Magnets placed in the proximal and distal esophagus attract one another and cause the esophagus to lengthen, then compression anastomosis occurs through ischemia in the tissue at the two ends once magnets are nearly together.
Magnets have been used for many years for esophageal atresia as a non-surgical alternative for esophageal anastomosis, promoting lengthening and approximation of the proximal and distal ends.
Dr. Slater agrees that not everyone with 2 cm gap should get a magnet; it can be used in select patients with cardiac disease or previous operations that increase anesthetic risk.
In a retrospective study of 13 patients over 17 years using Flourish magnets, all patients achieved anastomosis but all developed strictures post-operatively.
Update Course Rewind: Magnet Therapy for Esophageal Atresia
▶Ep 27 · 1:54
clinicalThe Flourish device is an FDA-approved commercially available catheter-based magnet system for esophageal atresia.↗
▶Ep 27 · 1:54
clinicalMagnets have been used for many years for esophageal atresia as a non-surgical alternative for esophageal anastomosis, promoting lengthening and approximation of the proximal and distal ends.↗
▶Ep 27 · 2:22
clinicalMagnets placed in the proximal and distal esophagus attract one another and cause the esophagus to lengthen, then compression anastomosis occurs through ischemia in the tissue at the two ends once magnets are nearly together.↗
▶Ep 27 · 2:41
clinicalThe proximal catheter has a suction port for suctioning saliva and the gastric port has a portion for feeds.↗
▶Ep 27 · 2:41
clinicalThe Flourish device has esophageal and gastric catheters with inner bullet-shaped magnets on each end, tapering down to a 10 French luminal surface.↗
▶Ep 27 · 3:11
clinicalFor Flourish device eligibility, gap length must be less than 4 centimeters because at greater lengths the magnets will not attract one another.↗
▶Ep 27 · 3:11
clinicalThere should be no fistula for Flourish device use, or if there is a fistula it must be repaired first.↗
▶Ep 27 · 3:11
clinicalPatients require a gastrostomy that can accommodate an 18 French catheter, which is the diameter of the gastric portion of the Flourish catheter.↗
▶Ep 27 · 7:51
clinicalThere is a possibility of trying to get the two ends together closer surgically and then using a magnet just for the anastomosis portion.↗
▶Ep 27 · 7:51
clinicalMagnets have been used sometimes for a staged repair rather than using internal traction sutures.↗
Update Course 2021: MAGNET THERAPY FOR ESOPHAGEAL ATRESIA
▶Ep 30 · 4:47
clinicalThe Flourish device is an FDA-approved commercially available device under humanitarian device exception from Cook Medical.↗
▶Ep 30 · 4:59
clinicalThe Flourish device uses compression anastomosis by causing ischemia of tissue between two magnets, which then sloughs off to create the anastomosis.↗
▶Ep 30 · 5:40
clinicalThe Flourish device tapers down to a 10 French coupling surface.↗
▶Ep 30 · 7:00
epidemiologicalIn a retrospective study of 13 patients over 17 years using Flourish magnets, all patients achieved anastomosis but all developed strictures post-operatively.↗
▶Ep 30 · 7:30
epidemiologicalTwo of 13 patients in the retrospective Flourish series required surgery for recalcitrant strictures after magnet placement.↗
▶Ep 30 · 8:00
clinicalFlourish device eligibility requires gap length less than 4 centimeters; if lengths are greater, magnets will not attract one another.↗
▶Ep 30 · 8:15
clinicalFlourish device requires either absent fistula (pure EA) or previously repaired fistula.↗
▶Ep 30 · 8:25
clinicalFlourish device requires gastrostomy that can accommodate 18 French catheter (diameter of gastric portion).↗
▶Ep 30 · 17:57
quoteI would I would definitely agree with you on basically all of those points and I not I was not involved in this case directly, but after getting some feedback, I do my understanding is that there was some using of it, um, that was against the advice of some of the Cook reps↗
▶Ep 30 · 18:30
quoteI do think that we do need to be responsible of using devices where you use it responsibly and in places where you'd be able to operate if there were a problem.↗
▶Ep 30 · 18:40
opinionDr. Slater agrees that not everyone with 2 cm gap should get a magnet; it can be used in select patients with cardiac disease or previous operations that increase anesthetic risk.↗
▶Ep 30 · 19:12
clinicalMagnets have been used as staged procedure: surgically approximate ends, then use magnet just for anastomosis portion rather than internal traction sutures.↗
Bethany's statements about Esophageal Atresia10 statements
Update Course Rewind: Magnet Therapy for Esophageal Atresia
▶Ep 4 · 1:54
clinicalThe Flourish device is an FDA-approved commercially available catheter-based magnet system for esophageal atresia.↗
▶Ep 4 · 1:54
clinicalMagnets have been used for many years for esophageal atresia as a non-surgical alternative for esophageal anastomosis, promoting lengthening and approximation of the proximal and distal ends.↗
▶Ep 4 · 2:22
clinicalMagnets placed in the proximal and distal esophagus attract one another and cause the esophagus to lengthen, then compression anastomosis occurs through ischemia in the tissue at the two ends once magnets are nearly together.↗
▶Ep 4 · 2:41
clinicalThe proximal catheter has a suction port for suctioning saliva and the gastric port has a portion for feeds.↗
▶Ep 4 · 2:41
clinicalThe Flourish device has esophageal and gastric catheters with inner bullet-shaped magnets on each end, tapering down to a 10 French luminal surface.↗
▶Ep 4 · 3:11
clinicalThere should be no fistula for Flourish device use, or if there is a fistula it must be repaired first.↗
▶Ep 4 · 3:11
clinicalFor Flourish device eligibility, gap length must be less than 4 centimeters because at greater lengths the magnets will not attract one another.↗
▶Ep 4 · 3:11
clinicalPatients require a gastrostomy that can accommodate an 18 French catheter, which is the diameter of the gastric portion of the Flourish catheter.↗
▶Ep 4 · 7:51
clinicalThere is a possibility of trying to get the two ends together closer surgically and then using a magnet just for the anastomosis portion.↗
▶Ep 4 · 7:51
clinicalMagnets have been used sometimes for a staged repair rather than using internal traction sutures.↗
Bethany's statements about Long Gap Esophageal Atresia12 statements
Update Course 2021: MAGNET THERAPY FOR ESOPHAGEAL ATRESIA
▶Ep 4 · 4:47
clinicalThe Flourish device is an FDA-approved commercially available device under humanitarian device exception from Cook Medical.↗
▶Ep 4 · 4:59
clinicalThe Flourish device uses compression anastomosis by causing ischemia of tissue between two magnets, which then sloughs off to create the anastomosis.↗
▶Ep 4 · 5:40
clinicalThe Flourish device tapers down to a 10 French coupling surface.↗
▶Ep 4 · 7:00
epidemiologicalIn a retrospective study of 13 patients over 17 years using Flourish magnets, all patients achieved anastomosis but all developed strictures post-operatively.↗
▶Ep 4 · 7:30
epidemiologicalTwo of 13 patients in the retrospective Flourish series required surgery for recalcitrant strictures after magnet placement.↗
▶Ep 4 · 8:00
clinicalFlourish device eligibility requires gap length less than 4 centimeters; if lengths are greater, magnets will not attract one another.↗
▶Ep 4 · 8:15
clinicalFlourish device requires either absent fistula (pure EA) or previously repaired fistula.↗
▶Ep 4 · 8:25
clinicalFlourish device requires gastrostomy that can accommodate 18 French catheter (diameter of gastric portion).↗
▶Ep 4 · 17:57
quoteI would I would definitely agree with you on basically all of those points and I not I was not involved in this case directly, but after getting some feedback, I do my understanding is that there was some using of it, um, that was against the advice of some of the Cook reps↗
▶Ep 4 · 18:30
quoteI do think that we do need to be responsible of using devices where you use it responsibly and in places where you'd be able to operate if there were a problem.↗
▶Ep 4 · 18:40
opinionDr. Slater agrees that not everyone with 2 cm gap should get a magnet; it can be used in select patients with cardiac disease or previous operations that increase anesthetic risk.↗
▶Ep 4 · 19:12
clinicalMagnets have been used as staged procedure: surgically approximate ends, then use magnet just for anastomosis portion rather than internal traction sutures.↗
