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Dr. Michel Gagner (Canada) and his team at the Westmount Square Surgical Center (Canada) will perform a Magnetic Duodeno-Jejunostomy for Superior Mesenteric Artery Syndrome (SMART) and answer all your questions.
Clinical Background
This procedure is a treatment for Superior Mesenteric Artery Syndrome (SMAS). SMAS is a rare condition where the third portion of the duodenum is compressed by a decreased space between the superior mesenteric artery and the aorta.
Common Symptoms: It often presents with symptoms of proximal small bowel obstruction , such as postprandial epigastric pain, early satiety, nausea, vomiting , and significant weight loss.
Typical Patient Profile: SMAS preferentially occurs in adolescents and young adults, with a general age range of 10 to 39 years.
Complications: If diagnosis is delayed, it can lead to malnutrition and dehydration , sometimes requiring enteral support or TPN.
Technique Description
The procedure to be demonstrated is a Laparoscopic-Endoscopic Assisted Magnetic Duodeno-Jejunostomy Side-to-Side. This technique is presented as a new option for treating SMAS.
Procedure Steps
The SMART procedure aims to create a patent bypass of the duodenal obstruction. The general steps are:
A magnet is delivered endoscopically into the compressed third portion of the duodenum.
A second magnet is delivered laparoscopically into the proximal jejunum.
The two magnets self-align and attract , creating a side-to-side compression anastomosis (a new connection) between the duodenum and the jejunum.
Training Objectives
To demonstrate how to create a patent duodeno-jejunostomy without enterotomies (incisions into the bowel).
To understand the minimally invasive aspects of this technique for treating SMAS.
To learn the setup and use of the magnetic delivery system and accessory instruments.
