Comparison of Skin Staples With Sutures for Anastomosis of the Small Intestine in Dogs

Coolman, Bradley R.; Ehrhart, Nicole; Pijanowski, Gerald J.; Ehrhart, E. J.; Coolman, Shindok L.

doi:10.1053/jvet.2000.7539

Cited by 67 publications

(142 citation statements)

References 12 publications

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“…This fact may be explained by the thorough check of the suture tightness during surgery, when the protective role of the omentum could not manifest itself significantly; or conversely, spontaneous adhesion of the omentum to the site of suture occurred in spite of the fact that it was not intentionally fixed on the operated part of the intestine. This latter explanation is supported by findings of experimental studies in dogs, confirming that almost always following a surgical intervention in the intestine, adhesion of the omentum at the site of the intestinal wall suture was demonstrated (Ellison et al 1982;Bone et al 1983;Coolman et al 2000). The omentum positively affects intestinal wall healing, as it provides sufficient blood supply, lymphatic drainage, and by formation of fibrinous adhesions it prevents the leakage of the bowel content into the abdominal cavity (McLachlin and Denton 1973;Ellison 1989).…”

Section: Discussionmentioning

confidence: 73%

Two Techniques of Intestinal Wall Suture in Surgical Treatment of Ileus in Dogs and the Importance of Omentalisation

Crha¹,

Lorenzová²,

Urbanová³

et al. 2008

Acta Vet. Brno

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Model experimental studies focused on the intestinal suture techniques in relation to healing, postoperative narrowing of the intestinal lumen or adhesion formation can not comprise a number of clinical factors (foreign body presence in the intestine, haematological abnormalities, septic peritonitis, different age of patients, etc.) that under clinical practice conditions may have an effect on the healing of the intestinal suture. The aim of this clinical study was to confirm in a group of dogs surgically treated for small bowel obstruction, whether different techniques of its wall suture may affect the frequency of possible dehiscence occurrence.This study compares two different techniques of intestinal wall suture in relation to postoperative dehiscence of the intestinal wall closure. Based on the clinical observation with regard to the risk of postoperative dehiscence and possible complications in form of adhesions, also the importance of omentalisation in the suture of small bowel was evaluated.No significant difference was demonstrated (p > 0.05) in the frequency of postoperative dehiscence at the site of the intestinal wall closure between the two-layer inverting and singlelayer appositional techniques of suture. Likewise, no significant difference was demonstrated (p > 0.05) in the frequency of dehiscence of intestinal wall suture between patients that underwent intestinal suture omentalisation and those whose intestinal wall suture was not complemented with omentalisation.Based on the results of this clinical study it may be stated that both manual single-layer approximation technique and two-layer inverting technique of the intestinal wall suture are equally safe from the viewpoint of possible dehiscence, and it depends on the surgeon's preference, which one of the said techniques he or she chooses. Concurrently it may be assumed that an exactly performed suture of the intestinal wall does not necessarily require omentalisation. Intestine, obstruction, dehiscenceSeveral experimental studies may be found in literature, dealing with individual techniques of intestinal suture in relation to healing, postoperative narrowing of the intestinal lumen or adhesion formation (Bennett and Zydeck 1970;Ellison et al. 1982;Bone et al. 1983). For this purpose, mainly approximation, inverting, or everting sutures were studied. These studies were done under experimental conditions, which exclude the effects of a number of clinical factors (e.g. presence of a foreign body in the bowel, haematological abnormalities, septic peritonitis, different age of patients, etc.) on the healing of the intestinal wall closure. We therefore decided to determine under conditions of clinical practice, whether different techniques of the intestinal wall suture may affect the frequency of occurrence of intestinal anastomotic dehiscence. Omentalisation and "serous patch" are surgical techniques that aim to form a permanent adhesion, either between the omentum and the intestine in the case of omentalisation; or in the case of the "serous pat...

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Section: Discussionmentioning

confidence: 73%

Two Techniques of Intestinal Wall Suture in Surgical Treatment of Ileus in Dogs and the Importance of Omentalisation

Crha¹,

Lorenzová²,

Urbanová³

et al. 2008

Acta Vet. Brno

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“…Coolman et al compared skin staples to suture for anastomoses of the small intestine in dogs [7,8] . They concluded that end-to-end intestinal anastomosis with a skin stapler is equivalent in burst strength, lumen circumference, and healing characteristics when compared to the traditional hand-sewn technique, and can be performed in significantly less time.…”

Section: Discussionmentioning

confidence: 99%

Profiling Surgical Staplers: Does Staple Direction Affect the Strength of the Anastomosis?

Kimura

Takahashi²,

Tanaka³

et al. 2015

Dig Surg

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Background: Few studies have been conducted regarding the optimal staple direction in gastrointestinal anastomosis. The purpose of this study was to evaluate the burst pressure of the anastomosis depending on the firing direction of the stapler. Methods: Pig esophagus and small bowel were used for all experiments. The small intestine represented a thin intestinal tract and the esophagus represented a thick intestinal tract. A side-to-side anastomosis was performed using a linear stapler, and the burst pressure was measured. A leak test on the anastomosis was then performed and burst pressures measured. Results: Burst pressures after anastomosis using a GIA™ 100-3.8 were 47.4 ± 10.4 mm Hg. With the same GIA, the burst pressure was significantly greater when the staples were driven from the small intestine into the esophagus (83.3 ± 17.3 mm Hg). Using the GIA™ 100-4.8, it was found that the burst pressure was significantly greater when the staplers were driven into the small intestine versus the esophagus (51.6 ± 7.1 vs. 68.6 ± 16.1 mm Hg). There was no significant difference between the different GIAs when fired in the same direction. Conclusion: Burst pressures were significantly greater when the staplers were driven from the small intestine into the esophagus. The direction of the staple line influences the strength of the anastomosis.

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“…Les indications sont nombreuses : résection de tumeurs digestives, résection d'un segment ischémié du tube digestif suite à un volvulus, une strangulation, une intussusception, la pré-sence d'un corps étranger, ou suite à une première chirurgie digestive compliquée (entérotomie ou entérectomie). Plusieurs techniques d'anastomose sont décrites en chirurgie vétérinaire : les anastomoses termino-terminales par suture [1] ou agrafes cutanées [2] et l'anastomose latéro-latérale par pinces auto-sutures [1,[3][4][5]. L'anastomose terminoterminale par suture reste aujourd'hui la technique la plus utilisée.…”

Section: Discussionunclassified

Six cas d’anastomose digestive termino-latérale par suture manuelle

Sarrau¹

2014

Revue Vétérinaire Clinique

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Comparison of Skin Staples With Sutures for Anastomosis of the Small Intestine in Dogs

Abstract: Skin stapling devices can be used to create technically simple, rapid, and safe end-to-end anastomoses in canine jejunum.

Cited by 67 publications

References 12 publications

Two Techniques of Intestinal Wall Suture in Surgical Treatment of Ileus in Dogs and the Importance of Omentalisation

Two Techniques of Intestinal Wall Suture in Surgical Treatment of Ileus in Dogs and the Importance of Omentalisation

Profiling Surgical Staplers: Does Staple Direction Affect the Strength of the Anastomosis?

Six cas d’anastomose digestive termino-latérale par suture manuelle

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