Abstract

Introduction Colorectal cancer is common in humans. After removal of the pathologic part of the colon, leakage at the site of anastomosis is a frequently reported complication. A new suture-free method for anastomosis of the colon has been developed, CARP (Compression Anastomotic Ring-locking Procedure). The use of staplers, the traditional method to seal the lumen of colon, may interfere with the CARP method. A new technology, based on the principle of a self-locking loop, was therefore developed for temporary sealing of the lumen i conjunction with the CARP method. The aim of this in vitro and in vivo study was to test the self-locking loop with the CARP implant for closure of the colon. Materials and methods A flexible band with a case containing a locking mechanism was constructed. Studs were added to one side of the flexible band in order to enhance the tissue grip at closure of the loop around tissue. Fresh intestines (lukewarm) from a pig were used in this cadaver test. The colon was transected approximately 15 cm from the anus. The CARP implant (anvil) was inserted into the lumen. The self-locking loop was placed around the transected colon and the loop was tightened around the CARP implant inside the lumen. The closure was visually inspected and the locked loop was removed for inspection of the compressed colonic tissue. The procedure was repeated ten times. The test was repeated in vivo in four pigs of approximately 50 kg, where the self-locking loop was used for closure of the lumen in conjunction with both CARP and circular stapler anastomosis. Results The self-locking implant could close the colonic lumen around the anvil in both the in vitro (n=10) and in vivo (n=8) model. Subjectively, the device achieved a tight closure of the colon and no damage to the intestines was seen on visual inspection at removal of the self-locking implant. Discussion/conclusion Subjectively, the technology was perceived as potentially timesaving and easy to use. The self-locking loop may be an alternative to staplers or purse-string closure for temporary closure of the colon lumen in conjunction with the CARP method. Further development, such as designing a tool for tightening the loop in a laparoscopic procedure, should be addressed.

Published in

Veterinary Surgery
2015, Volume: 44, number: 5, pages: E34-E34

Conference

ECVS 24th Annual Scientific Meeting 2015

SLU Authors

• Höglund, Odd

  • Department of Clinical Sciences, Swedish University of Agricultural Sciences
    

UKÄ Subject classification

Surgery
Other Medical Engineering


Permanent link to this page (URI)

https://res.slu.se/id/publ/69333