Technics of Staple Suturing in the Gastrointestinal Tract

Ravitch, Mark M.; Steichen, Felicien M.

doi:10.1097/00000658-197206010-00002

Cited by 148 publications

(35 citation statements)

References 3 publications

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“…Since Ravitch and Steichen [1]introduced a modified form of the Soviet-developed stapling instruments in the 1960s, various types of staplers and techniques have been advocated. The majority of stapled intestinal anastomoses are classified into two types: anatomical end-to-end anastomosis using a circular stapler, and functional end-to-end anastomosis using a linear stapler.…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Stapled and Hand-Sewn Anastomoses in Crohn’s Disease

et al. 1998

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Sixty-eight patients with Crohn’s disease who underwent intestinal resection were randomly divided into 2 groups: the stapled group (32 patients, 40 anastomoses) with functional end-to-end anastomoses made with linear staplers and with circular stapling anastomoses, and the hand-sewn group (36 patients, 48 anastomoses), with anastomoses achieved by layer-to-layer suturing. There were no significant differences in operative indications, age, sex, blood loss, or length of hospital stay between the groups. The operation times for right hemicolectomy and total colectomy in the stapled group were significantly shorter than those in the hand-sewn group. There were no significant differences in anastomotic dehiscence or recurrence between the stapling and hand-sewn procedures. These results indicate that these stapling techniques, even though producing an everted anastomosis, are not an adverse procedure for Crohn’s disease.

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Section: Introductionmentioning

confidence: 99%

A Comparison of Stapled and Hand-Sewn Anastomoses in Crohn’s Disease

et al. 1998

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“…Since the introduction of the mechanical stapler designed by Ravitch and Steichen [20], the most popular mechanical device for use in the performance of intestinal anastomosis has been the linear stapler or circular stapler [20,21]. However, Nudelman et al have reported that in the field of colorectal surgery, the CAC device has several advantages over the use of the stapler devices [10][11][12].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of NiTi Hand CAC™ 30 for jejunojejunostomy in gastric cancer surgery: results from a multicenter prospective randomized trial

et al. 2011

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Background Although a novel technique for the performance of intestinal sutureless anastomosis using a compression device has recently been investigated, it has not yet received widespread acceptance. We performed a multicenter prospective randomized trial in order to determine the clinical efficacy of the NiTi Hand CAC TM 30, a type of compression anastomosis clip (CAC), for jejunojejunostomy in gastric cancer surgery. Methods Forty-seven patients from 6 institutions, who were diagnosed with gastric adenocarcinoma, were enrolled; these patients were randomized to a CAC group and a hand-sewn (control) group. Three patients dropped out for various reasons, and results for 44 patients were finally analyzed. The CAC group consisted of 20 patients, and there were 24 patients in the control group. Results Anastomosis time, the primary endpoint of this trial, was shorter in the CAC group than in the control group (P \ 0.001). However, total operation times (P = 0.055) did not differ. All reconstructions were completed by Roux-en-Y anastomosis, and the complication rates of the two groups did not differ (P = 0.908); however, jejunojejunostomy leakage occurred in two patients in the CAC group. Conclusions Our prospective multicenter clinical trial showed that the use of the NiTi Hand CAC TM 30 for jejunojejunostomy in gastric cancer surgery was feasible and could reduce anastomosis time. However, considering that there were two cases of leakage, extended use of the NiTi Hand CAC TM 30 should be carefully applied.

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“…This patient was treated initially by a loop colostomy and ultimately required resection and end-to-end anastomosis. The EEA staplers have been used extensively in gastrointestinal surgery including stricture resection, 10,11 but their use in the pediatric age group is limited. Our patient was operated upon successfully using a simple technique without interfering with the anatomy and function of the sphincters and obviating a long-term colostomy.…”

Section: Discussionmentioning

confidence: 99%

Congenital Rectal Stenosis: A Simple Approach to Management

Al-Salem

Talwalker

1994

Annals of Saudi Medicine

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AH Al-Salem, A Al-Faraj, V Talwalker, Congenital Rectal Stenosis: A Simple Approach to Management. 1994; 14(1): 56-57 Rectal atresia is a rare type of high anorectal malformation and of the variants of rectal atresia, congenital rectal stenosis is the least common type.1 Various surgical procedures 2-5 have been described for the management of rectal atresia, but due to its rarity, there is no standard tested approach for its management. We present a case of congenital rectal stenosis in a 3-1/2-year-old female and describe a simple technique for its management. Case ReportA 3-1/2-year-old female was referred to Qatif Central Hospital because of soiling her pants with liquid stools since birth, and just prior to her presentation, she started to complain of abdominal pain and distention. On examination, she was found to have mild abdominal distention with palpable fecal masses in the abdomen. A hard fecaloma was palpated in the pelvis on rectal examination, while the rectum was empty. After repeated rectal washouts, it was noted that the fecaloma was in the proximal part of the rectum immediately above a diaphragm with a central hole about 3 cm from the dentate line. This was confirmed by a barium enema (Figures 1 and 2). Surgical TechniqueThe patient underwent a laparotomy through a transverse suprapubic incision. The upper third of the rectum and sigmoid colon were dilated and hypertrophied, while the lower part of the rectum was normal in caliber and the junction between the two was clearly seen. There was no other pathology. The sigmoid colon was opened longitudinally to visualize the septum, which had a central hole. The #28 EEA gun (without anvil) was introduced transanally. The shaft was guided into the opening by a finger into the proximal rectum, through the opening in the sigmoid colon. The anvil was screwed on the shaft through the colotomy opening until it was flush at the site of the central hole. The gun was then fired. The head was released and the entire instrument was recovered from the anus (Figures 3a, b, and c). The gun contained a complete disc of tissue with a central opening. The integrity of the anastomosis was confirmed and the opening in the sigmoid colon was closed longitudinally in two layers.

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Technics of Staple Suturing in the Gastrointestinal Tract

Cited by 148 publications

References 3 publications

A Comparison of Stapled and Hand-Sewn Anastomoses in Crohn’s Disease

A Comparison of Stapled and Hand-Sewn Anastomoses in Crohn’s Disease

Efficacy of NiTi Hand CAC™ 30 for jejunojejunostomy in gastric cancer surgery: results from a multicenter prospective randomized trial

Congenital Rectal Stenosis: A Simple Approach to Management

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