Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan.
Surg Endosc. 2012 Mar;26(3):764-70. doi: 10.1007/s00464-011-1949-x. Epub 2011 Oct 20.
The U-clip anastomotic device was developed to facilitate interrupted anastomoses without the need to tie sutures. Recently, this technology has been expanded into various fields of surgery. However, in the field of airway reconstruction, there have been no previous reports of this technology being used. The present study examined the technical feasibility of performing safe and efficient robot-assisted endoscopic airway reconstruction using nitinol U-clips in rabbits.
A total of six tracheal anastomoses with S60 U-clips were performed using the da Vinci Surgical System. Anastomosis time and complications were recorded. The effectiveness of anastomoses was evaluated by postoperative observation of rabbits for 8 weeks and measurement of anastomotic strictures and pathological findings.
All procedures were completed safely. Mean procedure time was 14 ± 1.8 min (mean ± SD). There were no perioperative complications; however, all animals died between postoperative days 14-27, and anastomotic stricture was the likely cause of death. All anastomoses had severe strictures; the mean stricture rate was measured as being 51.1 ± 33.3 (%).
Although the technical feasibility of robot-assisted endoscopic airway reconstruction using U-clips has been demonstrated in rabbits, the safety of this technique has not been evaluated. Our data suggest that U-clips are not a feasible approach for airway reconstruction surgery because of the occurrence of severe postoperative anastomotic stricture.
U 型夹吻合器的开发旨在实现无需打结缝线的间断吻合。最近，这项技术已扩展到各个外科领域。然而，在气道重建领域，尚无关于该技术应用的报道。本研究旨在检验使用镍钛诺 U 型夹通过机器人辅助内镜进行安全有效的气道重建的技术可行性。
使用达芬奇手术系统对 6 只兔子的气管进行了 6 处 S60U 型夹吻合。记录吻合时间和并发症。通过术后 8 周对兔子的观察以及对吻合口狭窄和病理发现的测量，评估吻合的效果。
所有手术均安全完成。平均手术时间为 14 ± 1.8 分钟（均值 ± 标准差）。无围手术期并发症；但所有动物均于术后第 14-27 天死亡，吻合口狭窄可能是导致死亡的原因。所有吻合口均出现严重狭窄，平均狭窄率为 51.1 ± 33.3（%）。
虽然在兔子中已经证明了使用 U 型夹进行机器人辅助内镜气道重建的技术可行性，但该技术的安全性尚未得到评估。我们的数据表明，U 型夹不是气道重建手术的可行方法，因为术后吻合口严重狭窄的发生率较高。
