Laparoscopic intracorporeal bowel anastomosis by a new suturing device: A study in a laparoscopic simulator with integrated animal organs

Summary

Laparoscopic bowel anastomosis is performed with increasing frequency either extracorporeally through a small incision or intracorporeally using special endoscopic staplers. Laparoscopic intracorporeal suturing is rarely used to perform anastomosis because it is difficult and time-consuming. The aim of this study is to assess a new suturing device for performing laparoscopic intracorporeal anastomosis. In a phantom experiment, three types of end-to-end monolayer anastomoses (open [O], laparoscopic suturing device [LD] and laparoscopic hand-suture [LH]) were performed in each of 10 segments of fresh cow small intestines. The mean anastomotic time for the (O) group was shorter than that for the (LD) and (LH) groups; the time needed was 13.8, 29 and 27.3 min, respectively. The initial bursting pressure for each of the (O), (LD) and (LH) groups was 55, 35.2 and 33.3 mmHg, respectively. There was no significant difference in anastomotic circumference between the three groups. The new laparoscopic suturing device can be used to perform bowel anastomosis. It needed a longer time and had a lower bursting pressure than open anastomosis, but it proved equal to laparoscopic hand-suture anastomosis. Considering that the suturing device is still in its development phase, better results can be expected in the future.