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Veterinary surgery : VS2023; 52(4); 545-553; doi: 10.1111/vsu.13946

Ex vivo evaluation of a technique for equine jejunocecal anastomosis using radiofrequency thermofusion and a Cushing oversew.

Abstract: To describe a technique for a side-to-side jejunocecal anastomosis in horses using radiofrequency thermofusion (TF) of the intestines supported by a Cushing oversew and to compare this anastomosis to handsewn and stapled techniques. Methods: Ex vivo study. Methods: Intestinal tracts from 24 slaughtered horses. Methods: A radiofrequency device was used to perform a jejunocecal anastomosis (Group RFA). The construction time and bursting pressure of this construct were compared with those of a hand-sewn double layer (Group HS) and stapled anastomoses (Group ST) without oversew of the staple line. Histology was also performed for the TF anastomoses to evaluate the extent of the thermal damage. Results: The median (range) construction time (min) for the TF (15.8 [14.4-16.8]) was not significantly different from that for the HS (25.5 [24.2-26.3]) and ST (10.8 [9.7-12.5]) groups (p = .07). The construction time for ST was shorter than that for HS group (p < .001). The average (standard deviation) bursting pressure (mmHg) for HS (153.1 +/- 17.5) was higher than that for RFA (76 +/- 15) and ST groups (48 +/- 13; p < .001). The bursting pressure of the RFA was higher than that of the ST anastomoses (p = .001). The thermal damage caused by the device was within the suture oversew in the deeper layers, whereas it extended a few mm beyond the suture line in the serosa. Conclusions: Radiofrequency assisted anastomoses provide similar construction times to current techniques and have a higher bursting pressure than ST anastomoses. Conclusions: Radiofrequency-assisted anastomoses with a suture oversew demonstrated comparable bursting pressures to ST anastomoses. The use of the radiofrequency device on the intestine is extra label and causes serosal tissue damage, which may increase the risk of adhesions.
© 2023 American College of Veterinary Surgeons.
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Publication Date: 2023-03-15 PubMed ID: 36922367DOI: 10.1111/vsu.13946Google 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.

This study tested a technique for conducting intestinal surgeries in horses using radiofrequency thermofusion (TF) and oversewing with sutures. Compared to traditional hand-sewn or stapling methods, this technique provided comparable construction times and stronger pressure resistance but caused some tissue damage, increasing risk of adhesions.

Study Objective and Methodology

  • The researchers aimed to describe and test a surgical method for horse intestines: a side-to-side jejunocecal anastomosis using radiofrequency thermofusion and a Cushing oversew.
  • They also wanted to contrast this method with traditional techniques, such as hand-sewn or stapled anastomoses.
  • The ex vivo study examined 24 rafts of horse intestines that were obtained from slaughtered horses.

Procedure and Comparison

  • In one of the groups, the anastomosis was performed using a radiofrequency device (Group RFA). This group’s construction time and bursting pressure were then compared to those of a hand-sewn layer (Group HS) and anastomoses created with staples (Group ST).
  • To check the extent of possible thermal damage, histological analyses were also carried out on the thermofused anastomoses.

Allotted Time and Bursting Pressure

  • The average time it took to construct thermofused (TF) anastomoses was not significantly different from other traditional methods (HS and ST).
  • However, a noteworthy difference was that the stapled (ST) anastomosis took less time to construct than the handsewn (HS) method.
  • The radiofrequency assisted (RFA) anastomoses had a higher bursting pressure than the stapled (ST) group, meaning it was stronger and could withstand more external pressure before rupturing.
  • However, the handsewn (HS) method had the highest bursting pressure — even higher than the radiofrequency thermofusion (TF) method.

Serosal Damage and Concluding Thoughts

  • The radiofrequency device caused thermal damage that remained within the suture oversew in the deeper layers. However, it extended a few millimeters beyond the suture line in the serosa or the outermost layer of the intestine. This might increase the risk of adhesions or scar-like tissue that can cause organs to stick together.
  • The study hence implies that the thermofusion-based method, backed by oversewing, offers construction times comparable to currently employed techniques and has a higher bursting pressure than methods using staples.
  • However, caution is needed due to its potential to cause serosal tissue damage, which poses an elevated risk of adhesive complications post-operation.

Cite This Article

APA
Gandini M, Cerullo A, Gallo L, Iussich S, Minoli L, Giusto G. (2023). Ex vivo evaluation of a technique for equine jejunocecal anastomosis using radiofrequency thermofusion and a Cushing oversew. Vet Surg, 52(4), 545-553. https://doi.org/10.1111/vsu.13946

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 52
Issue: 4
Pages: 545-553

Researcher Affiliations

Gandini, Marco
  • Department of Veterinary Sciences, University of Turin, Turin, Italy.
Cerullo, Anna
  • Department of Veterinary Sciences, University of Turin, Turin, Italy.
Gallo, Livio
  • Department of Veterinary Sciences, University of Turin, Turin, Italy.
Iussich, Selina
  • Department of Veterinary Sciences, University of Turin, Turin, Italy.
Minoli, Lucia
  • Department of Veterinary Sciences, University of Turin, Turin, Italy.
Giusto, Gessica
  • Department of Veterinary Sciences, University of Turin, Turin, Italy.

MeSH Terms

  • Animals
  • Horses / surgery
  • Intestine, Small
  • Anastomosis, Surgical / veterinary
  • Anastomosis, Surgical / methods
  • Suture Techniques / veterinary
  • Surgical Stapling / veterinary
  • Intestines

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