A prospective study of 50 cases of laparoscopic intestinal anastomosis by Endo GIA universal loading stapler (green/blue) versus Endo GIA articulating reload with tri staple technology (purple)

Authors

  • Mehulkumar K. Vasaiya Department of Surgery, Sir T. Hospital and Government Medical College, Bhavnagar, Gujarat, India
  • Samir M. Shah Department of Surgery, Sir T. Hospital and Government Medical College, Bhavnagar, Gujarat, India
  • Vikram B. Gohil Department of Surgery, Sir T. Hospital and Government Medical College, Bhavnagar, Gujarat, India
  • Milankumar S. Vaghasia Department of Surgery, Sir T. Hospital and Government Medical College, Bhavnagar, Gujarat, India

DOI:

https://doi.org/10.18203/2349-2902.isj20204667

Keywords:

Anastomotic leak, Endo GIA, Staple line, Laparoscopic intestinal anastomosis, Linear stapler, Stapler angulation

Abstract

Background: Intestinal anastomosis is a commonly performed procedure in surgery. Various evolvements have occurred in the field of intestinal anastomosis and recent advancement is the use of stapler in laparoscopic surgeries as a device for Gastrointestinal (GI) anastomosis. Few previous studies evaluating the clinical safety of the 2 laparoscopic linear stapling devices are available.

Methods: A prospective comparative study of 50 cases which met the inclusion and exclusion criteria were included in this hospital-based study. They were randomly allocated to two groups, Group A which underwent laparoscopic intestinal anastomosis by Endo GIA tri-staple (purple) stapler and Group B which underwent Endo GIA universal loading unit (blue/green) stapler. Primary outcome was assessed in terms of intra-operative staple line bleeding, operative time and post-operative anastomotic leak.

Results: Patients with laparoscopic intestinal anastomosis by Endo GIA tri-staple stapler (purple) have required less operation time as compared to Endo GIA universal loading unit. In Endo GIA universal loading unit (blue/green) 04% patients developed anastomotic leak and 40% patients had intra-operative staple line bleed while with Endo GIA tri-staple no postoperative anastomotic leak was found and 02% patients developed intra-operative staple line bleeding.

Conclusions: The result of our study has shown that the Endo GIA reload tri- staple (purple) is superior in terms of having no anastomosis leak, negligent staple line bleeding and less operation time as compared with Endo GIA universal loading unit (blue/green). Thus, laparoscopic intestinal anastomosis by Endo GIA reload tri-staple stapler (purple) technology is more effective and overall more efficient.

Metrics

Metrics Loading ...

Author Biographies

Mehulkumar K. Vasaiya, Department of Surgery, Sir T. Hospital and Government Medical College, Bhavnagar, Gujarat, India

General surgery department, Sir T Hospital, Bhavnagar

Samir M. Shah, Department of Surgery, Sir T. Hospital and Government Medical College, Bhavnagar, Gujarat, India

Head of department General surgery department , Sir T Hospital Bhavnagar

Vikram B. Gohil, Department of Surgery, Sir T. Hospital and Government Medical College, Bhavnagar, Gujarat, India

Associate professor department of surgery , Sir T Hospital Bhavnagar

Milankumar S. Vaghasia, Department of Surgery, Sir T. Hospital and Government Medical College, Bhavnagar, Gujarat, India

Department of surgery Sir T Hospital Bhavnagar

References

Buia A, Stockhausen F, Hanisch E. Laparoscopic surgery: a qualified systematic review. World J Methodol. 2015;5(4):238.

Stahl R. Laparoscopic anastomotic techniques. Sages Surgical Wiki. Available at: https://www.sages.org/wiki/laparoscopic-anastomotic-techniques/.

Chekan E, Whelan RL. Surgical stapling device–tissue interactions: what surgeons need to know to improve patient outcomes. Med Devices (Auckland, NZ). 2014;7:305.

Simper SC, Erzinger JM, Smith SC. Comparison of laparoscopic linear staplers in clinical practice. Surg Obes Rel Dis. 2007;3(4):446-50.

Man-i M, Suda K, Kikuchi K, Tanaka T, Furuta S, Nakauchi M, et al. Totally intracorporeal delta-shaped BI anastomosis following laparoscopic distal gastrectomy using the Tri-Staple™ reloads on the manual Ultra handle: a prospective cohort study with historical controls. Surg Endosc. 2015;29(11):3304-12.

Nagahisa Y, Morikawa A, Kato T, Hashida K, Ome Y, Kawamoto K. Feasibility of Endo GIA. Reinforced Reload with Tri-Staple. Technology for delta-shaped anastomosis. Asian J Surg. 2018;41:448-53.

Szomstein S, Whipple OC, Zundel N, Cal P, Rosenthal R. Laparoscopic Roux-en-Y gastric bypass with linear cutter technique: comparison of four-row versus six-row cartridge in creation of anastomosis. Surg Obes Rel Dis. 2006;2(4):431-4.

Hasegawa S, Nakayama S, Hida K, Kawada K, Sakai Y. Effect of Tri-Staple™ technology and slow firing on secure stapling using an endoscopic linear stapler. Digest Surg. 2015;32(5):353-60.

Agrawal A, Jain AK. To analyze variables considered as potential risk factors for gastro intestinal anastomotic leaks. Radiology. 2018;3(4):C87-9.

Downloads

Published

2020-10-23

Issue

Section

Original Research Articles