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The triple-stapled colonic anastomosis

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Diseases of the Colon & Rectum

Abstract

This study reports the preliminary results of a new totally stapled end-to-end colonic anastomosis in 11 dogs. This “triple-stapled” end-to-end anastomosis was performed with one circular staple line and two linear staple lines, eliminating the need for a colotomy or purse-string suture. The fact that the anvil and anvil stem of a new circular stapling device (Premium EEA) can be detached from the frame of the instrument allows the anvil stem to be brought out through the proximal linear stapled colon. The trocar mounted on the main stem of the circular stapler allows the stem of the main device to be brought out through the distal staple line. Thus, a totally stapled colonic anastomosis is created after mating the anvil stem and main stem of the instrument. The new anastomosis was evaluated radiographically and at necropsy. The use of this technique resulted in no clinically detectable leaks, suggesting that it may facilitate the performance of anterior resections in humans.

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References

  1. Goligher JC. Recent trends in the practice of sphincter-saving excision for rectal cancer. Ann R Coll Surg Eng I 1979;61:169–76.

    CAS  Google Scholar 

  2. Julian TB, Ravitch MM. Evaluation of the safety of end-to-end (EEA) stapling anastomoses across linear stapled closures. Surg Clin North Am 1984;64:567–77.

    PubMed  CAS  Google Scholar 

  3. Nance FC. New techniques of gastrointestinal anastomoses with the EEA stapler. Ann Surg 1979;189:587–600.

    Article  PubMed  CAS  Google Scholar 

  4. Knight CD, Griffen FD. An improved technique for low anterior resection of the rectum using the EEA stapler. Surgery 1980;88:710–4.

    PubMed  CAS  Google Scholar 

  5. LeBlanc KA, Russo VR. Modification of the end-to-end stapled anastomosis utilizing intersecting staple lines. Arch Surg 1988;123:110–2.

    PubMed  CAS  Google Scholar 

  6. Principles of Laboratory Animal Care and the Guide for the Care and Use of Laboratory Animals. NIH Publication No. 80:23 Revised 1985.

  7. Wheeless CR. Avoidance of permanent colostomy in pelvic malignancy using the surgical stapler. Obstet Gynecol 1979;54:501–5.

    Article  PubMed  Google Scholar 

  8. Beart RW, Kelly KA. Randomized prospective evaluation of the EEA stapler for colorectal anastomoses. Am J Surg 1981;141:143–7.

    Article  PubMed  Google Scholar 

  9. Smart CR. Cancer of colon and rectum in the United States: the scope of the problem. In: Beahrs OH, Higgins GA, Weinstein JJ, eds. Colorectal tumors. Philadelphia: JB Lippincott, 1986:3–7.

    Google Scholar 

  10. Morgenstern L. The intestinal anastomoses with the end-to-end stapling instrument: progress and problems, 1980. Arch Surg 1981;116:141–2.

    PubMed  CAS  Google Scholar 

  11. Goligher JC. Use of the circular stapling gun with the peranal insertion of anorectal purse-string suture for construction of very low colorectal or colon-anal anastomoses. Br J Surg 1979;66:501–4.

    PubMed  CAS  Google Scholar 

  12. Papachristou DN, Fortner JG. A modified circular stapler for gastro-intestinal anastomosis. Br J Surg 1981;68:132–4.

    PubMed  CAS  Google Scholar 

  13. Bokey EL, Phiels MT. An alternative technique of inserting the distal purse-string for the EEA stapling device in a low anterior resection. Aust NZ J Surg 1980;50:311–4.

    CAS  Google Scholar 

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Julian, T.B., Kolachalam, R.B. & Wolmark, N. The triple-stapled colonic anastomosis. Dis Colon Rectum 32, 989–995 (1989). https://doi.org/10.1007/BF02552280

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  • DOI: https://doi.org/10.1007/BF02552280

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