TITLE: SPARC Pig2 acute wired ColoMOCA implantation
AUTHORS: Brett Hanzlicek, Dennis Bourbeau, Margot Damaser

[DESCRIPTION]
<div class = "text-blocks"><div class = "text-block">In this study, we will be using Yorkshire Pigs, 50-70kg.  The purpose of this study is to develop a tool to measure bowel fullness and activity. This system will eventually be able to provide continuous, wireless, battery−powered data and ultimately be translated for use in research and clinicalapplications of bowel function. We will measure porcine bowel compliance, pressures, and dimensions in acute live animal studies.</div></div>

[STEPS]
?. [Anesthesia Preparation]
Anesthesia Preparation    Pigs will be initially anesthetized with an intramuscular dose of telazol (4.4−6.6 mg/kg). The animals will then be intubated orotracheally and maintained on isoflurane in oxygen (1-5%; depending on anesthetic depth). Anesthetic depth will be measured by the response to stimulus, heart rate, respiratory rate and eye position.    A peripheral catheter will be placed in an auricular vein for administration of fluids.     Attach monitor sensors (BP, pulse Ox, EKG, Temp)
?. [Surgical Preparation ]
Surgical Preparation     After anesthesia preparation, place the pig in a supine position. Insert a urine catheter with help of a guidewire and tape the catheter to side of the pig. The catheter reduces pressure that a bladder with urine would put on the colon.     Clean the (midline suprapubic) incision area using Betadine solution and isolate the area using sterile towels.    We use a 10F Dover catheter (Covidien; Catalog # 8887603101)
?. [Intrarectal Tesing]
Insert speculum (anoscope) approximately 10 cm into the rectum and remove stool.    -Empty the  bowel of stools by manual disimpaction.
?. [Intrarectal Tesing]
Insert ColoMOCA into rectum. -The ColoMOCA is powered using wires that run to a power supply.  The ColoMOCA collects pressure data using 2 pressure transducers.  The device also collects conductance, conductivity  and capacitance measurements using 4 electrodes that are attached to the device.  All data is wirelessly transmitted to a receiving coil (chataMOCA) outside of the body, which is connected to a laptop.  The data is visualized and collected using Labview software.
?. [Intrarectal Tesing]
Place receiving antenna (chataMOCA) on lower abdomen of pig.    -Make sure we are receiving a wireless signal from the coloMOCA.
?. [Intrarectal Tesing]
Insert Laborie Balloon catheter 5 cm into the rectum using surgilube and remove anoscope.    -The catheter has depth measurement printed on it.
?. [Intrarectal Tesing]
Pressing and hold (~5 sec) on lower pig abdomen.    -Record response of ColoMOCA pressure transducers using Labview    -Record pressure response from balloon catheter using Laborie software.
?. [Intrarectal Tesing]
Collect pressure and electrode measurements from ColoMOCA using artificial stool on top of ColoMOCA.     -Conductivity, conducatance and capacitance testing is performed using 4 electrode on the ColoMOCA in response to the device being in contact with real and artificial stool.  We use conductance reading to approximate volume.
?. [Intrarectal Tesing]
Remove ColoMOCA.
?. [Laparotomy]
Start Laparotomy    -With the animal in supine position, a midline suprapubic incision will be made to expose theperitoneal cavity and viscera.     The animal will then be transitioned from isoflurane anesthesia to an IV infusion cocktail of propofol (2.0−4.4 mg/kg/h), midazolam (0.4−0.7mg/kg/h) and fentanyl (0.003−0.005 mg/kg/h).
?. [Intracolonic Testing]
Incise proximal colon, distal from cecum, ~1cm long.
?. [Intracolonic Testing]
Insert ColoMOCA into the bowel through the incision.
?. [Intracolonic Testing]
Insert balloon catheter next to ColoMOCA for reference pressure.
?. [Intracolonic Testing]
Pressurize balloon catheter by filling the balloon with ~5 ml water.    -Record record pressure from catheter and ColoMOCA
?. [Intracolonic Testing]
Close the abdomen.
?. [Intracolonic Testing]
Pressing and hold (~5 sec) on pig abdomen where the ColoMOCA is implanted.    -Record pressure, volume, conductivity and capacitance measurements from the ColoMOCA and pressure measurements from the balloon catheter.
?. [Intracolonic Testing]
Open abdomen and rotate the ColoMOCA so that the pressure sensors are facing the wall of the colon.
?. [Intracolonic Testing]
Close abdomen.
?. [Intracolonic Testing]
Pressing and hold (~5 sec) on pig abdomen where the ColoMOCA is implanted.    -Record pressure, volume, conductivity and capacitance measurements from the ColoMOCA and pressure measurements from the balloon catheter.
?. [Euthansia]
Euathanize pig with Beuthanasia (100mg/kg IV).
?. [Surgical Preparation ]
Calibrate air-charged anorectal manometry catheter (Laborie T-DOC) on benchtop.    This catheter consists of a large balloon for rectal pressure and small balloons to collect anal sphincter pressure.
?. [Intrarectal Tesing]
Insert anoscope and then insert artificial stool so that it is on top of the ColoMOCA.  Remove anoscope.
?. [Post Mortem]
Measure colon and stool dimensions, including thickness and impedances.