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Integration between a percutaneous implant and the porcine small bowel.

Journal article
Authors Martin L Johansson
Peter Thomsen
Leif Hultén
Per Steinar Halvorsen
Erik Fosse
Bjørn Edwin
Published in Journal of biomedical materials research. Part B, Applied biomaterials
Volume 98
Issue 1
Pages 101-9
ISSN 1552-4981
Publication year 2011
Published at Institute of Clinical Sciences, Department of Surgery
Institute of Clinical Sciences, Department of Biomaterials
Pages 101-9
Language en
Links dx.doi.org/10.1002/jbm.b.31838
Subject categories Biomaterials Science, Clinical Medicine

Abstract

Inflammatory bowel diseases, cancer or trauma may require removal of all or part of the intestines, leaving the patient with a need to wear external stoma appliances for collection of bowel contents. By connecting the small bowel to a percutaneous port, equipped with a sealing lid, a fully continent and leak proof stoma can be created without a need for permanently wearing stoma appliance. The prerequisites for a connection between a permanent, transabdominal implant and a visceral organ are largely unexplored. Stoma ports made of titanium were implanted in the abdominal wall of domestic pigs and a branch of distal ileum was inserted through the ports. After being followed for 1-3 weeks, the ports were removed and subjected to histological evaluation to study the influence of their shape, structure, and position on the tissue response. Particular focus was attended to the attachment of the ileal serosal surface to the implants inner structure consisting of a titanium mesh. Macroscopic examination revealed fistulas and formation of abscesses in 4 of 11 the retrieved implants. Histological examination revealed regenerated and well-vascularized collagenous tissue around the mesh structure inside the implant. The integration was complete or partial for 10 of 11 ports. Despite various degrees of inflammation and tissue ingrowth, it was demonstrated for the first time that the serosal surface of ileum was firmly attached to the internal structure of the implant. These experiments provide a basis for optimization of the implant and surgical procedure before long-term functional animal experiments.

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