title: A novel double-balloon catheter device for fully endoluminal intestinal lengthening.
abstract: OBJECTIVE
  Distraction enterogenesis may provide a novel therapy for short bowel syndrome (SBS). Previously described methods have relied upon isolated intestinal segments or transmural fixation. Our objective was to develop a novel, fully endoluminal device, permitting placement and removal through an enteral stoma or orifice.
  
  
  METHODS
  A flexible device was designed consisting of two latex balloons mounted on coaxial catheters. The inner catheter allowed longitudinal force transmission from an external spring. Yorkshire pigs underwent jejunal Roux limb creation with device placement via jejunostomy. Balloons were inflated to 52 mmHg without significant reduction in bowel perfusion as measured by laser Doppler. The device was explanted after 7 days.
  
  
  RESULTS
  Distracted bowel achieved an increase in length of 26.1 ± 6.1 % vs nondistracted fed bowel. As the device resided in unfed bowel, a 66.7 ± 14.5% increase vs unfed bowel was noted. These corresponded to a gain of 6.3 ± 2.3 cm (0.9 ± 0.3 cm/day) and 12.9 ± 7.6 cm (1.8 ± 1.1 cm/day), respectively. Attachment sites demonstrated occasional epithelial sloughing with no balloon-associated perforation.
  
  
  CONCLUSIONS
  A novel double-balloon catheter device allows for fully endoluminal distraction enterogenesis. This approach may allow development of clinically applicable technology for the treatment of patients with SBS.
authors.affiliation: Section of Pediatric Surgery, Department of Surgery, University of Michigan, Mott Children's Hospital F3970, Ann Arbor, MI, 48109-0245, USA.
authors.forename: Farokh R
authors.initials: FR
authors.lastname: Demehri
authors.forename: Philip M
authors.initials: PM
authors.lastname: Wong
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Freeman
authors.forename: Yumi
authors.initials: Y
authors.lastname: Fukatsu
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Teitelbaum
mesh_terms: D000818:Animals; D057785:Catheters; D004195:Disease Models, Animal; D004867:Equipment Design; D005260:Female; D007583:Jejunum / Q000601:surgery*; D012778:Short Bowel Syndrome / Q000601:surgery*; D013552:Swine; D015626:Tissue Expansion / Q000379:methods*; D015625:Tissue Expansion Devices