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Research article
Effect of Three Different Needle Holders on Gastrointestinal Anastomosis Construction Time and Bursting Pressure in Equine Jejunal Segments
Kate Averay
The University of Sydney School of Veterinary Science
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8479-7771
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Equine small intestinal resection and anastomosis is a procedure where optimizing speed, without compromising integrity, is advantageous. There is a range of different needle holders available, but little is published on their impact on surgical technique in veterinary medicine.
The objectives of this study were to investigate if the needle holder type influences the anastomosis construction time, and the anastomosis quality (estimated by bursting pressure), and whether the bursting pressure is influenced by the anastomosis construction time.
Single layer end-to-end jejunojejunal anastomoses were performed on jejunal segments harvested from equine cadavers. These segments were randomly allocated to four groups. Three groups based on the needle holder type that was used: 16.5 cm Frimand (Group 1), 16 cm Mayo-Hegar (Group 2) or 20.5 cm Mayo-Hegar (Group 3) needle holders. One (Group 4) as control without anastomoses. Anastomosis construction time was recorded. Bursting pressure was determined by pumping green coloured fluid progressively into the lumen whilst recording intraluminal pressures. Maximum pressure reached prior to failure was recorded as bursting pressure. Construction times and bursting pressures were compared between needle holder, and the correlation between bursting pressure and construction time was estimated.
Results: Construction times were not statistically different between groups. Yet, the mean construction time was shortest in Group 2 followed by Group 3, with Group 1 having the longest mean construction time but showing most consistency.
Segments from Group 2 and Group 3 burst at a statistically significantly lower pressure than those from Group 4. Group 4 and Group 1 were not different. The mean bursting pressure was highest in Group 4, followed by Group 1 and Group 2, with Group 3 having the lowest mean bursting pressure.
Anastomosis construction time and bursting pressure were not correlated.
Conclusions: The tested needle holders had a significant effect on bursting pressure, but not on anastomosis construction time. The Frimand needle holder shows promise to be superior for anastomoses in a clinical setting. However, future studies need to confirm these findings.
Keywords
Equine small intestinal, Mayo-Hegar, anastomosis
Figure 1
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This is a list of supplementary files associated with this preprint. Click to download.
- RawDataJejunalanastomosis.xlsx
- File name: Raw Data_Construction time and bursting pressure in jejunal anastomosis File format: .xlsx Title of Data: Construction time and bursting pressure in jejunal anastomosis Description of Data: Raw data collected in this study with legend
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This preprint is under consideration at BMC Veterinary Research. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Effect of Three Different Needle Holders on Gastrointestinal Anastomosis Construction Time and Bursting Pressure in Equine Jejunal Segments
Kate Averay
The University of Sydney School of Veterinary Science
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8479-7771
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 13 Jan, 2021
No community comments so far
Editor assigned
On 08 Jan, 2021
Submission checks complete
On 07 Jan, 2021
Editor invited
On 06 Jan, 2021
First submitted
On 09 Nov, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Equine small intestinal resection and anastomosis is a procedure where optimizing speed, without compromising integrity, is advantageous. There is a range of different needle holders available, but little is published on their impact on surgical technique in veterinary medicine.
The objectives of this study were to investigate if the needle holder type influences the anastomosis construction time, and the anastomosis quality (estimated by bursting pressure), and whether the bursting pressure is influenced by the anastomosis construction time.
Single layer end-to-end jejunojejunal anastomoses were performed on jejunal segments harvested from equine cadavers. These segments were randomly allocated to four groups. Three groups based on the needle holder type that was used: 16.5 cm Frimand (Group 1), 16 cm Mayo-Hegar (Group 2) or 20.5 cm Mayo-Hegar (Group 3) needle holders. One (Group 4) as control without anastomoses. Anastomosis construction time was recorded. Bursting pressure was determined by pumping green coloured fluid progressively into the lumen whilst recording intraluminal pressures. Maximum pressure reached prior to failure was recorded as bursting pressure. Construction times and bursting pressures were compared between needle holder, and the correlation between bursting pressure and construction time was estimated.
Results: Construction times were not statistically different between groups. Yet, the mean construction time was shortest in Group 2 followed by Group 3, with Group 1 having the longest mean construction time but showing most consistency.
Segments from Group 2 and Group 3 burst at a statistically significantly lower pressure than those from Group 4. Group 4 and Group 1 were not different. The mean bursting pressure was highest in Group 4, followed by Group 1 and Group 2, with Group 3 having the lowest mean bursting pressure.
Anastomosis construction time and bursting pressure were not correlated.
Conclusions: The tested needle holders had a significant effect on bursting pressure, but not on anastomosis construction time. The Frimand needle holder shows promise to be superior for anastomoses in a clinical setting. However, future studies need to confirm these findings.
Figure 1
Figure 2