Non-Operative Correction for Long-Gap Esophageal Atresia
PI(S):
Minkyun Noh
Sponsor(s):
Boston Children’s Hospital

About 1000 infants a year in the states are born with their esophagus disconnected, which is called Esophageal Atresia (EA). The standard operation for esophageal atresia is Foker process, which requires several thoracotomies for placing traction sutures on esophageal ends, followed by primary anastomosis. There have been attempts to develop non-operative method for correcting esophageal atresia, especially by using magnetic force. Hendren et al. explored electromagnetic bougienage method to correct long gap esophageal atresia. Zaritzky et al. presented a method of magnetic compression anastomosis, which took advantage of large attracting force between two rare-earth permanent magnets.

In our research, a non-operative correction method for long-gap esophageal atresia is proposed. A magnetic-tipped catheter was designed for bougienage and compression anastomosis. The magnetic tip comprise syringe mechanism with an outer barrel, which functions as a fluidic stand-off. The pressure of the fluid could be measured externally so as to estimate the tip force. The catheter moves back and forth by friction drive (long stroke), and the syringe mechanism at the tip also generates more displacement (short stroke). 

A pair of the magnetic catheter is put into proximal and distal esophageal pouches respectively. They apply cycling stretching force on esophagus to stimulate it to grow. Once the esophagus grows in sufficient amount, the fluid in the magnetic syringe could be drawn off for magnetic compression anastomosis; the large force between two magnets squeezes the esophageal tissue, necrosis and regeneration of the sandwiched tissue leading to the compression anastomosis.

To view our research poster, please click here.

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