title: Bipolar radiofrequency-induced thermofusion of intestinal anastomoses--feasibility of a new anastomosis technique in porcine and rat colon.
abstract: OBJECTIVE
  In recent years, vessel sealing has become a well-established method in surgical practice for sealing and transecting vessels. Since this technology depends on the fusion of collagen fibers abundantly present in the intestinal wall, it should also be possible to create intestinal anastomoses by thermofusion. Bipolar radiofrequency-induced thermofusion of intestinal tissue may replace traditionally used staples or sutures in the future. The aim of this study was to evaluate the feasibility of fusing intestinal tissue ex vivo by bipolar radiofrequency-induced thermofusion.
  
  
  METHODS
  An experimental setup for temperature-controlled bipolar radiofrequency-induced thermofusion of porcine (n = 30) and rat (n = 18) intestinal tissue was developed. Colon samples were harvested and then anastomosed, altering compressive pressure to examine its influence on anastomotic bursting pressure during radiofrequency-induced anastomotic fusion. For comparison, mechanical stapler anastomoses of porcine colonic samples and conventional suturing of rat colonic samples identical to those used for fusion experiments were prepared, and burst pressure was measured.
  
  
  RESULTS
  All thermofused colonic anastomoses were primarily tight and leakage proof. For porcine colonic samples, an optimal interval of compressive pressure (1,125 mN/mm(2)) with respect to a high amount of burst pressure (41 mmHg) was detected. The mean bursting pressure for mechanical stapler anastomosis was 60.7 mmHg and did not differ from the thermofusion (p = 0.15). Furthermore, the mean bursting pressure for thermofusion of rat colonic samples was up to 69.5 mmHg for a compressive pressure of 140 mN/mm(2).
  
  
  CONCLUSIONS
  These results confirm the feasibility to create experimental intestinal anastomoses using bipolar radiofrequency-induced thermofusion. The stability of the induced thermofusion showed no differences when compared to that of conventional anastomoses. Bipolar radiofrequency-induced thermofusion of intestinal tissue represents an innovative approach for achieving gastrointestinal anastomoses.
authors.affiliation: Department of General, Vascular and Thoracic Surgery, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany. christoph.holmer@charite.de
authors.forename: Christoph
authors.initials: C
authors.lastname: Holmer
authors.forename: Hanno
authors.initials: H
authors.lastname: Winter
authors.forename: Matthias
authors.initials: M
authors.lastname: Kröger
authors.forename: Alexandra
authors.initials: A
authors.lastname: Nagel
authors.forename: Annika
authors.initials: A
authors.lastname: Jaenicke
authors.forename: Roland
authors.initials: R
authors.lastname: Lauster
authors.forename: Marc
authors.initials: M
authors.lastname: Kraft
authors.forename: Heinz J
authors.initials: HJ
authors.lastname: Buhr
authors.forename: Jörg-Peter
authors.initials: JP
authors.lastname: Ritz
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D003106:Colon / Q000601:surgery*; D019245:Compressive Strength; D004564:Electrocoagulation; D005240:Feasibility Studies; D051381:Rats; D013536:Suture Techniques; D013552:Swine; D013718:Tensile Strength