Different characteristics of circular staplers make the difference in anastomotic tensile strength

Giaccaglia, Valentina; Antonelli, M.; Franceschilli, Luana; Salvi, Pier Federico; Gaspari, Achille; Sileri, Pierpaolo

doi:10.1016/j.jmbbm.2015.08.029

Cited by 6 publications

(4 citation statements)

References 16 publications

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“…Although bursting pressure has been used to evaluate staplers [65,93] and anastomoses [57,[94][95][96][97][98], this has met criticism [15], because bursting pressures are only comparable within, but not beyond, a single study [14]. Consequently, breaking forces have been the standard to evaluate colorectal surgical stapling [37,38,63,92,99,100] but have also been used to investigate hand-sewn anastomoses [4,101,102]. As stapling is the standard for such colorectal anastomoses, endoscopic interventions that should supplement or even replace surgery in cases of intestinal perforation [30], a comparative assessment of the durability of the anastomoses requires using the same technique to evaluate them.…”

Section: Discussionmentioning

confidence: 99%

“…The intestinal segments were evaluated for a potential relationship to the allometric parameters of crown-rump length and body weight in order to contribute to the further refinement of experimental models of interventions. Our report focused on breaking forces of the intestine, because breaking forces are regularly used to evaluate enterotomy closures [36] and anastomoses [37,38].…”

Section: Introductionmentioning

confidence: 99%

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Not All Porcine Intestinal Segments Are Equal in Terms of Breaking Force, but None Were Associated to Allometric Parameters

Kratz,

Dauvergne,

Kronberg

et al. 2023

Gastroenterology Insights

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Biomechanics are gaining ground in gastroenterology in the creation of educational models and to describe the necessary forces to perforate hallow organs during endoscopy. We thus investigated the breaking forces of porcine intestinal segments and whether they could be predicted based on body weight or crown–rump length. Based on a priori power-analyses, 10 pigs were included. The breaking forces were determined with a motorized test stand. We found that the breaking forces of intestinal segments were different (H(6) = 33.7, p < 0.0001): Ileal breaking force (x¯ = 24.14 N) was higher than jejunal (x¯ = 14.24 N, p = 0.0082) and colonic (x¯ = 11.33 N, p < 0.0001) breaking force. The latter was also smaller than cecal breaking force (x¯ = 24.6 N, p = 0.0044). Likewise, rectal (x¯ = 23.57 N) breaking force was higher than jejunal (p = 0.0455) and colonic (p = 0.0006) breaking force. Breaking forces were not correlated to body weight or crown–rump length (R < 0.49, p > 0.148). Intestinal segments differ in their breaking forces. The colon had the least resistance to traction forces. It remains to be determined if similar relationships exist in humans in order to validate porcine models for endoscopy and surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Not All Porcine Intestinal Segments Are Equal in Terms of Breaking Force, but None Were Associated to Allometric Parameters

Kratz,

Dauvergne,

Kronberg

et al. 2023

Gastroenterology Insights

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“…Circular staplers also play an increasingly important role in vascular anastomoses [74]. The instrument is composed of a detachable anvil and a handling part, the last comprising a shaft that allocates the stapling cartridge and cutting element, a wing nut for opening and closing, and a handle to perform the firing and cutting operation [75]. This class of devices' cartridges contain a circular knife and a crown of staples of different heights that are available in a range of diameters to adapt to the dimension of the lumen to suture.…”

Section: Circular Staplersmentioning

confidence: 99%

Mechanical Stapling Devices for Soft Tissue Repair: A Review of Commercially Available Linear, Linear Cutting, and Circular Staplers

Burgio,

Bei,

Rodriguez Reinoso

et al. 2024

Applied Sciences

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Stapling devices have emerged as a widespread and effective option for soft tissue surgery, offering promising outcomes for patients by reducing complication rates and surgery time. This review aims to provide an exhaustive analysis of commercially available alternatives in the market, incorporating insights from market analysis, patent landscape, and the existing literature. The main focus lies in identifying and evaluating the most widely adopted and innovative stapling devices, including linear, linear cutting, circular, and powered staplers. In addition, this review delves into the realm of bioabsorbable staples, exploring the materials utilized and the surgical fields where these advanced staples find applications. To facilitate easy comprehension, the gathered information is presented in tables, highlighting the essential parameters for each stapling device. This comprehensive research about stapling devices is intended to aid healthcare practitioners and researchers in making informed decisions when choosing the most appropriate instrument for specific surgical procedures.

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“…Intestinal anastomosis is a basic technique to restore gut continuity. Several intestinal anastomosis techniques, including hand-sewn, stapled, laparoscopic, robotic, and sutureless anastomoses, are used with varied outcomes (1)(2)(3)(4)(5)(6)(7)(8). The hand-sewn intestinal anastomosis technique is divided into single-layer and double-layer suture techniques (9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Asymmetric figure-of-eight single-layer suture technique for intestinal anastomosis: A preliminary study

Liu

Zhang²,

Ren³

et al. 2023

Front. Surg.

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BackgroundAnastomotic leakage is a life-threatening complication. Improvement of the anastomosis technique is needed, especially in patients with an inflamed edematous intestine. The aim of our study was to evaluate the safety and efficacy of an asymmetric figure-of-eight single-layer suture technique for intestinal anastomosis in pediatric patients.MethodsA total of 23 patients underwent intestinal anastomosis at the Department of Pediatric Surgery of Binzhou Medical University Hospital. Demographic characteristics, laboratory parameters, anastomosis time, duration of nasogastric tube placement, day of first postoperative bowel movement, complications, and length of hospital stay were statistically analyzed. The follow-up was conducted for 3–6 months after discharge.ResultsPatients were divided into two groups: the single-layer asymmetric figure-of-eight suture technique (group 1) and the traditional suture technique (group 2). Body mass index in group 1 was lower than in group 2 (14.43 ± 3.23 vs. 19.38 ± 6.74; P = 0.036). The mean intestine anastomosis time in group 1 (18.83 ± 0.83 min) was less than that in group 2 (22.70 ± 4.11 min; P = 0.005). Patients in group 1 had an earlier first postoperative bowel movement (2.17 ± 0.72 vs. 2.80 ± 0.42; P = 0.023). The duration of nasogastric tube placement in group 1 was shorter than that in group 2 (4.12 ± 1.42 vs. 5.60 ± 1.57; P = 0.043). There was no significant difference in laboratory variables, complication occurrence, and length of hospital stay between the two groups.ConclusionThe asymmetric figure-of-eight single-layer suture technique for intestinal anastomosis was feasible and effective. More studies are needed to compare the novel technique with the traditional single-layer suture.

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Different characteristics of circular staplers make the difference in anastomotic tensile strength

Cited by 6 publications

References 16 publications

Not All Porcine Intestinal Segments Are Equal in Terms of Breaking Force, but None Were Associated to Allometric Parameters

Not All Porcine Intestinal Segments Are Equal in Terms of Breaking Force, but None Were Associated to Allometric Parameters

Mechanical Stapling Devices for Soft Tissue Repair: A Review of Commercially Available Linear, Linear Cutting, and Circular Staplers

Asymmetric figure-of-eight single-layer suture technique for intestinal anastomosis: A preliminary study

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