Document Detail

End-to-end compression anastomosis of the rectum: a pig model.
MedLine Citation:
PMID:  17334866     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Generations of investigators have attempted to achieve compression bowel anastomosis by a sutureless device, providing temporary support to the tissue and facilitating the natural healing process. The biocompatibility of nickel-titanium alloy has made it attractive for use in medical implants and devices, and several studies have described the creation of a side-to-side compression anastomosis in colon surgery with a nickel-titanium clip. We evaluated the feasibility and safety of a newly designed gun for applying a nickel-titanium compression anastomosis ring (CAR) to create an end-to-end colorectal anastomosis in a porcine model. MATERIALS AND METHODS: A segment of the proximal rectum was resected in 25 pigs. The bowel ends were anastomosed transanally by an end-to-end CAR device. The animals' follow-up continued for up to 8 weeks, and included general health status, weight gain, blood tests, and abdominal X-ray. They were then sacrificed. The anastomoses were studied for burst pressure, anastomotic index, and histopathology. RESULTS: One pig died due to iatrogenic bowel injury unrelated to the CAR device. There was no other morbidity/mortality. The other animals recovered and gained weight. Burst pressure studies demonstrated a minimum pressure of 160 mmHg at time point 0 that escalated quickly to >300 mmHg. The mean anastomotic index after 8 weeks was 0.81. Histologic evaluation revealed minimal inflammation and minimal fibrosis at the anastomosis site. CONCLUSION: The principles of compression anastomosis are better executed with the use of memory shape alloys. The promising results of this novel technique should encourage further studies of this technology.
Doron Kopelman; Shlomo Lelcuk; Joel Sayfan; Ibrahim Matter; Ehud P Willenz; Luis Zaidenstein; Ossama A Hatoum; Boaz Kimmel; Amir Szold
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of surgery     Volume:  31     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-05     Completed Date:  2007-09-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  532-7     Citation Subset:  IM    
Department of Surgery B, HaEmek Medical Center, Afula, Israel.
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MeSH Terms
Anastomosis, Surgical / instrumentation*
Biocompatible Materials
Feasibility Studies
Prosthesis Design
Prosthesis Implantation
Rectum / surgery*
Reg. No./Substance:
0/Biocompatible Materials; 7440-02-0/Nickel; 7440-32-6/Titanium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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