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Investigating the effects of various suturing parameters on the leakage from the intestinal anastomosis site: finite element analyses

Kanani Zahra, Rouhi Gholamreza, Khoorjestan Sanaz Mosafer

Biocybernetics and Biomedical Engineering

2019

Vol. 39, no. 4

983--991

In this work, effects of various parameters, including regularity of sewing, distance of holes from the edge of the tissue (D), distance between holes (L), suturing pattern, and material and size of the suture on the leakage of human large intestine anastomosis site were investigated, using finite element method (FEM). The effects of various parameters of suturing on leakage were investigated in four different steps: 1. regularity of suturing; 2. variations in D (small, medium and large), and L (small, medium and large); 3. suturing pattern; and 4. material and size of the suture. The models mimicked two sides of human large intestine tissue, sewn together. By considering a 50 mm displacement on right-side free edge of tissue, the surface areas of the gaps created around the holes were calculated, and a gap surface area equals to, or greater than 0.07 mm2 was considered as the leaking specimen. Results showed that in the case of irregular suturing, compared to the regular one, the likelihood of leakage increases. Additionally, in the cases with large D and medium L, the likelihood of leakage decreases. It was found that zigzag pattern has less leakage probability compared with simple continuous and interrupted patterns. Furthermore, by increasing the diameter and elastic modulus of the suture, the likelihood of leakage will increase. Results of this study are in agreement with experimental evidences.

New egzoluminal circular surgical stapler

Drop R., Mazurkiewicz S., Woźny Z., Majcher P., Tabor A.

Acta of Bioengineering and Biomechanics

2010

Vol. 12, no. 3

113-117

The study presents the design, prototype version and preliminary results of in vivo testing of the egzoluminal circular surgical stapler for “end-to-end” anastomosis of bowels after the resection, where staples are put outside the intestinal lumen, and walls of the intestinal tube directly contact the intestinal mucous membrane. The adopted idea of an “end-to-end” intestinal anastomosis as well as a strong need for a device that would be re-usable have determined its specific design. The device is characterised by a kinematic mode of operation, different from the operating mode of commonly used staplers, and hence by a specific combination of the individual components. The in vivo tests, successfully conducted on animals, have proved that this method of anastomosis as well as the device used for its practical performance are fully applicable in clinical practice, as best shown by patent application No. P 386369.