheter device for fully endoluminal intestinal lengthening. Pediatr Surg Int 30, 1223–1229 (2014). https://doi.org/10.1007/s00383-014-3612-9

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  • DOI: https://doi.org/10.1007/s00383-014-3612-9

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