[The "grasping tie". I. Introduction to and technical notes of an innovative mechanical tool aimed at formation of "purse string" in digestive surgery].
The grasping tie is an original and mechanical tool, conceived and planned to be used in digestive surgery, to temporary grasp and fasten at the axis of the head or the anvil of a circular stapler the tract of the gut chosen for anastomosis. Its use permit to fix the lower oesophageal stump in total gastrectomy, or that of the rectal stump in the lower rectal resection, respectively to the axis of the circular stapler component for the time necessary to perform the mechanical anastomosis. That is performed by the employment of a thin nylon ribbon, which will be progressively tightened as requested like a one way running knot about the tract of the gut and at the axis of the part of the stapler. The device will be repeatedly activated by an handle located at one of its ends, tightening progressively at the other end a thin nylon ribbon preventively put and laced around the chosen point of the digestive tract to grasp firmly and irreversibly the gut to the axis of the stapler, and then cut away by a trigger of the device in the same end of the handle. The nylon ring will be extracted together with the muscle-mucosal rings once completed the stapler suture, so that nothing of the ribbon remains in the patient. Its function is alternative to the classical tool used to prepare a purse-string suture on a segment of the digestive tract. Its advantages in front of that tool is the minimal space it requires for its use, therefore with operative advantages in fixing the head of the circular stapler in the oesophagus during the reconstructive steps after a total gastrectomy, and in fixing the lower rectum to the axis of anvil of a circular stapler preventively introduced in the anus and extruded. Moreover its employment is advantageous in closing from the outside the two ends of a tract of the gut where a tumour is located, so allowing a safe subsequent manipulation of the gut without oncologic prejudice.
Picardi
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Dipartimento di Scienze Chirurgiche Sperimentali e Cliniche Cattedra di Chirurgia Generale, I Divisione Clinicizzata di Chirurgia, Università degli Studi G. d'Annunzio di Chieti. picardi@unich.it
D000714:Anastomosis, Surgical / Q000295:instrumentation*; D013505:Digestive System Surgical Procedures; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D012007:Rectum / Q000601:surgery*; D013528:Surgical Staplers; D013536:Suture Techniques
"Grasping tie"--I. Presentazione e note tecniche di un innovativo strumento meccanico per la confezione della "borsa di tabacco" in chirurgia digestiva.