Mechanical lengthening in multiple intestinal segments in-series

Abstract Purpose Current models of mechanical intestinal lengthening employ a single device in an isolated segment. Here we demonstrate that polycaprolactone (PCL) springs can be deployed in-series to lengthen multiple intestinal segments simultaneously to further increase overall intestinal length. Methods A Roux-en-y jejunojejunostomy with a blind Roux limb was created in the proximal jejunum of rats. Two encapsulated 10-mm PCL springs were placed in-series into the Roux limb and were secured with clips. After 4 weeks, the lengthened segments were retrieved for histological analyses. Results Lengthening two intestinal segments simultaneously was achieved by placing two PCL springs in-series. The total combined length of the lengthened segments in-series was 45 ± 4 mm. The two jejunal segments with PCL springs (25 ± 2 and 20 ± 2 mm) were significantly longer than control segments without the spring (14 ± 1 mm, p < 0.05). Conclusion Spring-mediated lengthening can be achieved using multiple springs placed sequentially. The use of the Roux-en-y surgical model allowed easy insertion of springs in a blind Roux limb and arrange them in-series. Combined with relengthening techniques, we can use these methods to increase the length of small intestine to reach clinical significance. Level of Evidence: 1 Experimental