“Tie over ring” sutureless compression based gastrointestinal anastomotic method: experimental rat model

Hiradfar, Mehran; Shojaeian, Reza; Zabolinejad, Nona; Gharavifard, Mohammad; Sabzevari, Alireza; Joodi, Marjan; Yal, Nazila; Sharifabad, Parisa Saeedi; Hajian, Sara; Nazarzadeh, Reza; Lotfinejad, Nasim

doi:10.1016/j.jpedsurg.2013.07.007

Cited by 6 publications

(3 citation statements)

References 12 publications

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“…The rat is a better model due to its small size, rapid breeding, and cost effectiveness 4 . However, hand-sewing intestinal anastomosis in small animals such as rats is technically difficult, time consuming and associated with high postoperative complications 20 . At present, no device has been validated for gastrointestinal anastomosis in rats.…”

Section: Discussionmentioning

confidence: 99%

Gastrojejunal anastomosis in rats using the magnetic compression technique

Zhang²,

Liu

et al. 2018

Sci Rep

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Rats are suitable animal models in which to study the effects of gastric bypass surgery. However, construction of gastrojejunal anastomosis in the rat is technically demanding and is associated with high rate of postoperative complications. The aim of this study was to explore the feasibility and efficacy of the magnetic compression technique (MCT) in side-to-side gastrojejunal anastomosis in rats. Thirty male rats underwent gastrojejunal anastomosis using one of three techniques: hand-sewn, magnetic compression using cuboid magnets, and magnetic compression using magnetic rings. The mean anastomosis time using the magnetic compression technique was significantly less than that of the hand-sewn technique (3.6 ± 0.96 and 6.50 ± 1.58 vs. 14.40 ± 2.37 minutes,). The survival rate was highest in animals treated with magnetic compression using cuboid magnets (100%), followed by animals treated with magnetic compression using magnetic rings (90%) and then hand sewing (70%). The mean burst pressure did not differ significantly between the magnetic compression and hand-sewn anastomoses. Anastomoses constructed by magnetic compression were smoother and flatter than hand-sewn anastomoses. The results showed that MCT is a simple and feasible method for gastrojejunal anastomosis in the rat.

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Section: Discussionmentioning

confidence: 99%

Gastrojejunal anastomosis in rats using the magnetic compression technique

Zhang²,

Liu

et al. 2018

Sci Rep

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“…Other mechanical tests such as measurement breaking strength or tensile strength are extensively criticized for either being not sensitive enough to measure in the early healing phase and because of its technical difficulties [ 42 ]. Histological healing parameters are often reported in experimental studies regarding gastrointestinal anastomoses, mostly by grading scales regarding factors based on cutaneous wound healing such as inflammatory cell infiltration, fibroblast activity, collagen deposition and vascularity or neoangiogenesis [ 30 , 43 – 45 ]. These parameters are considered helpful in evaluating the general wound healing process at the anastomotic site.…”

Section: Discussionmentioning

confidence: 99%

Colorectal anastomotic healing: why the biological processes that lead to anastomotic leakage should be revealed prior to conducting intervention studies

et al. 2015

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BackgroundAnastomotic leakage (AL) remains the most dreaded complication after colorectal surgery and causes high morbidity and mortality. The pathophysiology of AL remains unclear, despite numerous studies that have been conducted on animals and humans, probably due to the undetermined healing process of colorectal anastomoses. Increasing basic knowledge on this healing process may shed more light on causal factors of AL, and additionally reduce the quantity and accelerate the quality of experimental studies. In this debate article, our aim was to provide different perspectives on what is known about the colorectal healing process in relation to wound healing and AL.DiscussionSince knowledge on anastomotic healing is lacking, it remains difficult to conclude which factors are essential in preventing AL. This is essential information in the framework of humane animal research, where the focus should lie on Replacement, Reduction and Refinement (3Rs). While many researchers compare anastomotic healing with wound healing in the skin, there are substantial recognized differences, e.g. other collagen subtypes and different components involved.SummaryBased on our findings in literature as well as discussions with experts, we advocate stop considering anastomotic healing in the gastrointestinal tract and cutaneous healing as a similar process. Furthermore, intervention studies should at least address the anastomotic healing process in terms of histology and certain surrogate markers. Finally, the anastomotic healing process ought to be further elucidated – with modern techniques to achieve 3Rs in animal research - to provide starting points for potential interventions that can prevent AL.

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“…After anastomosis completion, the specimen was stored in normal saline solution at room temperature and tested within 1 h. The leakage testing was conducted essentially as described previously (23,(31)(32)(33)(34)(35)(36). Briefly, a 4-cm flexible pipe was tightly connected to a 50-ml syringe, which was inserted into the proximal end of the anastomosis.…”

Section: Leakage Testingmentioning

confidence: 99%

An alternative asymmetric figure-of-eight single-layer suture technique for bowel anastomosis in an in vitro porcine model

et al. 2022

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Anastomotic techniques are of vital importance in restoring gastrointestinal continuity after resection. An alternative asymmetric figure-of-eight single-layer suture anastomotic technique was introduced and its effects were evaluated in an in vitro porcine model. Twelve 15-cm grossly healthy small intestine segments from a porcine cadaver were harvested and randomly divided into asymmetric figure-of-eight single-layer suture (figure-of-eight suture) and single-layer interrupted suture technique (interrupted suture) groups (n = 6 in each group). The anastomosed bowel was infused with methylene blue solution to test anastomotic leakage. Anastomosis construction time, leakage, and suture material cost were recorded and analyzed statistically using Fisher's exact test and Student's t-test. One anastomotic leakage occurred (16.67%) in the figure-of-eight suture group, and two (33.33%) in the interrupted suture group (p > 0.9999). The anastomosis construction time was relatively short in the figure-of-eight suture group, but the difference did not reach a statistically significant level between the two groups. The mean number of suture knots and the cost of suture material in the figure-of-eight suture group were significantly decreased in comparison to the interrupted suture group (15.67 ± 3.30 vs. 22.17 ± 2.03, 167.11 ± 35.20 vs. 236.45 ± 21.70 CNY, p < 0.01, respectively). Our results suggested that the alternative asymmetric figure-of-eight suture technique was safe and economic for intestinal anastomosis. An in vivo experiment is required to elucidate the effects of this suture technique on the physiological anastomotic healing process.

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“Tie over ring” sutureless compression based gastrointestinal anastomotic method: experimental rat model

Cited by 6 publications

References 12 publications

Gastrojejunal anastomosis in rats using the magnetic compression technique

Gastrojejunal anastomosis in rats using the magnetic compression technique

Colorectal anastomotic healing: why the biological processes that lead to anastomotic leakage should be revealed prior to conducting intervention studies

An alternative asymmetric figure-of-eight single-layer suture technique for bowel anastomosis in an in vitro porcine model

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