A self-locking loop as an alternative to purse-string suture in colon anastomosis
Colorectal cancer is among the most common and most deadly cancer types in man. Surgical removal of the tumour is the treatment of choice. Anastomotic leakage is a common and feared complication to this procedure associated with further complications and increased mortality. The exact mechanisms and...
| Autor principal: | |
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| Formato: | Second cycle, A2E |
| Lenguaje: | Inglés Inglés |
| Publicado: |
2016
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| Acceso en línea: | https://stud.epsilon.slu.se/9606/ |
| _version_ | 1855571550621663232 |
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| author | Maxon, Oskar |
| author_browse | Maxon, Oskar |
| author_facet | Maxon, Oskar |
| author_sort | Maxon, Oskar |
| collection | Epsilon Archive for Student Projects |
| description | Colorectal cancer is among the most common and most deadly cancer types in man. Surgical removal of the tumour is the treatment of choice. Anastomotic leakage is a common and feared complication to this procedure associated with further complications and increased mortality. The exact mechanisms and risk factors of anastomotic leakage have yet to be completely understood. Alternative techniques to anastomose colon are currently investigated, aimed to develop safer and easier methods with reduced risk of complications.
Intraluminal stapling or manual suturing are the conventionally used methods of anastomosis. Adaptive Anaerobic Anastomosis is a new method for anastomosis of the colon that is currently under development. The methodology is in principal based on two ring-shaped implants that lock the two intestinal ends together while the lumen remains open and allows passage of intestinal content. As the colon heals the locking rings will eventually detach and pass through the rectum.
In Adaptive Anaerobic Anastomosis and intraluminal stapling, the colon lumen is temporarily sealed around the anvil shaft of the device using a purse-string suture. The aim of this study was to evaluate the feasibility of replacing the purse-string suture for closure of the colon, using a short-time implant in the form of a flexible self-locking loop, mainly in conjunction with the Adaptive Anaerobic Anastomosis method.
The self-locking loop was tested in vitro on pig intestines (n=10) and in vivo in ten pigs anastomosed using either Adaptive Anaerobic Anastomosis or intraluminal stapling.
The self-locking device could close the lumen around the Adaptive Anaerobic Anastomosis and stapler instruments. Subjectively, the device achieved a good tissue grip and a tight closure of the colon. The technology was perceived as easy to use and potentially time saving. This study suggested that the self-locking device may be an alternative to stapler or purse-string suture for the temporary closure of the colon in colon anastomosis. Additionally, possible improvements of the design of the self-locking loop were suggested. |
| format | Second cycle, A2E |
| id | RepoSLU9606 |
| institution | Swedish University of Agricultural Sciences |
| language | Inglés Inglés |
| publishDate | 2016 |
| publishDateSort | 2016 |
| record_format | eprints |
| spelling | RepoSLU96062016-09-29T12:17:09Z https://stud.epsilon.slu.se/9606/ A self-locking loop as an alternative to purse-string suture in colon anastomosis Maxon, Oskar Animal diseases Colorectal cancer is among the most common and most deadly cancer types in man. Surgical removal of the tumour is the treatment of choice. Anastomotic leakage is a common and feared complication to this procedure associated with further complications and increased mortality. The exact mechanisms and risk factors of anastomotic leakage have yet to be completely understood. Alternative techniques to anastomose colon are currently investigated, aimed to develop safer and easier methods with reduced risk of complications. Intraluminal stapling or manual suturing are the conventionally used methods of anastomosis. Adaptive Anaerobic Anastomosis is a new method for anastomosis of the colon that is currently under development. The methodology is in principal based on two ring-shaped implants that lock the two intestinal ends together while the lumen remains open and allows passage of intestinal content. As the colon heals the locking rings will eventually detach and pass through the rectum. In Adaptive Anaerobic Anastomosis and intraluminal stapling, the colon lumen is temporarily sealed around the anvil shaft of the device using a purse-string suture. The aim of this study was to evaluate the feasibility of replacing the purse-string suture for closure of the colon, using a short-time implant in the form of a flexible self-locking loop, mainly in conjunction with the Adaptive Anaerobic Anastomosis method. The self-locking loop was tested in vitro on pig intestines (n=10) and in vivo in ten pigs anastomosed using either Adaptive Anaerobic Anastomosis or intraluminal stapling. The self-locking device could close the lumen around the Adaptive Anaerobic Anastomosis and stapler instruments. Subjectively, the device achieved a good tissue grip and a tight closure of the colon. The technology was perceived as easy to use and potentially time saving. This study suggested that the self-locking device may be an alternative to stapler or purse-string suture for the temporary closure of the colon in colon anastomosis. Additionally, possible improvements of the design of the self-locking loop were suggested. Colorektalcancer är bland de vanligaste och mest dödliga cancertyperna hos människa. Behandling är i första hand kirurgiskt avlägsnande av tumören. Anastomosläckage är en vanligt förekommande och fruktad komplikation associerad med ytterligare komplikationer och ökad mortalitet. Mekanismer och riskfaktorer för anastomosläckage är inte helt kända. Alternativa metoder för anastomos av colon är under utveckling. Konventionellt används intraluminär stapling eller manuell suturering för att skapa anastomos av colon. Adaptiv Anaerob Anastomos är en ny metod under utveckling. Metodiken baseras i princip på två ringformade implantat som låser ihop tarmändarna medan tarmlumens kontinuitet kvarstår för passage av tarminnehåll. Efter läkning lossnar låsringarna och passerar ut med avföringen. Vid både Adaptiv Anaerob Anastomos och intraluminär stapling försluts tarmlumen tillfälligt runt verktygets städ med en tobakspungssutur. Målet med denna studie var att utvärdera möjligheten att ersätta denna tobakspungssutur med ett korttidsimplantat i form av en självlåsande loop, huvudsakligen vid användning av Adaptiv Anaerob Anastomos. Den självlåsande loopen testades in vitro på färsk gristarm (n=10) samt in vivo på tio grisar vid anastomos med antingen Adaptiv Anaerob Anastomos eller intraluminär stapling. Den självlåsande loopen kunde användas för att försluta lumen runt städet vid Adaptiv Anaerob Anastomos samt runt troakar och städ vid intraluminär stapling. Subjektivt åstadkoms ett bra vävnadsgrepp och en god förslutning. Teknologin upplevdes som enkel att använda och potentiellt tidsbesparande. Resultatet av studien antyder att en självlåsande loop kan användas för att ersätta tobakspungssutur eller stapler för tillfällig förslutning av colon vid colonanastomos. I arbetet identifieras även potentiella förbättringar av den självlåsande loopens design. 2016-09-14 Second cycle, A2E NonPeerReviewed application/pdf en https://stud.epsilon.slu.se/9606/1/maxon_o_160929.pdf Maxon, Oskar, 2015. A self-locking loop as an alternative to purse-string suture in colon anastomosis. Second cycle, A2E. Uppsala: (VH) > Dept. of Clinical Sciences (until 231231) <https://stud.epsilon.slu.se/view/divisions/OID-715.html> urn:nbn:se:slu:epsilon-s-5890 eng |
| spellingShingle | Animal diseases Maxon, Oskar A self-locking loop as an alternative to purse-string suture in colon anastomosis |
| title | A self-locking loop as an alternative to purse-string suture in colon anastomosis |
| title_full | A self-locking loop as an alternative to purse-string suture in colon anastomosis |
| title_fullStr | A self-locking loop as an alternative to purse-string suture in colon anastomosis |
| title_full_unstemmed | A self-locking loop as an alternative to purse-string suture in colon anastomosis |
| title_short | A self-locking loop as an alternative to purse-string suture in colon anastomosis |
| title_sort | self-locking loop as an alternative to purse-string suture in colon anastomosis |
| topic | Animal diseases |
| url | https://stud.epsilon.slu.se/9606/ https://stud.epsilon.slu.se/9606/ |