Objective: 1. To induce tissue regeneration of small intestine using small intestinal submucosa (SIS) extracellular matrix. 2. To increase absorptive capacity of the bowel
Methods: Five pigs given general anesthesia underwent a laparotomy. A segment of the small bowel approximately 15-30 cm. distal to the ligament of Treitz was isolated. An antimesentric enterotomy incision 3 to 10 cm was made. A lyophilized, multi-laminate construct of small intestinal submucosa (SIS) was sutured to the enterotomy incision and reinforced by the greater omentum with marker stitches. The size on construct ranged from 1.5 x 3 cm to 2 x 9 cm in the five animals. The abdomen was closed.
Result: All animals survived, gained weight and were euthanized after six weeks. There was no sign of leak or peritonitis. A fibrous cord connected remodeled intestine to the greater omentum. Histological results showed the SIS material to be replaced with connective tissue, thinned mucosa and relatively mature epithelium. Re-epethelization with normal crypts, regenerated smooth muscle fibers and angiogenesis were seen.
Conclusion: The results provided evidence of functioning tissue regeneration with SIS meterial. This regeneration is due to cells recruitment and tissue specific differentiation and was facilitated by the vascular supply provided by the greater omentum.