In vitro evaluation of an inverted end-to-end equine jejunojejunal anastomosis using skin staples.
Authors: Gandini Marco, Bertuglia Andrea
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Jejunal anastomosis in horses traditionally relies on time-consuming hand-sewn techniques, prompting Gandini and Bertuglia to evaluate whether surgical skin staples could provide a faster alternative without compromising structural integrity. Using fresh cadaveric jejunal segments from eight horses, the researchers created paired end-to-end anastomoses on each specimen—one using conventional 2-layer inverting sutures and one using a single layer of skin staples—then measured creation time, luminal diameter via contrast radiography, and bursting pressure under standardised inflation conditions. The stapling technique significantly reduced operative time and produced larger anastomotic lumens; whilst burst pressures were lower than hand-sewn repairs, they remained substantially above those documented for other established anastomotic methods. These in vitro findings suggest that skin staple anastomosis could meaningfully reduce surgical duration in colic cases, though the clinical advantages require validation through in vivo studies before widespread adoption in equine practice. The technique's ease of execution may be particularly valuable in high-stress surgical situations where time efficiency directly impacts patient recovery outcomes.
Read the full abstract on PubMed
Practical Takeaways
- •Skin staple jejunal anastomosis offers a faster alternative to hand-sewn techniques in the operating theatre, potentially reducing anaesthesia time and surgical stress
- •The larger lumen diameter achieved with stapling may reduce risk of stricture formation post-operatively
- •While bursting pressure is lower with staples, values remain mechanically adequate; however, in vivo validation in clinical cases is still needed before routine adoption
Key Findings
- •Skin staple jejunal anastomosis was significantly faster than 2-layer hand-sewn technique
- •Stapled anastomoses had larger lumen diameter (anastomotic index) compared to hand-sewn repairs
- •Bursting pressure of stapled anastomoses was significantly lower than hand-sewn but remained well above clinically acceptable thresholds
- •Staple technique demonstrated comparable mechanical performance to hand-sewn 2-layer anastomosis despite reduced bursting pressure