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11–14 APRIL, 2018, HELSINKI, FINLAND
16:26–16:29
S3-11 (PP)
MAGNETIC COMPRESSION ANASTOMOSIS DEVICE
TO SIMPLIFY LAPAROSCOPIC PYELOPLASTY- REPORT
OF PRELIMINARY EXPERIMENTAL RESULTS
Tamas CSERNI
1
, Daniel HAJNAL
2
, Andras NAGY
3
, Daniel URBAN
2
, Daniel ERCES
2
,
Rainer KUBIAK
4
, George RAKOCZY
5
, Josef KASZAKI
2
and Supul HENNAYAKE
1
1) Royal Manchester Children's University Hospital, Paediatric Urology, Manchester, UNITED KINGDOM - 2) University
of Szeged, Institute of Surgical Research, Szeged, HUNGARY - 3) University of Szeged, Department of Radiology,
Szeged, HUNGARY - 4) Klinikum Braunschweig, Pediatric Surgery, Braunschweig, GERMANY - 5) Royal Manchester
Children's University Hospital, Paediatric Surgery, Manchester, UNITED KINGDOM
PURPOSE
The Anderson-Hynes pyeloplasty is a technically challanging laparoscopic procedure. The most
difficult part is the laparoscopic suturing of the uretero-pelvic anastomosis. Robotics is still an
exepensive alternative. Our aim is to design a cheap purpose-made device to simplify laparoscopic
pyeloplasty.
MATERIAL AND METHODS
After ethical approval laparoscopy was performed in 3 pigs to dissect the pyelo-ureteric junction
(PUJ) and create a side-to-side uretero-pelvic anastomosis with magnetic cylinders on a modified
"blue stent". The procedures were converted to open due to technical difficulty of inserting a ne-
phrosytomy catheter with the magnet into the non-dilated renal pelvis. In 3 further pigs the ureter
was first loosely ligated. Six weeks later transperitoneal laparoscopic procedure was successfully
used to tailor the dilated renal pelvis and perform a magnetic compression uretero-pelvic anas-
tomosis with a modified internal JJ stent. X-rays were performed on day 1, 7 and 14 postop. The
animals were sacrificed 6 weeks later, the position of the magnets, the patency of the anastomosis
was assessed and Hematoxilin-eosin staining was performed.
RESULTS
The magnets were found attached to each other on the 7
th
day postop. Narrow anastomosis was
seen in 3 cases where the magnets moved below or above the anastomosis. Wide and patent
anastomosis was found in 3 cases when the magnets remained at the level of the anastomosis
2 weeks after insertion.
CONCLUSIONS
It is possible to simplify laparoscopic pyeloplasty with a purpose-made magnetic compression
device. Our prototype still needs refinements but it may become a cheap alternative of robotics in
the future.