2005 Abstracts: Use of a Novel Gastrointestinal Anastomotic Device in An Animal Model
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Use of a Novel Gastrointestinal Anastomotic Device in An Animal Model
Adrian Park, Stephen M. Kavic, University of Maryland, Baltimore, MD; Ron Kolata, Ethicon Endosurgery, Cincinnati, OH; Lyn Freeman, Ethicon Endo-surgery, Cincinnati, OH; Phil Long, Pathology Associates, Cincinnati, OH
In abdominal procedures, a fundamental requirement is the capability for construction of a technically sound gastrointestinal anastomosis. Having previously developed a new device for creation of gastrointestinal anastomoses, which may be deployed in open surgical procedures, laparoscopic surgery, or by endoluminal means, we now investigated the use of this prototype in an animal model.
Sixteen adult mongrel dogs and sixteen pigs were studied with creation of gastrointestinal anastomoses. Each dog underwent a single surgical procedure with creation of both a gastroduodenal (GD) anastomosis and a jejuno-jejunostomy (JJ), whereas each pig had a JJ anastomosis only. Anastomoses were created with a conventional circular stapler or the prototype Anastomotic Device (AD). All anastomoses were leak-tested and reinforced with sutures if necessary. Recovery time was either two or six weeks. All animals recovered well after the operation, and there were no deaths or complications during follow-up. At follow-up, all anastomoses were patent, without evidence of stricture or leak. At both two and six weeks, the pigs had comparable healing between the conventional stapled and AD anastomoses. Neither the staples nor the AD device was completely covered by mucosa at 42 days, but healing was progressing with minimal evidence of inflammation and fibrosis. For the dogs, the GD anastomoses were similar between the experimental and control groups. All animals had mucosal coverage at the anastomosis by six week follow-up. In the JJ anastomoses, mucosal healing was noted for both experimental and control anastomoses, and was more complete at six weeks than at two weeks. In three animals, the AD anastomotic device had sloughed, leaving a patent anastomosis at the original site. In these animals, the sloughed device cleared the ileum without evidence of obstruction. This new, prototypical device provides equivalent functional outcomes compared to conventional circular stapling in the construction of gastrointestinal anastomoses at two and six weeks post-implantation. The ability to deploy this device at laparoscopy or endoscopy may make it a more versatile tool than currently available stapling technology.
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