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BMC veterinary research2021; 17(1); 167; doi: 10.1186/s12917-021-02871-4

Effect of three different needle holders on gastrointestinal anastomosis construction time and bursting pressure in equine jejunal segments.

Abstract: Equine small intestinal resection and anastomosis is a procedure where optimizing speed, without compromising integrity, is advantageous. There are a range of different needle holders available, but little is published on the impact surgical instrumentation has on surgical technique in veterinary medicine. The objectives of this study were to investigate if the needle holder type influences the anastomosis construction time, the anastomosis bursting pressure and whether the bursting pressure is influenced by the anastomosis construction time. Single layer end-to-end jejunojejunal anastomoses were performed on jejunal segments harvested from equine cadavers. These segments were randomly allocated to four groups. Three groups based on the needle holder type that was used: 16.5 cm Frimand (Group 1), 16 cm Mayo-Hegar (Group 2) or 20.5 cm Mayo-Hegar (Group 3) needle holders. One (Group 4) as control without anastomoses. Anastomosis construction time was recorded. Bursting pressure was determined by pumping green coloured fluid progressively into the lumen whilst recording intraluminal pressures. Maximum pressure reached prior to failure was recorded as bursting pressure. Construction times and bursting pressures were compared between needle holder, and the correlation between bursting pressure and construction time was estimated. Results: Construction times were not statistically different between groups (P = 0.784). Segments from Group 2 and Group 3 burst at a statistically significantly lower pressure than those from Group 4; P = 0.031 and P = 0.001 respectively. Group 4 and Group 1 were not different (P = 0.125). The mean bursting pressure was highest in Group 4 (189 ± 61.9 mmHg), followed by Group 1 (166 ± 31 mmHg) and Group 2 (156 ± 42 mmHg), with Group 3 (139 ± 34 mmHg) having the lowest mean bursting pressure. Anastomosis construction time and bursting pressure were not correlated (P = 0.792). Conclusions: The tested needle holders had a significant effect on bursting pressure, but not on anastomosis construction time. In an experimental setting, the Frimand needle holder produced anastomoses with higher bursting pressures. Further studies are required to determine clinical implications.
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Publication Date: 2021-04-15 PubMed ID: 33858391PubMed Central: PMC8048223DOI: 10.1186/s12917-021-02871-4Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research examines whether types of needle holders used in equine small intestinal surgery can affect the time taken to make sutures (anastomosis construction time) or the strength of those sutures (bursting pressure). The results found no difference in construction time but found differing levels of suture strength, with the Frimand needle holder linked to higher bursting pressure.

Research Methodology

  • The study was carried out on segments of small intestine (jejunum) taken from horse cadavers.
  • Four groups were set up: three where different types of needle holders were used (16.5 cm Frimand, 16 cm Mayo-Hegar or 20.5 cm Mayo-Hegar) and one control group where no sutures were made.
  • Construction time for suturing, and the suture’s bursting pressure, were recorded for each group. The bursting pressure was tested by pumping fluid into the sutured segment until the suture failed and recording the pressure at that moment.

Results

  • The time taken to construct sutures did not vary significantly between the groups using different needle holders.
  • The sutures made with the 16 cm and 20.5 cm Mayo-Hegar holders showed a significantly lower bursting pressure than the control group.
  • No significant difference in bursting pressure was found between the control group and the group used 16.5 cm Frimand holders.
  • The group with the highest average bursting pressure was the control group, followed by the Frimand group, then the 16 cm Mayo-Hegar group, with the 20.5 cm Mayo-Hegar group having the lowest average.
  • No correlation was found between construction time and bursting pressure.

Conclusions

  • The type of needle holder used in this procedure had a significant impact on the strength of the suture (bursting pressure) but not on the time taken to construct sutures.
  • In the experimental conditions of the research, the 16.5cm Frimand holder was found to make sutures with the highest burst pressure.
  • Further research is needed to understand the clinical implications of these findings and whether the use of different needle holders could lead to different clinical outcomes in live animals undergoing small intestine surgery.

Cite This Article

APA
Averay K, van Galen G, Ward M, Verwilghen D. (2021). Effect of three different needle holders on gastrointestinal anastomosis construction time and bursting pressure in equine jejunal segments. BMC Vet Res, 17(1), 167. https://doi.org/10.1186/s12917-021-02871-4

Publication

BMC veterinary research
ISSN: 1746-6148
NlmUniqueID: 101249759
Country: England
Language: English
Volume: 17
Issue: 1
Pages: 167
PII: 167

Researcher Affiliations

Averay, Kate
  • Camden Equine Centre, Sydney School of Veterinary Science, University of Sydney, 410 Werombi Rd, Brownlow Hill, Sydney, New South Wales, 2570, Australia. kate.averay@gmail.com.
van Galen, Gaby
  • Camden Equine Centre, Sydney School of Veterinary Science, University of Sydney, 410 Werombi Rd, Brownlow Hill, Sydney, New South Wales, 2570, Australia.
Ward, Michael
  • Sydney School of Veterinary Science, University of Sydney, 410 Werombi Rd, Brownlow Hill, 2570, New South Wales, Australia.
Verwilghen, Denis
  • Camden Equine Centre, Sydney School of Veterinary Science, University of Sydney, 410 Werombi Rd, Brownlow Hill, Sydney, New South Wales, 2570, Australia.

MeSH Terms

  • Anastomosis, Surgical / instrumentation
  • Anastomosis, Surgical / veterinary
  • Animals
  • Female
  • Horses / surgery
  • Jejunum / surgery
  • Male
  • Operative Time
  • Surgical Instruments / veterinary
  • Suture Techniques / veterinary

Conflict of Interest Statement

The authors declare no conflict of interest related to this report.

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