Clinical utilization of mechanical sutures for intestinal anastomosis in Macaca mulatta

Using three mechanical stapling instruments that employ stainless steel wire staples, a Mann-Bollman fistula was created on the terminal ileum in 27 rhesus monkeys (Macaca mulatta). Two functional end-to-end anastomoses were accomplished and an ileostium constructed. Staples of various sizes were used; it was found that pediatric-sized staples were necessary for the intestinal tissue of these primates. Six months after surgery, microscopic examination revealed encapsulation of the staples by granulomatous inflammatory tissue. When staples of the proper size were selected, mechanical suturing provided rapid and consistent anastomoses, and wound closures had less edema, inflammation and necrosis than with conventional suturing methods.