Fig 1.
Image of three-dimensionally printed spring with angled bidirectional surface features.
(A) Direction of features is indicated by the arrows. One of the surface hooks is isolated by a box. Scale bar is 5 mm. (B) Zoomed in side view schematic of isolated surface feature and corresponding dimensions.
Fig 2.
(A) Jejunum prior to surgery: a is proximal jejunum, b is distal jejunum; (B) Roux-en-y jejunojejunostomies with two blind jejunal limbs and end-to-side anatomoses; (C) stoma model with Roux limb and end-to-side anastomosis.
Fig 3.
Image of springs in Roux-en-y and in-continuity models.
(A) Representative photos of expanded and compressed springs with hooked surface features and (B) smooth surface. (C) Operative image showing Roux-en-y configuration with two blind Roux limbs with the hooked spring placed in the Roux limb on the left of the image and smooth spring placed in the Roux limb on the right of the image. (D) Operative image showing in-continuity model with hooked spring proximal to anastomosis and smooth spring distal to anastomosis. Arrowheads mark areas of India ink injected at the ends of the compressed springs.
Fig 4.
Abdominal radiographs of spring placement.
Radiographs show metal clips at the ends of the spring and on adjacent mesentery on (A) post-operative day 7 and (B) post-operative day 21. Hooked spring is labeled with three metal clips at each end, shown in black box. Smooth surface spring is labeled with two metal clips at each end, shown in white box. The smooth surface spring had migrated by post-operative day 21. Stars mark the mesenteric clips. Scale object measurement is 2.1 cm in diameter.
Fig 5.
Intestinal segment at time of specimen retrieval.
Intestinal segment with fully expanded hooked spring at time of specimen retrieval on post-operative day 28.
Fig 6.
Histology of jejunum with spring versus normal jejunum.
Jejunal segments with hooked spring demonstrate significantly increased crypt depth and muscularis propria thickness relative to normal jejunum without spring. Light microscopy images of hematoxylin and eosin-stained (A) normal jejunum without spring and (B) jejunum with hooked spring in-continuity at 4× magnification. Scale bar is 100 μm.