A memory-shape temperature-dependent nickel-titanium device for colonic anastomosis in laparoscopic surgery.
Minimally invasive surgery is a growing issue in medicine and is also increasingly being used for colonic surgery. With this procedure, the involved colon is dissected laparoscopically, exteriorized through a small incision and the segment containing the tumor is resected. The anastomosis is done extraperitoneally either by hand suture or with a stapler. Our study was designed to evaluate the feasibility of using a memory-shape compression anastomosis clip (CAC) to perform colonic anastomosis in laparoscopy. Ten patients who were scheduled for laparoscopic colonic surgery entered the study. In five patients, the anastomosis was performed with the CAC and in five patients, with a stapler. To perform anastomosis with CAC, the two edges of the resected colon are placed parallel. Two 5-mm incisions are made close to the edges, where the CAC is introduced in an open position after being cooled in ice water at 0 degrees C, using a special applier. The applier introduces the clip which clamps the two bowel loops together, creating a small incision through the clamped walls, and then releasing the clip inside the intestine. The two 5-mm incisions are then sutured. The clip is expelled with the stool within five to seven days after the operation, creating a perfect uniform anastomosis. Neither group had complications related to the anastomosis. Our study shows that the use of the CAC for colonic laparoscopic surgery is simple, very efficient and shortens operation time. It creates a uniform anastomosis, coming close to the no-touch concept in surgery, may prevent infection, and is low in cost compared to the stapler.
Nudelman
Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel.
Fuko
Rubin
Lelcuk