Intravascular stapler for "open" aortic surgery: preliminary results.

Area of Science:

• Vascular surgery
• Surgical device innovation
• Animal models in research

Background:

• Aortic anastomosis is a critical step in cardiovascular surgery.
• Minimizing aortic cross-clamping time and reducing anastomotic leakage are key surgical goals.
• Current suturing techniques can be time-consuming and prone to complications.

Purpose of the Study:

• To evaluate the efficacy of a novel stapling device for aortic anastomosis.
• To compare the performance of stapled versus sutured anastomoses in a porcine model.
• To assess the impact of the stapling device on procedure time and anastomotic integrity.

Main Methods:

• 12 mm Gore-Tex grafts were used for end-to-end aortic anastomosis in 12 pigs.
• Anastomoses were created using either a stapling device or traditional 4/0 Prolene sutures.
• Grafts and anastomoses were histologically examined at 1 week, 1 month, and 3 months post-operation.
• Leakage was quantified using a dedicated circulation model.

Main Results:

• Stapled anastomoses were significantly faster, taking 1.0 ± 0.25 minutes compared to 8.5 ± 1.5 minutes for sutured anastomoses.
• Histological examination revealed no significant differences in tissue healing between the two methods.
• The stapled anastomosis demonstrated a six-fold reduction in the rate of leakage compared to the sutured anastomosis.

Conclusions:

• Stapled aortic anastomoses offer a potential method to reduce cross-clamping time and decrease anastomotic leakage.
• This technique may be particularly advantageous for laparoscopic aortic procedures.
• Further randomized controlled trials are warranted to validate the clinical efficacy of the stapling device.