title: Mechanical lengthening in multiple intestinal segments in-series.
abstract: OBJECTIVE
  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 4weeks, 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±4mm. The two jejunal segments with PCL springs (25±2 and 20±2mm) were significantly longer than control segments without the spring (14±1mm, p<0.05).
  
  
  CONCLUSIONS
  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.
  
  
  METHODS
  1 Experimental.
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, University of California, Los Angeles, CA, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Scott
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, University of California, Los Angeles, CA, USA.
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Rouch
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, University of California, Los Angeles, CA, USA.
authors.forename: Nhan
authors.initials: N
authors.lastname: Huynh
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, University of California, Los Angeles, CA, USA.
authors.forename: Elvin
authors.initials: E
authors.lastname: Chiang
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, University of California, Los Angeles, CA, USA.
authors.forename: Shant
authors.initials: S
authors.lastname: Shekherdimian
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, University of California, Los Angeles, CA, USA.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Lee
authors.affiliation: Department of Bioengineering, University of California, Los Angeles, CA, USA.
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Wu
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, University of California, Los Angeles, CA, USA; Department of Bioengineering, University of California, Los Angeles, CA, USA. Electronic address: jdunn@mednet.ucla.edu.
authors.forename: James C Y
authors.initials: JC
authors.lastname: Dunn
mesh_terms: D000713:Anastomosis, Roux-en-Y; D000818:Animals; D005260:Female; D007583:Jejunum / Q000601:surgery*; D023421:Models, Animal; D011091:Polyesters; D051381:Rats; D017207:Rats, Sprague-Dawley; D012778:Short Bowel Syndrome / Q000601:surgery*; D015626:Tissue Expansion / Q000295:instrumentation / Q000379:methods*; D015625:Tissue Expansion Devices
chemical_list: D011091:Polyesters; C016240:polycaprolactone
keywords: Biodegradable lengthening device; Bowel lengthening; Distraction enterogenesis; Mechanical enterogenesis; Short bowel syndrome; Spring lengthening device