Optimal intracorporeal anastomosis for colectomy: A comparative experimental evaluation through 3D anastomosis models

Abstract

Intracorporeal anastomosis (IA) is gradually becoming widespread; however, there are no detailed reports on its configuration. The aim of this study was to create three-dimensional IA models and compare their configurations in detail. Three types of IA models were used: overlap anastomosis (OLA), delta-shaped anastomosis (DSA), and functional end-to-end anastomosis (FEEA). In experiment 1, three-dimensional images of each anastomosis model were created. Additionally, the length of each staple line comprising the anastomotic site was measured. In experiment 2, the length of intestinal mobilization required for anastomosis was compared. The circumference of the anastomosis in OLA (141.5 ± 3.3 mm) was significantly greater than those in DSA (87.9 ± 0.9 mm; p < 0.001) and FEEA (89.6 ± 10 mm; p < 0.0001). The length of the intestinal tract after the anastomosis in DSA (33 ± 6.9 mm) was significantly shorter than that in FEEA (76 ± 2 mm; p < 0.0001) and OLA (60 ± 5 mm; p < 0.002). In this study, we successfully constructed three-dimensional images of IA models. OLA may be the least likely cause of stricture, and DSA may contribute to minimizing bowel mobilization required for anastomosis.