Design of Three-Dimensional-Printed Compression Ring for Enhanced Wound Healing of Colorectal Anastomosis to Minimize Dehiscence and Leakage Post Colectomy

Abstract

Bowel resection surgery, also known as colectomy, is a primary therapeutic intervention where a neoplastic or cancerous segment of the bowel is removed and an anastomosis constructed to reestablish intestinal continuity. Several techniques can be used to create the anastomosis, including mechanical staplers or manual sutures. A potentially life-threatening complication in colon anastomosis is dehiscence and leakage. Various contributing factors can hinder the formation of anastomosis, including technical failure (human error, staple malfunction), inflammation caused by foreign body response (sutures and staples), collagenolytic bacteria, and patient comorbidities (chemotherapy, old age, and obesity). Here, we report a three-dimensional (3D)-printed compression ring with electrical stimulation (ES) functionality to improve wound healing and anastomotic closure. The device consists of a one-way locking mechanism for initial deployment, an elastic band tightening mechanism to secure seal as tissue heals, and electrodes for electrical stimulation to enhance wound healing. The compression ring was assembled with 83.4±3.9 N of force and delivers 147.5±8.8 kPa of pressure to tissue, effectively restricting blood flow to the clamped tissue. This helps to create the anastomosis between remaining tissue on either side. Our design facilitates manual assembly without necessitating an additional delivery device. Electrical impedance analysis confirmed adequate tissue–electrode contact. We tested this device with ex vivo ovine intestinal tissue and confirmed that the compression ring was able to withstand up to 2.0±0.4 kPa intraluminal pressure immediately following installation. By combining mechanical strength and electrical stimulation, this device could potentially improve wound healing, anastomotic closure, and minimize the risk of leaks.