{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,12]],"date-time":"2025-07-12T00:01:58Z","timestamp":1752278518533,"version":"3.41.2"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"04","funder":[{"name":"Kidneys For Life Charity, Manchester","award":["505256"],"award-info":[{"award-number":["505256"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n               Objective\u2003The pyeloureteral anastomosis remains the most challenging part of pyeloplasty. A purpose-built anastomotic device could simplify this step and potentially improve outcomes. The concept of a pyeloureteral magnetic anastomosis device (PUMA) was proven in minipigs, but only in short term. Our aim was to test the PUMA in domestic pigs and achieve a prolonged follow-up period.<\/jats:p><jats:p>\n               Methods\u2003Five female domestic pigs underwent laparoscopy and ligation of the left ureter. Four weeks later, laparoscopic implantation of the PUMA was planned. Removal of the device and a retrograde contrast study were scheduled after another 4 weeks. The experiment was terminated when the animals could no longer be properly cared for due to their weight.<\/jats:p><jats:p>\n               Results\u2003Due to unexpected smaller ureteric diameters, a modified PUMA could only be successfully inserted in pig number 3 (49\u2009kg). Four weeks later, the device was found to be dislocated, but the anastomosis remained patent. After modifying the study protocol, the PUMA was successfully implanted in pigs number 4 (96\u2009kg) and 5 (68\u2009kg) 8 weeks after ureteric ligation. Pig 4 developed malignant hyperthermia and died. In pig 5, the magnets were removed 4 weeks later. After an additional 8 weeks, the animal reached 135\u2009kg and was terminated. The anastomosis remained patent and preserved its diameter.<\/jats:p><jats:p>\n               Conclusion\u2003Despite limitations, our study successfully demonstrated that the PUMA can achieve a patent ureteric anastomosis in domestic pigs. This suggests a potential for minimally invasive ureteric anastomosis in clinical settings. Further research is needed to optimize the technique and validate its effectiveness in humans.<\/jats:p>","DOI":"10.1055\/a-2507-8135","type":"journal-article","created":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T19:29:01Z","timestamp":1737401341000},"page":"316-321","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility and Challenges of Pyeloureteral Magnetic Anastomosis Device in Domestic Pigs: A Stepwise Approach with Extended Observation"],"prefix":"10.1055","volume":"35","author":[{"given":"Rainer","family":"Kubiak","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Children's Hospital of Eastern Switzerland, Sankt Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zita","family":"Hornok","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Hungarian Reformed Church Bethesda Children's Hospital, Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domokos","family":"Csukas","sequence":"additional","affiliation":[{"name":"Surgical Research and Techniques, Heart and Vascular Center, Semmelweis University, Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Ferencz","sequence":"additional","affiliation":[{"name":"Surgical Research and Techniques, Heart and Vascular Center, Semmelweis University, Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamas","family":"Cserni","sequence":"additional","affiliation":[{"name":"Department of Pediatric Urology, Manchester Children's Hospitals, Manchester, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,1,20]]},"reference":[{"issue":"10","key":"ref1","doi-asserted-by":"crossref","first-page":"1038454","DOI":"10.3389\/fped.2022.1038454","article-title":"Comparison of laparoscopic pyeloplasty vs. robot-assisted pyeloplasty for the management of ureteropelvic junction obstruction in children","volume":"10","author":"M P\u00e9rez-March\u00e1n","year":"2022","journal-title":"Front Pediatr"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"229.e1","DOI":"10.1016\/j.jpurol.2016.04.007","article-title":"Global minimally invasive pyeloplasty study in children: results from the Pediatric Urology Expert Group of the European Association of Urology Young Academic Urologists working party","volume":"12","author":"M S Silay","year":"2016","journal-title":"J Pediatr Urol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.euros.2022.05.009","article-title":"Transperitoneal versus retroperitoneal robotic-assisted laparoscopic pyeloplasty for ureteropelvic junction obstruction in children. 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