A new technique for intestinal isoperistaltic anastomosis utilizing a linear stapler for enlargement after anastomosis performed with a circular stapler.
BACKGROUND
The high incidence of anastomotic stenosis after gastrointestinal surgery using circular staplers is a major problem. In response, we have developed a new technique that uses a linear stapler to enlarge an anastomotic opening made using a circular stapler.


METHODS
Anastomoses were created by the new technique or by the conventional approach using a circular stapler in pig small intestine. The method was also applied in treatment of a colon cancer patient.


RESULTS
The area of the anastomotic opening obtained with the new technique was more than 3 times that in the control (p < 0.001), with no significant difference between the methods in a leak test. Follow-up of the patient undergoing surgery with this approach revealed an uneventful course with a widely patent anastomosis confirmed after 3 months.


CONCLUSIONS
This procedure provides a larger anastomotic opening than conventional anastomosis with circular staplers, without impairing the integrity of the anastomosis.
Takeyama
H
H
Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-ku, Nagoya, 467-8601, Japan. takeyama@med.nagoya-cu.ac.jp
Sawai
H
H
Sato
M
M
Akamo
Y
Y
Yamamoto
M
M
Funahashi
H
H
Manabe
T
T
D000714:Anastomosis, Surgical / Q000295:instrumentation; D000818:Animals; D004867:Equipment Design; D007421:Intestine, Small / Q000601:surgery*; D013528:Surgical Staplers; D013552:Swine