Automatic aortic anastomosis with an innovative computer-controlled circular stapler for surgical treatment of aortic aneurysm.
OBJECTIVE
This study applied a computer-controlled mechanical stapler to vascular end-to-end anastomosis to achieve an automatic aortic anastomosis between the aorta and an artificial graft. In this experimental study, we created a mechanical end-to-end anastomotic model and assessed the strength of the anastomotic site under high pressure.


METHODS
We used a computer-controlled circular stapler named iDrive (Power Medical Interventions, Covidien plc, Dublin, Ireland) for the anastomosis between the porcine aorta and an artificial graft. Then the mechanically stapled group (group A) and the manually sutured group (group B) were compared 10 times, and we assessed the differences at several levels of pressure.


RESULTS
To use a mechanical stapler in vascular anastomosis, some special preparations of both the aorta and the artificial graft are necessary to narrow the open end before the procedures. To solve this problem, we established a specially designed purse-string suture for both and finally established end-to-end vascular anastomosis. The anastomosis speed of group A was statistically significantly faster than that of group B (P < .01). The group A anastomotic sites also showed significantly more tolerance to high pressure than those of group B.


CONCLUSIONS
The computer-controlled stapling device enabled reliable anastomosis of the aorta and the artificial graft. This study showed that mechanical vascular anastomosis with the iDrive was sufficiently strong and safe relative to manual suturing.
Division of General and Cardiothoracic Surgery, Kanazawa University School of Medicine, Kanazawa, Japan. takatamunehisa0223@yahoo.co.jp
Munehisa
M
Takata
Go
G
Watanabe
Hiroshi
H
Ohtake
Teruaki
T
Ushijima
Shojiro
S
Yamaguchi
Yujiro
Y
Kikuchi
Yoshitaka
Y
Yamamoto
D000714:Anastomosis, Surgical; D000818:Animals; D001014:Aortic Aneurysm / Q000601:surgery*; D001331:Automation; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D004867:Equipment Design; D008422:Materials Testing; D023421:Models, Animal; D011312:Pressure; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000295:instrumentation*; D013528:Surgical Staplers; D017792:Surgical Stapling / Q000009:adverse effects / Q000295:instrumentation*; D013536:Suture Techniques; D013552:Swine