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At least 631 records · Page 35Linked to original sources
PubMed1998

Late removal of releasable sutures after trabeculectomy or combined trabeculectomy with cataract extraction supplemented with antifibrotics.

PURPOSE: Releasable scleral flap sutures have been effectively used in trabeculectomy. The suggested time for suture removal is within the first two postoperative weeks. The authors wished to determine whether the use of intraoperative antifibrotics alters the time of suture removal and the results of surgery. METHODS: The charts of 324 patients (388 eyes) undergoing trabeculectomy and 141 patients (174 eyes) undergoing combined trabeculectomy with cataract extraction with a minimum follow-up of 12 months were retrospectively reviewed. All eyes received intraoperative antifibrotics; mitomycin C in 534 eyes and 5-fluorouracil in 29 eyes. Two releasable scleral flap sutures were used in all of the eyes. RESULTS: The removal time of at least one of the two releasable sutures was later than 21 days postoperatively in 89 eyes of 83 patients with trabeculectomy (22.9%) and in 58 eyes of 55 patients with combined surgery (33.3%). The suture removal was deferred in 39 eyes because of an early complication such as hypotony (intraocular pressure (IOP) < or = 5 mm Hg), bleb leak, or shallow or flat anterior chamber. There was no complication in the other 108 eyes, but suture removal was delayed until the IOP was more than 10 mm Hg. Immediate IOP reduction was (mean +/- standard deviation) 6.3 +/- 2.8 mm Hg when suture removal was performed beyond 3 weeks. There was a decreased response as the postoperative time until suture removal increases (r = -0.57). No serious complication associated with late suture removal was noted during the follow-up period (mean +/- standard deviation, 19.8 +/- 10.1 months). CONCLUSION: Intraoperative pharmacologic modulation of wound healing in trabeculectomy and combined trabeculectomy with cataract extraction extends the period that releasable suture removal is clinically effective. However the response decreases with a longer interval to releasable suture removal.

Aged↗
PubMed1998

Rapid palatal expansion: Part 1. Mineralization pattern of the midpalatal suture in cats.

The mineralization pattern of the midpalatal suture after rapid palatal expansion was investigated in 10 treated and 2 control cats, in light of the tendency of RPE to relapse. The rapid palatal expansion treatment consisted of active (25 days), retention (60 days), and relapse (60 days) phases. Standardized occlusal radiographs were taken periodically and analyzed for suture width, suture optical density in anterior vs. posterior regions, and suture area measurements of radiopaque vs. radiolucent zones. Nine cats exhibited suture splitting. During the active phase, the radiolucent zone (nonmineralized tissue) increased 12-fold and the increase in optical density was 50% greater in the anterior over the posterior suture region, demonstrating increased formation of loose connective tissue at the anterior region. During the retention period, the suture's radiopaque zone (mineralized tissue) increased by 62%, the radiolucent zone declined (64%) and the suture width decreased (65%) indicating reorganization of mineralized tissue. The decrease in optical density (increased mineralization) was 2.5 times greater in the posterior over the anterior suture region, indicating that the remineralization (closure) pattern of the expanded suture is analogous to a zipper closed in a posteroanterior direction. During the relapse phase, the reduction in total suture area (41%) and in the radiopaque zone (32%) indicates medial convergence of the maxillary horizontal processes. From our findings we extrapolated that the retention of the suture anterior region should be longer than the posterior region to catch up the lag in rebuilding and maturation of the newly deposited hard tissue.

Animals↗
PubMed1991

Lens optical quality is a direct function of lens sutural architecture.

We analyzed the structural and functional relationship between lens sutures and lens optical quality (focal length variability) by correlative scanning electron microscopy (SEM) and laser scan analysis. Twenty-two rabbit lenses (8 pigmented and 14 albino) were used in this study. Lenses were initially scanned by a low-power helium-neon laser beam that was passed either at an acute angle to a lens suture or along a lens suture. The results of laser scan analysis with the incident beam passed at an acute angle to a lens suture showed that generally, rabbit lenses were well corrected for spherical aberration. Subsequent SEM analysis showed that areas of lenses scanned that produced the least amount of focal variability were characterized by uniform fiber cells arranged in parallel, radial cell columns. In contrast, the results of laser scan analysis with the incident beam passed along a lens suture showed that there was significant focal length variability, i.e., spherical aberration at the lens sutures. Subsequent SEM analysis showed that the areas of lenses scanned that produced the greatest amounts of focal variability (lens sutures) were characterized by nonuniform fiber cell ends arranged as erratic suture branches in single growth shells and collectively as erratic suture planes formed between growth shells extending from the embryonic nucleus to the lens periphery. Furthermore, the amount of focal variability was directly proportional to the degree of structural disorder at the lens sutures. This is the first study to unequivocally show that the relationship between lens optical quality and specific parameters of lens morphology (lens sutures) can be quantified. These findings may help to elucidate the pathologic changes that lead to presbyopia and cortical cataractogenesis because these lenses are characterized by asymmetrical suture patterns and planes.

Animals↗
PubMed1997

Esophagojejunostomy with manual single layer suturing after a total gastrectomy for gastric cancer.

BACKGROUND: We wished to verify the clinical usefulness of manually performed single layer suturing for an esophagojejunostomy after a total gastrectomy versus stapled suturing. METHODS: We compared retrospectively 24 patients who underwent manual single layer suturing with 38 patients who underwent stapled suturing. RESULTS: Anastomotic leakage was seen in one patient (4%) with single layer suturing and one patient (3%) with stapled suturing. No anastomotic stenosis was seen in the patients with single layer suturing. There was no difference in the operative time, blood loss, postoperative days for oral intake, or the length of hospital stay between the patients with single layer suturing and those with stapled suturing. CONCLUSIONS: Manual single layer suturing is considered to be as safe as stapled suturing and is also thought to be clinically useful in reducing anastomotic failure for esophagojejunostomy.

Adult↗
PubMed2003

Influence of suture material and surgical technique on risk of reoperation after non-mesh open hernia repair.

BACKGROUND: Although mesh techniques are used with increasing frequency, sutured repair still has a place in groin hernia surgery. Studies relating suture material to recurrence rate have yielded conflicting results. The aim of the present study was to analyse the influence of suture material and sutured non-mesh technique on the risk of reoperation in open groin hernia repair using data from the Swedish Hernia Register. METHODS: The relative risk of reoperation after sutured repair using non-absorbable, late absorbable and early absorbable sutures was compared in multivariate analyses, taking into account known confounding factors. RESULTS: Between 1992 and 2000, 46,745 hernia repairs were recorded in the Swedish Hernia Register. Of these, 18,057 repairs were performed with open non-mesh methods and were included in the analysis. Using non-absorbable suture as reference, the relative risk of reoperation after repair with early absorbable suture and late absorbable suture was 1.50 (95 per cent confidence interval (c.i.) 1.22 to 1.83) and 1.03 (95 per cent c.i. 0.83 to 1.28) respectively. Using the Shouldice repair as reference, other sutured repairs were associated with a significantly higher relative risk of reoperation (1.22, 95 per cent c.i. 1.03 to 1.44). CONCLUSION: A non-absorbable or a late absorbable suture is recommended for open non-mesh groin hernia repair. The Shouldice technique was found to be superior to other open methods.

Adolescent↗
PubMed1995

Reinforced poly(L-lactic acid) fibres as suture material.

In this study, reinforced poly(L-lactic acid) (PLLA) fibers made by a dry-spinning/hot-drawing process were evaluated for use as a suture. The initial tensile strength of the PLLA fibers was lower than the initial tensile strength of the commercially available sutures: PDS, Vicryl, silk, and Ethilon. However, after 12 weeks immersion in a phosphate saline buffer at 37 degrees C, PDS sutures have lower tensile strength than PLLA sutures and the tensile strength of Vicryl was unmeasurable because of fragmentation. Initially, PLLA fibers disintegrated into fibrils during degradation triggering an inflammatory response comparable to degradable multifilament sutures. However, the intensity of the inflammatory response against the PLLA fibers decreased and after 80 weeks implantation in the muscle layer of the abdominal wall of rats it was comparable to the one against Ethilon. The inflammatory response against Ethilon, which is considered to be nondegradable, increased in the same period, probably due to the change in shape. In practice, the handling characteristics of PLLA sutures are superior to the monofilament sutures like PDS and Ethilon and comparable with the multifilament sutures like Vicryl and silk. The knot security of PLLA sutures are expected to be better than the knot security of the monofilament sutures, but this remains to be investigated. It is concluded that dry-spun/hot-drawn (reinforced) PLLA fibers have the potential for use as long-term degradable suture material.

Animals↗
PubMed1992

Running nylon suture dissolution after penetrating keratoplasty.

We attempted to evaluate whether the low degrees of astigmatism achieved early in the postkeratoplasty period with the combined interrupted/running suturing technique were maintained for long periods of time. For 13 to 70 months (mean, 30.2 months), we monitored a group of patients (25 eyes) who had previously undergone the combined interrupted/running suturing technique (12 interrupted 10-0 nylon sutures and one running 11-0 nylon suture). Nine running sutures broke spontaneously, causing a significant increase of the keratometric astigmatism of the entire population from 1.7 +/- 1.6 to 3.4 +/- 2.6 diopters (mean +/- standard deviation). The mean vector-corrected change in astigmatism after suture breakage was 4.9 +/- 2.6 diopters. Surgical procedures to reduce astigmatism were required in many of the eyes in which the 11-0 running nylon suture broke. Our results suggested that 11-0 nylon is not an ideal material for the running suture because its high rate of spontaneous disruption leads to undesired, statistically significant increases in postkeratoplasty astigmatism. Further, our results indicated that the selective suture technique can maintain low degrees of astigmatism only if the sutures remain intact. Studies of the effect of keratoplasty suturing techniques on astigmatism should probably include a follow-up that is sufficiently long to indicate its long-term value to the patient.

Adult↗
PubMed1993

Suture anchor failure strength--an in vivo study.

Suture anchors are increasingly used to secure tendons or ligaments to bone. These devices are applicable for arthroscopic shoulder stabilization and rotator cuff repair. This study reports the in vivo characteristics of four anchors, including one absorbable anchor composed of poly-L-lactic acid. Failure strength and method of failure were recorded for these anchors as a function of time. Samples of four anchors [Mitek G2, Zimmer Statak, Acufex TAG wedge, and the absorbable Arthrex expanding suture plug (ESP)] were implanted into ram femurs and harvested at intervals. Each bone-anchor-suture system was stressed to failure. The failure force and failure method was recorded. Mitek G2 and Statak suture anchors failed consistently at 30 pounds by suture breakage. They had no implantation difficulties. The TAG wedge exhibited suture pull-out and implant flipping at insertion. The TAG wedge failed by suture cut-out, anchor pull-out, and suture breakage. Its average failure strength was initially 16 pounds, but increased to 28 pounds at 2 weeks and reached the 30-pound level by 4 weeks. The ESP poly-L-lactic acid anchors experienced implantation breakage in 20% because of their greater length and composition. At pull-out testing, the ESP failed by suture cut-out, anchor pull-out, and suture breakage. Failure strength was initially 27 pounds, was 17 pounds at 2 weeks, and increased to 30 pounds by 6 weeks. The absorbable ESP does not have initial pull-out strength comparable with the Mitek and Statak suture anchors but does achieve this strength by 6 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Intradermal buried vertical mattress suture as sole skin closure: evaluation of 149 cases.

Various buried suture techniques have been reported for dermatological surgery, but in most cases, superficial non-absorbable sutures are placed additionally. The aim of this study was to evaluate whether the intradermal buried vertical mattress suture can be safely used without additional skin suturing. Following 149 procedures in 126 patients, the colour and dehiscence of the scar and the presence of hypertrophy, granulomas or keloids were analysed. The cosmetic results were excellent to good in 78.5%, satisfactory in 19.5% and poor in 2%. Single additional superficial sutures had to be placed in only 14.7%. Suture marks were absent. Hypertrophic scarring was significantly more frequent in scars sutured with polyglactine than in scars sutured with polydioxanone. Early wound dehiscence, secondary wound healing and infection due to missing superficial skin sutures did not occur. This suture technique is safe, easy and fast to perform, and achieves good cosmetic results without leaving suture marks.

Adolescent↗
PubMed2005

Ideal suture diameter is critical for consistent middle cerebral artery occlusion in mice.

OBJECTIVE: The use of transgenic and knockout mice has led to a need for a consistent model of mouse transient focal cerebral ischemia. In a great majority of the published mouse middle cerebral artery (MCA) occlusion studies, the methods indicated the type of intraluminal suture used without indicating the actual suture diameter after modification. We attempted to determine the ideal suture diameter to produce consistent occlusion in the MCA of adult male C57BL/6 mice. METHODS: Suture tips were coated to a depth 4 mm with glue, and 6-0 sutures of eight different, precisely measured diameters were produced. The coated 6-0 sutures in different diameters were introduced 10 mm into the internal carotid artery via the external carotid artery of the mice to produce MCA occlusion (n = 40; five animals for each diameter), and the mice (22-24 g) were transaortically perfused with saline. The base of the brain was exposed, and photographs of the vessels were obtained before and after transaortic injection of Evans blue dye to determine the consistency of MCA occlusion for each suture diameter. Cerebral blood flow was measured 10 minutes before occlusion and 20 minutes after reperfusion, and 2,3,5-triphenyltetrazolium chloride staining was performed to demonstrate the ischemic damage in additional animals with 110-microm (n = 5) and 180-microm (n = 8) diameter sutures. RESULTS: Sutures measuring 170 microm and 180 microm in diameter consistently occluded the MCA of C57BL/6 mice. In addition, 2,3,5-triphenyltetrazolium chloride staining demonstrated consistent infarction with 180-microm diameter sutures. The infarct volume was 36.3 +/- 4.2 mm3. CONCLUSION: Small changes in the diameter of the occlusion suture tip affect consistency in the mouse MCA occlusion model.

Animals↗
PubMed2006

[Tendon holding capacities of the suture materials used in repairing Achilles tendon rupture].

OBJECTIVES: We evaluated tendon holding capacities of suture materials that are commonly used in repair of Achilles tendon ruptures. METHODS: Achilles tendons of 60 sheep were removed by incisions 2-cm proximal to the calcaneal insertion and 1-cm distal to the musculotendinous junction. The tendons were randomly divided into six groups and sutures were placed with the Kessler technique at the distal end of the tendons using one of the following suture materials: 2 polydioxanone (PDS), 1 PDS, 2 Vicryl, 1 Vicryl, 2 Ethibond, and 1 Prolene. The distal end of the suture material was left free. Each specimen was mounted in an Instron machine, with the tendon being placed proximally and the suture material distally. The system was loaded with a displacement rate of 20 mm/min. RESULTS: Failure of all the specimens was due to pull-out of the suture material through the tendon. There were no failures due to suture breakage. The highest and the lowest tendon holding capacities were found with 2 PDS and 2 Ethibond sutures, respectively. CONCLUSION: Following Achilles tendon repair, the healing period, in particular the first three weeks, is precarious for pull-out of the suture material through the tendon. Thus, tendon holding capacity of the suture material is an important factor for the strength of the repair. Among the tested suture materials, 2 PDS was found to have the highest tendon holding capacity.

Achilles Tendon↗
PubMed2006

A biodegradable button to augment suture attachment in rotator cuff repair.

Recent experimental studies suggest that the use of suture anchors for rotator cuff tear (RCT) repair transfers the "weak link" to the suture-tendon interface where failure occurs as the sutures cut through the tendon. The purpose of this study was to evaluate the effect of using a suture augmentation button on the fixation strength of rotator cuff tendon repair. A 1.5 cm by 2 cm defect was created in the supraspinatus tendon of seven cadaveric shoulder pairs and two suture anchors inserted in each humerus for suture attachment. For one of each pair, the defect was repaired with sutures placed in a horizontal mattress configuration. The other side was repaired with the sutures being passed through low profile, bioabsorbable buttons placed on the bursal tendon surface prior to knot tying. The supraspinatus tendon was cyclically loaded at a physiologic rate and load (33 mm/sec and 180 N, respectively). The number of loading cycles was recorded when the specimens developed 0.75 cm and 1.5 cm gaps at the repair site. The specimens were then tested to failure. Specimens in the unaugmented group developed 0.75 cm and 1.5 cm gaps at an average of 135 cycles and 362 cycles, respectively. The button augmented group developed these gaps at average of 420 cycles and 708 cycles, respectively. These differences were statistically significant (p < 0.05). The gaps progressively increased in all specimens, which eventually failed by suture cutting through tendon in all specimens. This study demonstrates that in vitro, suture augmentation with a low profile, bioabsorbable button provides significantly enhanced fixation when using suture anchors to repair torn rotator cuff tendon. This device may be a useful adjunct to current methods of rotator cuff repair.

Absorbable Implants↗
PubMed1995

Absorbable polydioxanone suture and results in total anomalous pulmonary venous connection.

BACKGROUND: Despite theoretical advantages of absorbable suture in the growing vascular anastomosis, there has not been a documented advantage over nonabsorbable suture in preventing late anastomotic stenosis in total anomalous pulmonary venous connection (TAPVC). METHODS: We reviewed our experience from 1982 to 1994 with 65 hospital survivors of total TAPVC repair to examine the influence of suture type on survival and incidence of late pulmonary venous obstruction. From 1982 until 1988, we used continuous nonabsorbable polypropylene suture for the pulmonary venous-left atrial anastomosis in supracardiac, infracardiac, and mixed types of TAPVC: In 1989, we adopted a running absorbable polydioxanone suture technique. Cardiac catheterization and echocardiography were used to evaluate late pulmonary venous obstruction. RESULTS: Late pulmonary venous obstruction occurred in 17% (4/23) of survivors after repair with polypropylene suture compared with 3.2% (1/32) after repair with polydioxanone suture (p < 0.05). There were no instances of late pulmonary venous obstruction in the intracardiac TAPVC group (0/10). All late pulmonary venous obstructions occurred within 16 months after operation. The actuarial 3-year and 5-year freedom from late pulmonary venous obstruction was 100% for intracardiac TAPVC, 96% for the polydioxanone group, and 81% for the polypropylene group. Five patients died late (5/65, 7.7%), 3 in the polypropylene suture group (3/23, 13%) and 2 in the polydioxanone group (2/32, 6%). CONCLUSIONS: Continuous absorbable polydioxanone suture for the repair of TAPVC results in a low incidence of late pulmonary venous obstruction and death and appears to offer advantages over a continuous nonabsorbable suture. A continuous nonabsorbable suture may limit growth of a vascular anastomosis, particularly one involving a "low-pressure" anastomosis such as in the repair of TAPVC:

Absorption↗
PubMed1999

Anti-CD3/anti-CD28 monoclonal antibody-coated suture enhances the immune response of patients with head and neck squamous cell carcinoma.

OBJECTIVE: To test whether anti-CD3/anti-CD28 (alphaCD3/alphaCD28) monoclonal antibodies could be coated on surgical suture and used to enhance T-cell immune function in patients with advanced-stage head and neck squamous cell carcinoma (HNSCC). DESIGN: AlphaCD3/alphaCD28 monoclonal antibodies at varying concentrations and ratios were coated on surgical sutures and tested on peripheral blood mononuclear cells from normal donors to identify the optimal stimulating condition. Immune-enhancing properties of alphaCD3/alphaCD28 monoclonal antibody suture were tested on peripheral blood mononuclear cells and regional lymph node mononuclear cells isolated from patients with advanced HNSCC and on normal donor peripheral blood mononuclear cells. Proliferation, T-cell phenotype, and cytokines were measured during 8-day in vitro stimulation with alphaCD3/alphaCD28 suture and compared with alphaCD3/alphaCD28-coated tissue culture plastic, a previously recognized carrier. RESULTS: Optimal stimulation was observed with monofilament nylon incubated with alphaCD3/alphaCD28, 2 microg/mL, at a 1:1 ratio for 18 hours at 37 degrees C. Strong proliferation of peripheral blood mononuclear cells and lymph node mononuclear cells in patients with HNSCC was induced by alphaCD3/alphaCD28 suture. There was no difference in maximal proliferation between alphaCD3/alphaCD28 plastic and suture. On day 6 after alphaCD3/alphaCD28 suture stimulation, T-cell subpopulations expressing CD3, CD4, CD8, CD28, and CD45RO were enhanced. Suture stimulation significantly enhanced interleukin 2 secretion when compared with plastic stimulation (P = .01). Both alphaCD3/alphaCD28 suture and plastic stimulated interferon gamma secretion. CONCLUSIONS: To our knowledge, this study is the first to report the modification of surgical suture to create an immunomodulant. AlphaCD3/alphaCD28-coated suture expanded T cells from patients with HNSCC and induced a T(H)1 immune response, which may be a useful therapeutic tool in the treatment of HNSCC and other diseases.

Adjuvants, Immunologic↗
PubMed1989

Surgical manipulation and the tensile strength of polypropylene sutures.

Laboratory studies were performed on 509 size 6-0 polypropylene sutures to examine the effects of surgical manipulation on suture tensile strength. Results showed that dragging sutures over the torn edge of the foil package, permanently kinking sutures, or axially twisting them up to four times did not decrease tensile strength. Similarly, the tug exerted by operating room nurses on polypropylene sutures did not decrease their tensile strength. Two manipulations, however, did decrease breaking strength. The presence of a stray knot reduced suture strength 17%, and grasping sutures with DeBakey forceps decreased suture strength in a dose-dependent fashion. When experienced surgeons grasped sutures with forceps out of direct vision, their grasping forces were well below that which alters tensile strength. Nevertheless, these results demonstrate that sutures that have acquired a stray knot should be discarded and that sutures should not be grasped with mechanical devices such as forceps.

Plastics↗
PubMed2007

Does the mendosal suture exist in the adult?

There is a paucity of information in the literature regarding the mendosal suture. Furthermore, reports of the closure of this presumed suture of childhood are variable. This study seeks to establish the presence or absence of this structure in the adult. Fifty adult skulls were evaluated for the presence or absence of the mendosal suture. Sixteen percent of specimens were found to have a mendosal suture. Six specimens were found to have these sutures bilaterally, and two had sutures on the right side only. Most sutures were linear in nature. The mendosal suture approximated the superior nuchal line in all specimens and more or less traveled medial and perpendicular to the lambdoidal suture. The length of these sutures ranged from 0.8 to 1.4 cm (1.1 cm). Our hopes are that these data will prove useful to both the anatomist and clinicians, so that, when present, misinterpretation of the mendosal suture will be avoided.

Adult↗
PubMed1983

Efficacy of polyglycolic acid (Dexon) microsutures in peripheral nerve anastomoses in the rat: 1. Epineural suture.

The efficacy of polyglycolic acid (Dexon) microsuture in peripheral nerve repair was studied using 84 and 28 reanastomoses of freshly severed rat sciatic nerve employing Dexon and nylon 9-0 interrupted epineural suture technique. Animals were sacrificed and sutured portions of the nerves were histologically examined. There were almost identical suture reactions by day 7, except that the intensity of polymorphonuclear (PMN) and macrophage infiltrate in the nylon-sutured nerves was far greater than in the Dexon-sutured group. Although the intensity of the nylon-suture reaction subsided considerably after day 21, the lymphocytes, macrophages, and plasma cells surrounded the suture as long as the sutures remained in the nerves up to 12 months postoperatively. The Dexon-sutured nerve segments showed disappearance of the inflammatory cells as soon as the sutures were completely absorbed. The Dexon sutures were still detectable at months 1 and 2 but not after month 3.

Animals↗
PubMed1985

Low colorectal anastomoses. An experimental assessment of two sutured and two stapled techniques.

Extraperitoneal colorectal anastomoses were constructed in dogs by four methods: one layer of sutures (N = 10), two layers of sutures (N = 10), EEA staples (N = 10), and SPTU staples (N = 10). Dehiscence occurred in eight sutured and one stapled anastomosis (P less than 0.05). The four leaks following two layer sutured anastomoses caused three deaths, whereas all four leaks following one-layer sutured anastomoses were only detected radiologically (P less than 0.02). In the stapled group, the single leak followed EEA anastomosis and was fatal. Anastomotic narrowing was greater in sutured than stapled groups (P less than 0.05). Two layers of sutures produced gross narrowing compared with one layer (P less than 0.002). Two rows of staples (EEA) produced more narrowing than one row (SPTU) (P less than 0.01). Mean hydroxyproline concentrations and bursting pressures on the seventh postoperative day were higher in stapled than sutured anastomoses (P less than 0.05). Submucosal alignment, mucosal continuity, tissue viability, and stage of healing were all inferior for two-layer sutured anastomoses, reaching statistical significance for tissue viability (P less than 0.05). Stapled anastomoses were completed significantly faster (32.6 +/- 7.3 minutes) than sutured (54.1 +/- 8.4 minutes) (P less than 0.01). This experimental study has demonstrated that stapling is a fast and reliable method of colorectal anastomosis with a low complication rate. The shortcomings of the standard two-layer sutured anastomosis are discussed.

Animals↗