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Gastrointestinal sutureless anastomosis using fibrin glue: reinforcement of the sliding absorbable intraluminal nontoxic stent and development of a stent placement device.
- Source :
-
Journal of investigative surgery : the official journal of the Academy of Surgical Research [J Invest Surg] 1996 Mar-Apr; Vol. 9 (2), pp. 111-30. - Publication Year :
- 1996
-
Abstract
- Sutureless anastomosis of the gastrointestinal tract using fibrin glue and sliding absorbable intraluminal nontoxic stents (SAINTs) has two shortcomings, stent shaft breakage and the lack of a transanal insertion device (TID) for low anterior resection. Reinforcement of the sucrose base SAINT (R-SAINT) is described. Sutureless anastomosis is attempted using a stapleless mechanical stapler (SS) and used as preprototype to screen histologically and mechanically for TID anastomoses in the small intestine. Finally, a prototype absorbable head SAINT placement device (SAINT-PD) intended for TID, similar to the SS, is utilized on the small intestine. Fifty-seven Landrace pigs weighing 25-35 kg were used to perform 58 anastomoses, including the small intestine (15 manual, 19 SAINT, 11 SS, 5 R-SAINT, 6 SAINT-PD) and large intestine (2 R-SAINT). All anastomoses performed with the R-SAINT succeeded on the first attempt even if the shaft cracked. The SS technique proved impractical, but the histological screen results from 7 to 60 days did approximate those of corresponding SAINT anastomoses. The SAINT-PD demonstrated operational improvement over the SS, but the histological results were similar to both the SS and SAINT. The advantages of the R-SAINT and SAINT-PD are that they leave no foreign bodies or pressure clamping devices at the anastomostic site. Larger studies may show the R-SAINT and the SAINT-PD to be practical, new surgical tools in sutureless fibrin glue anastomosis.
- Subjects :
- Absorption
Anastomosis, Surgical instrumentation
Animals
Cicatrix
Equipment Design
Intestine, Large pathology
Intestine, Large surgery
Intestine, Small pathology
Intestine, Small surgery
Surgical Staplers
Swine
Time Factors
Anastomosis, Surgical methods
Biocompatible Materials
Digestive System Surgical Procedures
Fibrin Tissue Adhesive
Stents
Subjects
Details
- Language :
- English
- ISSN :
- 0894-1939
- Volume :
- 9
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of investigative surgery : the official journal of the Academy of Surgical Research
- Publication Type :
- Academic Journal
- Accession number :
- 8725551
- Full Text :
- https://doi.org/10.3109/08941939609012464