title: Flow through a mechanical distraction enterogenesis device: a pilot test.
abstract: BACKGROUND
  We tested the coupling portion of a prototype intraluminal distraction enterogenesis device to allow flow-through of simulated enteric contents (SEC) in both pig and human jejunum.
  
  
  METHODS
  SEC was made using 80% corn syrup. Ten-cm pig and human intestinal segments had a spoke-shaped 2.2 cm coupling adaptor sutured in place, intraluminally. The adaptor had a flow-through area of 33.6 mm(2). SEC was pumped into the proximal part of the intestinal segment at 0.083 mL/s. The times to first passage of SEC through the coupler (first drop), 10 mL, and 20 mL of SEC eluted from the distal end were recorded.
  
  
  RESULTS
  Mean time to first drop elution was 155 ± 38 s with pig, and 149 ± 22 s with human bowel (P = 0.8). This corresponded to a hydrostatic pressure of 37.5 mmHg before the initial drop passed through. Mean flow rates were 0.094 mL/s in pig bowel and 0.084 mL/s in human bowel (P = 0.09). To account for occlusion from luminal debris, a 75% occlusion of coupler holes was studied in the smaller pig bowel to investigate if reductions in flow-through area could be tolerated. Mean time to first drop increased slightly to 171 ± 15 s, but the elution rate stayed the same (P = 0.5).
  
  
  CONCLUSIONS
  After a physiologic level of initial pressure buildup allowing the first drop of SEC to pass the coupling adaptor, our prototype intestinal coupling adaptor did not obstruct flow-through of SEC, even after a 75% decrease in flow-through area. This type of attachment represents a viable approach to placing a device in-continuity without obstructing flow of enteric contents.
authors.affiliation: Section of Pediatric Surgery, Department of Surgery and the C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Eiichi A
authors.initials: EA
authors.lastname: Miyasaka
authors.forename: Manabu
authors.initials: M
authors.lastname: Okawada
authors.forename: Richard
authors.initials: R
authors.lastname: Herman
authors.forename: Brent
authors.initials: B
authors.lastname: Utter
authors.forename: Jonathan
authors.initials: J
authors.lastname: Luntz
authors.forename: Diann
authors.initials: D
authors.lastname: Brei
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Teitelbaum
mesh_terms: D000818:Animals; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D007415:Intestinal Obstruction / Q000517:prevention & control; D007583:Jejunum / Q000254:growth & development / Q000502:physiology* / Q000601:surgery*; D008954:Models, Biological; D010865:Pilot Projects; D011312:Pressure; D019736:Prostheses and Implants; D011474:Prosthesis Design; D012778:Short Bowel Syndrome / Q000503:physiopathology / Q000601:surgery*; D013314:Stress, Mechanical; D034421:Sus scrofa; D014783:Viscosity