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Does Intestinal Peristalsis Cause Suture Failure After Instrument Suture?
Yasushi Rino1, Toru Aoyama2, Yukio Maezawa2
1Department of Surgery, Yokohama City University, School of Medicine, Yokohama, Japan; rino@yokohama-cu.ac.jp.
In Vivo (Athens, Greece)
|June 27, 2023
Summary
Duodenal peristalsis during gastrectomy may increase the risk of anastomotic complications. This study identified peristalsis in 28.6% of cases, finding it significantly linked to complications, suggesting preventative measures like over-sewing.
Area of Science:
- Gastrointestinal Surgery
- Surgical Complications
- Robotic Surgery
Background:
- Anastomotic leakage is a severe complication following gastrectomy for gastric cancer.
- Forceful stapler extraction during surgery may contribute to anastomotic complications.
- Duodenal peristalsis is hypothesized to cause forceful stapler extraction.
Purpose of the Study:
- To investigate the relationship between duodenal peristalsis and anastomotic complications after gastrectomy.
- To establish a definition for evaluating duodenal peristalsis during robotic-assisted surgery.
Main Methods:
- Retrospective analysis of 49 Da Vinci system surgery videos (2015-2021).
- Defined duodenal peristalsis as visible, repeated contractions (≥3 times).
- Evaluated suture failure in cases with and without observed duodenal peristalsis.
Main Results:
- Duodenal peristalsis was observed in 14 (28.6%) of 49 patients.
- Anastomotic complications occurred in 3 patients, all exhibiting significant duodenal peristalsis.
- Peristalsis was significantly associated with complications (p=0.0198).
Conclusions:
- A novel definition for duodenal peristalsis evaluation was established.
- Duodenal peristalsis is a significant risk factor for anastomotic complications post-gastrectomy.
- Manual over-sewing or reinforcement materials may mitigate these risks.
