Use of a cauterizing laparoscopic linear stapler in intestinal anastomosis.
The purpose of this study was to assess the usefulness of a cauterizing laparoscopic linear stapler for intestinal anastomosis. In a porcine model, intestinal anastomoses performed with a standard laparoscopic linear stapler, a cauterizing laparoscopic linear stapler (RF stapler), and a two-layer, hand-sewn technique were compared by measuring bursting pressures at 4 and 7 days after surgery. During surgery, the RF stapler provided better hemostasis than the regular stapler for mesenteric transection. At 4 days, one leak occurred in the RF stapler group, and the bursting pressure in the RF stapler group was significantly lower than the bursting pressures in the regular stapler group and the hand-sewn group. In addition, the bursting pressure was significantly greater in the hand-sewn group than in the regular stapler group at 4 days. By 7 days, there were no differences in bursting pressure among the groups. We recommend that the RF stapler not be used for intestinal anastomosis. However, the device may be beneficial for controlling vasculature.
Hardacre
J M
JM
Department of Surgery, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Mendoza-Sagaon
M
M
Murata
K
K
Talamini
M A
MA
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D002425:Cautery; D005069:Evaluation Studies as Topic; D005260:Female; D007421:Intestine, Small / Q000601:surgery*; D010535:Laparoscopy; D017792:Surgical Stapling / Q000295:instrumentation*; D013552:Swine; D013718:Tensile Strength; D013997:Time Factors; D014945:Wound Healing