Laboratory Assessment of Anastomotic Configurations Utilized for Intracorporeal Anastomosis in Laparoscopic Right Hemicolectomy.

Abstract

Background: An intracorporeal anastomosis for colorectal resections has several advantages over a traditional extracorporeal anastomosis. A double stapled intracorporeal anastomosis compared to a single-stapled technique could reduce operative time and increase uptake of this beneficial technique. However, the patency and calibre of this anastomosis require laboratory assessment.

Objective: The aim of the study was to assess and compare the luminal diameter and patency of the double-stapled (intracorporeal type) anastomosis (DICA) with a single-stapled (intracorporeal type) anastomosis (SICA) and a double-stapled (extra-corporeal type) anastomosis (ECA).

Methods: Experimental laboratory-based study using fresh bovine intestine. Construction and assessment of two of each of the following anastomotic types: DICA, SICA, and ECA. The primary outcome measure was the luminal diameter of the anastomosis, comparing the ratios of the narrowest point of the anastomosis to the narrowest luminal diameter. Secondary outcome tests were leak and patency testing for each anastomosis.

Results: All six anastomoses were found to be patent and without any anastomotic leakage. The ratio of narrowest anastomotic diameter to narrowest luminal diameter for all three anastomoses was comparable (extracorporeal anastomosis 1.16, single-stapled intracorporeal anastomosis 1.0 and double-stapled intracorporeal anastomosis 0.97).

Conclusion: This study confirms the in vitro patency and the adequacy of luminal diameter of the double stapled (intracorporeal type) anastomosis.