Disposable skin staplers for closure of linear gastrointestinal incisions in dogs

Schwartz, Zvi; Coolman, Bradley R.

doi:10.1111/vsu.12759

Cited by 9 publications

(9 citation statements)

References 34 publications

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“…10 Other studies showed that the presence of foreign bodies was a risk factor for dehiscense, although there is a conflict in this finding among several studies. 6,7,12,56 In this study, both foreign bodies and dehiscence were most common within the jejunum, which was consistent with prior studies. Moreover, previous studies revealed gastrointestinal ulceration is more common in the proximal gastrointestinal tract, especially in the stomach.…”

Section: Discussionsupporting

confidence: 92%

“…Unfortunately, the reasons of the original surgery for the cases with dehiscence were not recorded in the present study, although foreign bodies were the most common reason for enterotomy or enterectomy in prior studies. 6,8,56 A previous study reported that linear foreign bodies were most common between the stomach and jejunum, whereas nonlinear foreign bodies were most common within the jejunum. 57 Another study showed that enterotomy was most commonly performed at the jejunum for foreign body retrieval.…”

Section: Discussionmentioning

confidence: 99%

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Association of the origin of contamination and species of microorganisms with short‐term survival in dogs with septic peritonitis

Uetsu¹,

Houston²,

Bailey³

et al. 2022

Aust Veterinary J

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Objective To assess the association between anatomical location of contamination and mortality in dogs with gastrointestinal and biliary origin of septic peritonitis.Methods Medical records at two private referral hospitals between 2003 and 2020 were retrospectively reviewed. Cases were included if the origin of contamination was confirmed intraoperatively within the gastrointestinal or biliary tract. Cases were excluded if the dog died or was euthanized intraoperatively or where the data regarding the origin of contamination were not available. The association of anatomical origin with survival was assessed specifying the locations as stomach, small intestine, large intestine and biliary tract. The gastrointestinal tract origin was further subdivided into pylorus, nonpylorus, duodenum, jejunum, ileum, caecum and colon. ResultsThe overall survival rate was 75.9% (n = 44/58). There were no significant differences in survival among different anatomical origins of contaminations before or after subdivision (P = 0.349 and 0.832, respectively). Also, there was no association between isolated microorganism species in microbiological culture and the anatomical origin (P = 0.951) and the microorganism species was not associated with survival (P = 0.674).Conclusions There was no association between anatomical location of leakage, microorganism species and survival although further studies are warranted to analyse the relationships between anatomical leakage site and microorganism species as well as microorganism species and mortality.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Association of the origin of contamination and species of microorganisms with short‐term survival in dogs with septic peritonitis

Uetsu¹,

Houston²,

Bailey³

et al. 2022

Aust Veterinary J

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“…Linear GI incisions were closed in 333 dogs, with a dehiscence rate of rate of only 1.2%. However, the staples anchored a linear foreign body in two cases . The method was also used to close GI incisions in 29 cats without apparent dehiscence …”

Section: Selection Of Closure Methodsmentioning

confidence: 99%

Intestinal surgery in small animals: historical foundations, current thinking, and future horizons

2019

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Intestinal wounds require precise closure after intestinal biopsy, enterotomy, or enterectomy in small animals. Preexisting factors such as intra‐abdominal sepsis and hypoalbuminemia as well as poor surgical technique increase the risk of intestinal dehiscence, with considerable negative impact on patient morbidity and mortality. Live dog studies have demonstrated the dangers of mucosal eversion especially in the septic abdomen. Approximating patterns preserve luminal diameter, heal optimally, and have equal bursting strength compared with inverting patterns after 24 hours. Simple interrupted and simple continuous suture patterns and disposable skin staples are established alternatives for manual wound closure. Knotless quilled suture currently used in laparoscopic gastropexy techniques shows bursting strength equal to monofilament sutures in dog cadaveric intestine. Dehiscence rates with hand sewn vs titanium automated stapling anastomosis are similar in uncomplicated cases; however, auto stapling devices may be the preferred method of anastomosis when preexisting abdominal sepsis is present and when patient size allows it. Regardless of the technique, current standard of care involves leak testing and omental wrapping, followed by early postoperative feeding. The past decade has ushered in an exciting new era of laparoscopic assisted techniques that have the potential to reduce postoperative pain and patient morbidity. An understanding of these applications will establish the future of minimally invasive small animal intestinal surgery for veterinary specialists. In summary, surgeons have a variety of methods at their disposal for optimal clinical outcome in small animal intestinal surgery.

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“…The use of surgical stapling devices for intestinal anastomosis have also been described. There are several variants of realization: evertingend-to-end anastomosis using a triangulation technique and linear stapler (TA -thoracoabdominal) [35]; inverting-everting -functional end-to-end stapled anastomosis -FEESA [1,18,36,37,38,39,40,41]; inverting -circular EEA Staplers [17,42] and skin staples approximating anastomoses [14,43,44,45,46]. The intestinal staplers do induce inversion or eversion [2,15,47].…”

Section: Introductionmentioning

confidence: 99%

Comparison of two end-to-end continuous sutures for intestinal anastomoses in dogs.

Igna

Dascălu

Sicoe

et al. 2021

Preprint

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Background: Single-layer appositional closures are preferred to inverting or everting patterns, as submucosal apposition has been shown to promote primary healing of the intestinal wall, whereas inverted or everted closures require second-intention healing and can increase the risk of luminal stenosis or anastomosis site leakage. There are different suture patterns available, but relatively few studies comparing these aspects have been published.The aim of this study was to compare two suture techniques for end-to-end anastomosis of the canine intestine (jejunum and colon): handsewn intestinal anastomosis by appositional simple continuous suture and inverting Cushing suture. The objectives of this study were to investigate 1.) whether the type of suture influences the specific effort to which the anastomosis site is submitted to, 2.) whether the anastomosis technique influences the diameter of the intestinal lumen and 3.) survival and complication rates in canine clinical cases undergoing end-to-end anastomoses. Results: The equilibrium angle for implanting the sutures in an anastomosis is 35°, aspect completely fulfilled by the simple continuous suture. The efforts to which sutures are submitted to in anastomoses are minimal for the Cushing suture. The difference in size of the anastomoses’ lumen between simple continuous suture and the Cushing suture are minimal, without being statistically relevant. The differences between the lumen of the anastomoses performed using PDS and those performed using PGA are not statistically relevant. The retrospective analysis of the outcome for 676 dogs (clinical cases) that underwent intestinal resection and anastomosis reveals that the dehiscence rate was 1.48%, out of which 1.18% following simple continuous anastomoses, and 0.3% following Cushing anastomoses. Narrowing of the intestinal lumen due to anastomotic healing was not registered.Conclusions: Use of the Cushing suture should be considered for performing an end-to-end intestinal anastomosis, although more studies are required to determine if there are any clinically significant differences between the sutures investigated in this study.

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Disposable skin staplers for closure of linear gastrointestinal incisions in dogs

Abstract: Skin staplers provide safe and effective closure of gastrotomies, enterotomies, and colonotomies in dogs. This method is reliable, efficient, and affordable in the hands of veterinary surgeons with varying skill levels.

Cited by 9 publications

References 34 publications

Association of the origin of contamination and species of microorganisms with short‐term survival in dogs with septic peritonitis

Association of the origin of contamination and species of microorganisms with short‐term survival in dogs with septic peritonitis

Intestinal surgery in small animals: historical foundations, current thinking, and future horizons

Comparison of two end-to-end continuous sutures for intestinal anastomoses in dogs.

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