Intestinal lengthening via multiple in-continuity springs

J Pediatr Surg. 2019 Jan;54(1):39-43. doi: 10.1016/j.jpedsurg.2018.10.036. Epub 2018 Oct 5.


Background: Short bowel syndrome is a debilitating condition with few effective treatments. Spring-mediated distraction enterogenesis can be used to lengthen intestine. The purpose of this study is to determine whether multiple springs in series can safely increase the total amount of lengthening.

Methods: Juvenile mini-Yucatan pigs each received three nitinol springs placed within their jejunum. Plication was used to narrow the intestine around each spring to secure them. Compressed springs were used in the experimental group, while uncompressed springs were used in the control group. The intestine was examined 3 weeks later for lengthening and histologic changes.

Results: All pigs tolerated diets postoperatively with continued weight gain, and no dilation or obstruction of the intestine was observed. Segments of intestine that contained compressed springs had a significant increase in length from 2.5 cm to 3.9 ± 0.2 cm per spring, compared to segments containing control springs that showed no change (p < 0.001).

Conclusions: Intestinal plication can be safely used to secure multiple springs in series to achieve intestinal lengthening without compromising intestinal function. Using several springs at once allows for a greater amount of total lengthening. This is a promising model that has potential in the treatment of short bowel syndrome.

Keywords: Distraction enterogenesis; Plication; Short bowel syndrome; Spring-mediated lengthening.

MeSH terms

  • Alloys / pharmacology
  • Animals
  • Digestive System Surgical Procedures / instrumentation
  • Digestive System Surgical Procedures / methods*
  • Intestines / surgery*
  • Short Bowel Syndrome / surgery*
  • Swine
  • Tissue Expansion Devices*


  • Alloys
  • nitinol