Student: Kara Celi
Date: 2024-10-10
Time: 10:00 AM-11:30 AM
Location / Meeting Link: UAW 2110 

Committee Members:
Scott Hollister, PhD – Georgia Institute of Technology, Department of Biomedical Engineering (advisor); 

Rudolph Gleason, PhD – Georgia Institute of Technology, Department of Mechanical Engineering and Biomedical Engineering; 

Shaun Kunisaki, MD – Johns Hopkins University, School of Medicine


Title: Computational Modeling to Simulate Traditional and Sleeve-Augmented Esophageal Atresia Repair with Neonatal and Adult Esophageal Tissue

Abstract:
Esophageal atresia (EA), a birth defect marked by discontinuity between the proximal and distal esophagus, affects 1 in 4100 live births. This discontinuity can be classified as short- or long-gap (>3 cm), and current surgical management involves primary anastomosis. There is a greater incidence of post-operative complications following long-gap primary repair such as strictures and anastomotic leakage ascribed to tension at the anastomotic site. For short-gap repair, short-term repair outcomes and survivability have improved considerably, but long-term management into adulthood presents challenges requiring surgical interventions. Based on our prior clinical successes with patient-specific manufacture of devices assisting soft tissue repair, we proposed a computational model suggesting an elastomeric sleeve sutured around a primary anastomosis would further reduce anastomotic tensions compared to primary anastomosis alone. This model utilized esophageal mechanical properties derived from adult pigs. Although esophageal anatomy is frequently studied, there is limited data on esophageal mechanics, specifically changes with different age groups. To develop a repair strategy for EA, predicting anastomotic forces for both neonatal and adult tissue is critical. Esophageal nonlinear elasticity changes with age, impacting anastomotic tension prediction. In this study we 1) mechanically test neonatal and adult sheep tissues; 2) develop constitutive parameters ascribed to these tissues mechanics; and 3) computationally verify differences across neonatal and adult sleeve-assisted repair and the consequent anastomotic tension reduction compared to primary repair. This study uses computational modeling to estimate how mechanical property changes during growth from neonatal to adulthood would affect anastomotic tension under suture alone and suture-plus-sleeve repair.