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However, endoscopic device development is hampered by challenges in respecting the dimensional restrictions, due to the narrow access route, and by achieving adequate force transmission. As the overall goal of our research is the development of a patient adaptable, endoscopic anastomosis manipulator, biomechanical and size-related characterization of gastrointestinal organs are needed to determine technical requirements and thresholds to define functional design and load-compatible dimensioning of devices.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We built an experimental setup to measure colon tissue compression piercing forces. We tested 54 parameter sets, including variations of three tissue fixation configurations, three piercing body configurations (four, eight, twelve spikes) and insertion trajectories of constant velocities (5\u00a0mms<jats:sup>\u22121<\/jats:sup>, 10\u00a0mms<jats:sup>\u22121<\/jats:sup>,15\u00a0mms<jats:sup>\u22121<\/jats:sup>) and constant accelerations (5\u00a0mms<jats:sup>\u22122<\/jats:sup>, 10\u00a0mms<jats:sup>\u22122<\/jats:sup>, 15\u00a0mms<jats:sup>\u22122<\/jats:sup>) each in 5 samples. Furthermore, anatomical parameters (lumen diameter, tissue thickness) were recorded.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>There was no statistically significant difference in insertion forces neither between the trajectory groups, nor for variation of tissue fixation configurations. However, we observed a statistically significant increase in insertion forces for increasing number of spikes. The maximum mean peak forces for four, eight and twelve spikes were 6.4\u2009\u00b1\u20091.5\u00a0N, 13.6\u2009\u00b1\u20091.4\u00a0N and 21.7\u2009\u00b1\u20095.8\u00a0N, respectively. The 5th percentile of specimen lumen diameters and pierced tissue thickness were 24.1\u00a0mm and 2.8\u00a0mm, and the 95th percentiles 40.1\u00a0mm and 4.8\u00a0mm, respectively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The setup enabled reliable biomechanical characterization of colon material, on the base of which design specifications for an endoscopic anastomosis device were derived. The axial implant closure unit must enable axial force transmission of at least 28\u00a0N (22\u2009\u00b1\u20096\u00a0N). Implant and applicator diameters must cover a range between 24 and 40\u00a0mm, and the implant gap, compressing anastomosed tissue, between 2 and 5\u00a0mm.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11548-021-02371-8","type":"journal-article","created":{"date-parts":[[2021,4,23]],"date-time":"2021-04-23T08:11:28Z","timestamp":1619165488000},"page":"1335-1345","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Design of a force-measuring setup for colorectal compression anastomosis and first ex-vivo results"],"prefix":"10.1007","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5576-3262","authenticated-orcid":false,"given":"Jana","family":"Steger","sequence":"first","affiliation":[]},{"given":"Isabella","family":"Patzke","sequence":"additional","affiliation":[]},{"given":"Maximilian","family":"Berlet","sequence":"additional","affiliation":[]},{"given":"Stefanie","family":"Ficht","sequence":"additional","affiliation":[]},{"given":"Markus","family":"Eblenkamp","sequence":"additional","affiliation":[]},{"given":"Petra","family":"Mela","sequence":"additional","affiliation":[]},{"given":"Dirk","family":"Wilhelm","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2021,4,23]]},"reference":[{"key":"2371_CR1","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1097\/SLA.0b013e3181952888","volume":"249","author":"DA Etzioni","year":"2009","unstructured":"Etzioni DA, Mack TM, Beart RW, Kaiser AM (2009) Diverticulitis in the United States: 1998\u20132005: changing patterns of disease and treatment. 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