Technical aspects of formation of lower colorectal staple suture

The article introduces an experimental clinical investigation of correlation between compression time and staple suture characteristics. The experiment was carried out in a clinic. Colonic resection was performed in 10 patients with benign tumors. Characteristics of staple sutures with 30-second-, 1 -minute-, 3-minute-compression and no compression were analyzed. Intraoperative study of mechanical features of staple suture included identification of staple separation force, staple configuration, bleeding intensity in anastomosis line; besides a histological study was carried out after staple removal. Also suture stability of 3 types of circular colorectal anastomosis was analyzed in 15 laboratory pigs. The outcomes proved that intestinal staple sutures with 30-second-compression are significantly more mechanically stable. Moreover, a longer compression leads to structural tissue damage of anastomosis, whereas no-compression suture causes suture line bleeding, which frequently requires additional hemostasis. Investigation of circular anastomosis features shows that end-to-end anastomosis in monostaple technique is the most stable, while bi-staple anastomosis is less stable, J-shaped reservoir anastomosis being the least stable.