Extraluminal helicoidal stretch (Helixtretch): A novel method of intestinal lengthening

PurposeWe sought to test a novel, extraluminal method of intestinal lengthening that precludes violation of the intestinal wall.MethodsSprague–Dawley rats (n = 45) with size-matched bowel segments isolated by Roux-en-Y reconstruction were divided into three groups. Group 1 (n = 14) had no further manipulations. In Groups 2 (n = 12) and 3 (n = 19), the isolated segment was wrapped around a length-matched device in a helicoidal fashion. In Group 2, the device consisted of plain polyurethane tubing. In Group 3, it consisted of a gradually expanding hygroscopic hydrogel (12.5 mm final diameter). Euthanasia was performed at 8–21 days. Statistical analysis was by two-way ANOVA (P < 0.05).ResultsOverall survival was 87% (39/45). There was a statistically significant increase in bowel length in Group 3 compared to the other two groups (P < 0.001). This increase correlated with the number of helicoidal coils (P = 0.018), but not with post-operative time (P > 0.50). There were no significant differences in total DNA/protein ratio across the groups (P = 0.65). Histologically, there was an apparent increase in the goblet cell density in Group 3.ConclusionsMeasured extraluminal helicoidal stretch (Helixtretch) is tolerated by the intestine. Helixtretch induces bowel lengthening in a rodent model. Further analysis of this novel, minimally invasive alternative for intestinal augmentation is warranted.