Development of a tracheal stapling device.
OBJECTIVE
Recent years have witnessed a multitude of technical advances regarding gastrointestinal and vascular anastomosis. However, difficulties still hamper tracheal and bronchial anastomosis. We have therefore developed a novel set of instruments and performed end-to-end anastomosis of the transected canine cervical trachea to establish the operative procedures.


METHODS
A novel set of instruments was developed for tracheal anastomosis including two pairs of forceps for grasping the free tracheal ends, a metal connecting device, and clamping forceps for staple insertion. Briefly, the operative procedure involves fixation of forceps circumferentially to hold the cut trachea. End-to-end anastomosis is completed by joining the forceps with a clamp and stapling the tracheal ends everted outward. End-to-end anastomosis of the cervical trachea was performed on 23 dogs. Animals were monitored on a daily basis, and bronchofiberscopy was performed periodically. Deaths from all causes were evaluated by immediate necropsy. Sixteen dogs were sequentially sacrificed at 1, 2, 3 and at 6 months after surgery.


RESULTS
In our dog model, stenosis at the anastomosis of the cervical trachea was found as a complication in 8 of 23 cases. Tracheal rupture occurred in a further 3 cases, slight granulation in another 4, and the remaining 8 showed no complication. Histological findings of anastomotic healing were similar to those reported for hand suture.
Department of Respiratory Surgery, Toyokawa City Hospital, 1-19 Koumei-cho, Toyokawa City, Aichi 442-8561, Japan.
T
T
Nishida
S
S
Sasaki
H
H
Tomino
Y
Y
Yamakawa
Y
Y
Fujii
A
A
Masaoka
D000714:Anastomosis, Surgical / Q000295:instrumentation*; D000818:Animals; D004285:Dogs; D004867:Equipment Design; D013537:Sutures; D014132:Trachea / Q000601:surgery*