Skin stapled bowel anastomosis in a canine model

Area of Science:

• Gastrointestinal Surgery
• Surgical Techniques
• Comparative Effectiveness Research

Background:

• Colonic anastomoses are crucial in gastrointestinal surgery.
• Traditional handsewn techniques can be time-consuming and costly.
• Exploring alternative methods for anastomosis construction is essential for improving surgical efficiency.

Purpose of the Study:

• To compare the safety and cost-effectiveness of skin staplers versus sutures for colonic anastomosis.
• To evaluate the early and late bursting strength of stapled versus sutured anastomoses.
• To assess the learning curve and performance ease of skin stapled techniques.

Main Methods:

• Prospective randomized study involving 20 healthy dogs.
• Ascending colon transection and reanastomosis using either skin staplers or sutures.
• Assessment of anastomosis time, cost, early bursting strength, and late bursting pressure.
• Histological examination of anastomotic sites and post-mortem analysis for mortality.

Main Results:

• Skin stapled anastomoses were significantly faster (mean 7.95 min vs. 23.5 min, p < 0.001) and less costly (SGD17.85 vs. SGD21.15, p = 0.18).
• No significant difference was found in early or late bursting strengths between stapled and sutured groups.
• Mortality rates were observed in both groups, with 3 deaths in the stapled group and 1 in the sutured group prior to sacrifice.

Conclusions:

• Skin stapled colonic anastomoses are technically straightforward and efficient.
• The technique presents a viable and potentially advantageous alternative to handsewn methods.
• Further clinical studies are warranted to confirm safety and efficacy in human patients.