Waage Anne, Gagner Michel, Biertho Laurent, Jacob Brian P, Kim Won-Woo, Faife Barbara, Sekhar Nikhilesh, del Genio Gianmattia
Department of Surgery, Karolinska University Hospital, Stockholm, Sweden.
Obes Surg. 2005 Jun-Jul;15(6):782-7. doi: 10.1381/0960892054222704.
In this porcine survival model, we compared laparoscopic computer-mediated flexible circular stapled (SurgASSIST) gastro-jejunostomies in Roux-en-Y gastric bypass (RYGBP) to open hand-sewn (HS) and laparoscopic end-to-end (EEA) anastomosis.
RYGBP was performed in 15 pigs. Depending on the technique used to create the gastro-jejunostomy, the pigs were divided in 3 groups. In group A, a standard two-layer hand-sewn anastomosis were performed. In group B and C, gastro-jejunostomies using EEA (B) or SurgASSIST (C) were attempted. Operation time, intraoperative technical failure, postoperative anastomotic leakage, and necropsy results were measured.
14 pigs survived surgery. One leakage from the gastro-jejunostomy was detected intraoperatively in group B. There was no evidence of leakage postoperatively from the proximal gastro-jejunostomy in any groups. No statistical difference was found between the groups concerning the operation time or the diameter and degree of healing of the anastomosis.
We found the SurgASSIST system safe for performing gastro-jejunostomies in laparoscopic RYGBP. There were no anastomotic failures intra- or postoperatively. At necropsy, there was no evidence of anastomotic stricture or delayed healing processes.
在这个猪存活模型中，我们将腹腔镜计算机辅助的柔性圆形吻合器（SurgASSIST）胃空肠吻合术用于Roux-en-Y胃旁路术（RYGBP），并与开放手工缝合（HS）和腹腔镜端端（EEA）吻合术进行比较。
对15头猪实施RYGBP。根据用于创建胃空肠吻合术的技术，将猪分为3组。A组进行标准的两层手工缝合吻合术。在B组和C组中，尝试使用EEA（B组）或SurgASSIST（C组）进行胃空肠吻合术。测量手术时间、术中技术失败情况、术后吻合口漏及尸检结果。
14头猪术后存活。B组术中检测到1例胃空肠吻合口漏。任何组术后近端胃空肠吻合口均无漏出迹象。各组之间在手术时间或吻合口直径及愈合程度方面未发现统计学差异。
我们发现SurgASSIST系统在腹腔镜RYGBP中进行胃空肠吻合术是安全的。术中及术后均无吻合失败情况。尸检时，没有吻合口狭窄或愈合延迟过程的证据。
