In Vitro Evaluation of an Inverted End‐to‐End Equine Jejunojejunal Anastomosis Using Skin Staples

Objective— To compare functional indices of end‐to‐end (EEA) jejunojejunal anastomosis using skin staples in horses with a 2‐layer inverting hand‐sewn technique. Study Design— Experimental study. Sample Population— Jejunal segments from 8 fresh equine cadavers. Methods— For each bowel segment, 2 EEA anastomoses were created: one 2‐layer hand‐sewn and one 1‐layer using skin staples. Time for anastomosis creation was recorded and compared. Lumen diameter of each anastomosis was measured on digital radiographs after intraluminal instillation of contrast medium and inflation of the jejunal segments to 14 mm Hg. Anastomotic indices (a compensated measure of stoma diameter) and bursting pressure were determined. Results— EEA jejunal anastomosis using skin staples was significantly faster than use of a 2‐layer hand‐sewn technique. Anastomotic index, a measure of lumen size, was significantly larger with the skin‐staple technique; however, the bursting pressure of stapled anastomoses was significantly less than for the hand‐sewn technique, but the values were well above those reported for other anastomotic techniques. Conclusions— An anastomotic technique using skin staples was easy to learn and perform, effective and faster, and mechanically comparable with a hand‐sewn 2‐layer technique. Clinical Relevance— The staple technique could be beneficial in equine gastrointestinal surgery by reducing anastomosis time, although further in vivo studies are needed to establish clinical safety.