title: "Tie over ring" sutureless compression based gastrointestinal anastomotic method: experimental rat model.
abstract: BACKGROUND
  Giving the ever-rising trend of pediatric minimally invasive surgery besides early neonatal surgical interventions, intestinal anastomosis turns out to be a time consuming stage due to several anatomical as well as technical difficulties. A perfect bowel anastomosis method should be easy, rapid, safe and reliable in creation of bowel continuity with minimal tissue damage. In this light, sutureless anastomotic methods have been introduced, using compression based anastomosis with biofragmentable rings or powerful magnets. Accordingly, this experimental animal model study has evaluated the result of an easy, rapid intestinal sutureless anastomotic technique via simple tying over an intraluminal ring, in comparison with conventional handsewn bowel anastomosis.
  
  
  METHODS
  Thirty Wistar-Albino male rats were enrolled and small bowel was transected via a midline laparotomy. A grooved plastic ring was inserted into the ileal lumen and both intestinal cutting ends were fixed over the ring with a simple tie in the first group. On the other hand, enteroenterostomy was performed by the conventional method of handsewn anastomosis in the second group. After 14 days, rats were sacrificed to evaluate for intraperitoneal adhesion and abscess formation in addition to other evidences of anastomotic leakage. Furthermore, the anastomotic site integrity, tensile strength and healing stage were assessed microscopically.
  
  
  RESULTS
  The mean operative time and intraoperative bleeding in the tie over ring group were significantly less than those in the handsewn anastomosis group. Anastomotic stricture was more common in the conventional anastomosis group while the anastomotic tensile strength was significantly higher in the tie over ring group. Histopathological healing parameters and final healing score were almost similar in both groups but mean inflammatory cell infiltration in handsewn anastomosis was significantly higher.
  
  
  CONCLUSIONS
  "Tie over ring" is a simple method of anastomosis that is feasible, fast, safe and functionally effective for bowel reconstruction in animal models that could be reconsidered in human bowel anastomosis.
authors.affiliation: Endoscopic & Minimally Invasive Surgery Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashad, Iran.
authors.forename: Mehran
authors.initials: M
authors.lastname: Hiradfar
authors.affiliation: Endoscopic & Minimally Invasive Surgery Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashad, Iran. Electronic address: Drshojaeian@ymail.com.
authors.forename: Reza
authors.initials: R
authors.lastname: Shojaeian
authors.affiliation: Endoscopic & Minimally Invasive Surgery Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashad, Iran.
authors.forename: Nona
authors.initials: N
authors.lastname: Zabolinejad
authors.affiliation: Endoscopic & Minimally Invasive Surgery Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashad, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Gharavifard
authors.affiliation: Endoscopic & Minimally Invasive Surgery Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashad, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Sabzevari
authors.affiliation: Endoscopic & Minimally Invasive Surgery Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashad, Iran.
authors.forename: Marjan
authors.initials: M
authors.lastname: Joodi
authors.affiliation: Endoscopic & Minimally Invasive Surgery Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashad, Iran.
authors.forename: Nazila
authors.initials: N
authors.lastname: Yal
authors.affiliation: Endoscopic & Minimally Invasive Surgery Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashad, Iran.
authors.forename: Parisa
authors.initials: P
authors.lastname: Saeedi Sharifabad
authors.affiliation: Endoscopic & Minimally Invasive Surgery Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashad, Iran.
authors.forename: Sara
authors.initials: S
authors.lastname: Hajian
authors.affiliation: Endoscopic & Minimally Invasive Surgery Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashad, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Nazarzadeh
authors.affiliation: Endoscopic & Minimally Invasive Surgery Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashad, Iran.
authors.forename: Nasim
authors.initials: N
authors.lastname: Lotfinejad
mesh_terms: D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods; D057868:Anastomotic Leak / Q000209:etiology; D000818:Animals; D016063:Blood Loss, Surgical; D013505:Digestive System Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D007082:Ileum / Q000473:pathology / Q000601:surgery*; D020007:Implants, Experimental; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D023421:Models, Animal; D061646:Operative Time; D010969:Plastics; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D013530:Surgical Wound Infection / Q000209:etiology; D013536:Suture Techniques; D013718:Tensile Strength; D000267:Tissue Adhesions / Q000209:etiology / Q000473:pathology
chemical_list: D010969:Plastics
keywords: Anastomosis; Bowel; Minimally invasive surgery; Pediatrics; Sutureless