In vitro comparison of three suture techniques for anastomosis of the equine small intestine.
Abstract: The equine small intestine can be affected by a variety of disorders that may require some form of bypass or anastomosis. Many suture patterns have been used in equine anastomoses to minimise post operative complications, which include leakage from the anastomosis site, stenosis and adhesions. Because of the critical condition of horses undergoing colic surgery, it is imperative this is performed as quickly as possible. Objective: To evaluate, in vitro, differences in the time of execution and leakage pressure between the Lembert single layer, Gambee and Lembert double layer suture patterns for intestinal anastomosis in the horse and correlate the time taken to complete the anastomosis and hemicircumference of the anastomotic site. Methods: Small intestinal loops were anastomosed with one of the 3 suture patterns. The intestines, immersed in polyionic solution, were insufflated via a flexible rubber hose, connected to a sphygmomanometer bulb, inserted into the lumen at one end and fixed at 25 cm from the anastomosis site with a locking clip. A tube fixed in the same manner at the other end, connected to a pressure gauge, was used to evaluate the pressure at which leakage from the anastomosis site, revealed by the presence of bubbles, was present. Results: The time spent in the execution of the Lembert single layer was significantly less than that for both Gambee and Lembert double layer. The leakage pressure of Lembert single layer was significantly higher than that recorded for both Gambee and Lembert double layer. Conclusions: This study shows that the continuous Lembert single layer pattern takes less time to execute and fails at higher pressures than the Lembert double layer or Gambee patterns.
© 2011 EVJ Ltd.
Publication Date: 2011-12-07 PubMed ID: 22082446DOI: 10.1111/j.2042-3306.2011.00494.xGoogle Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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This study compares the effectiveness and efficiency of three different surgical suturing techniques used in managing disorders of the equine small intestine. The researchers found that the Lembert single layer pattern is faster to execute and more pressure-resistant than the other two methods.
Objective
The objective of this research was to evaluate differences in execution time and leakage pressure among three suture patterns used for intestinal anastomosis in horses: the Lembert single layer, the Gambee, and the Lembert double layer. The researchers also sought to correlate the time taken to complete the anastomosis and the hemicircumference of the anastomosis site.
Methods
- The researchers performed anastomosis on small intestinal loops using each of the three suturing techniques.
- Once anastomosed, the intestines were surrounded by a polyionic solution and filled with air through a flexible rubber hose connected to a sphygmomanometer bulb.
- The hose was attached to one end of the intestine and fixed 25 cm away from the anastomosis site with a locking clip to maintain position.
- A pressure gauge connected to a tube fixed on the other end of the intestine was used to measure the pressure at which leakage from the anastomosis site, marked by bubble formation, occurred.
Results
- The researchers found a significant difference in the time of execution and leakage pressure of the different suturing methods.
- The Lembert single layer pattern took less time to complete than the Gambee and Lembert double layer techniques.
- Further, the Lembert single layer withstood higher pressures before leakage occurred, compared to the Gambee and Lembert double layer patterns.
Conclusions
This research indicates that the Lembert single layer suturing pattern is both quicker to complete and can withstand higher pressures compared to the Gambee and the Lembert double layer suturing patterns. This efficiency and reliability could have significant implications for the management of equine intestinal disorders, particularly in minimizing post-operative complications like leakage.
Cite This Article
APA
Auletta L, Lamagna F, Uccello V, Lamagna B, Pasolini MP.
(2011).
In vitro comparison of three suture techniques for anastomosis of the equine small intestine.
Equine Vet J Suppl(40), 46-50.
https://doi.org/10.1111/j.2042-3306.2011.00494.x Publication
Researcher Affiliations
- Department of Veterinary Clinical Sciences, Section of Surgery, Faculty of Veterinary Medicine, University of Studies of Napoli Federico II, Napoli, Italy. luigi.auletta@yahoo.it
MeSH Terms
- Animals
- Horses
- Intestine, Small / surgery
- Suture Techniques / veterinary
Citations
This article has been cited 6 times.- Liu C, Wang Y, Zhao AR, Hu FA, Fan Q, Han G, Ding G, Fu T, Geng L, Yin H. An alternative asymmetric figure-of-eight single-layer suture technique for bowel anastomosis in an in vitro porcine model.. Front Surg 2022;9:896542.
- Suzuki Y, Nomura K, Matsui A, Kikuchi D, Hoteya S. Utility and Feasibility of Removing Surgical Staples from the Remnant Stomach or Gastric Conduit during Endoscopic Submucosal Dissection.. Intern Med 2023 Apr 1;62(7):963-972.
- Lenoir A, Perrin BRM, Lepage OM. Ex Vivo Comparison of a UV-Polymerizable Methacrylate Adhesive versus an Inverting Pattern as the Second Layer of a Two-Layer Hand-Sewn Jejunal Anastomosis in Horses: A Pilot Study.. Vet Med Int 2021;2021:5545758.
- Averay K, van Galen G, Ward M, Verwilghen D. Effect of three different needle holders on gastrointestinal anastomosis construction time and bursting pressure in equine jejunal segments.. BMC Vet Res 2021 Apr 15;17(1):167.
- Bracamonte JL, Devick I, Thomas KL, Hendrick S. Comparison of hand-sewn and oversewn stapled jejunojejunal anastomoses in horses.. Can Vet J 2018 Jan;59(1):67-73.
- Feng F, Sun L, Xu G, Hong L, Yang J, Cai L, Li G, Guo M, Lian X, Zhang H. Albert-Lembert versus hybrid-layered suture in hand sewn end-to-end cervical esophagogastric anastomosis after esophageal squamous cell carcinoma resection.. J Thorac Dis 2015 Nov;7(11):1917-26.
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