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At least 379 records · Page 21Linked to original sources
PubMed2004

Laparoscopic repair of various types of biliary-enteric fistula: three cases.

Biliary-enteric fistula is one of the reasons for converting from laparoscopic cholecystectomy (LC) to open surgery. Here we present three cases of various types of biliary-enteric fistula treated successfully by laparoscopic surgery. Two cases were diagnosed preoperatively, and the remaining case intraoperatively. The first patient had a cholecystoduodenal fistula with a common bile duct stone. The second patient had cholecystocolic and choledochoduodenal fistulas with a common bile duct stone, and the third patient had a cholecystogastric fistula. The fistulas were repaired laparoscopically by intracorporeal suturing or with an endoscopic linear stapling device. All the patients had good postoperative courses without any postoperative complication. Our experience has shown us that with advances in surgical skills and instruments, laparoscopic surgery for biliary-enteric fistula can be adopted as the first treatment choice regardless of the preoperative diagnosis.

Biliary Fistula↗
PubMed1995

Removal of the instrument Makar shoulder staple.

When confronted with the challenge of hardware removal during revision shoulder stabilization procedures, specialized instrumentation such as the Instrument Makar staple driver/extractor may become necessary. The Synthes DHS/DCS coupler screw may be more readily available, and can effectively substitute for the Instrument Makar staple driver/extractor.

Arthroscopy↗
PubMed1999

Sutureless small bowel anastomoses: experimental study in pigs.

OBJECTIVE: To evaluate a new technique for experimental anastomosis with fibrin glue, and to compare the results with those of stapled and one-layer sutured anastomosis. DESIGN: Open laboratory study. SETTING: Teaching hospital, Sweden. ANIMALS: Ten Swedish domestic pigs. INTERVENTIONS: Each pig had three anastomoses made in the small bowel, one by each technique. The pigs were killed on the 4th postoperative day. MAIN OUTCOME MEASURES: Blood flow, collagen concentration, anastomotic index, breaking strength, thickness of bowel wall, and histological appearance. RESULTS: Two pigs died postoperatively, leaving 8 for analysis. The blood flow at each anastomotic site studied by the microsphere technique was similar irrespective of the type of anastomosis (p = 0.3), as was anastomotic collagen concentration (p = 0.09). The anastomotic index, however, was significantly higher in the stapled than in the glued or sutured ones (p = 0.03). The glued anastomosis was the weakest, being only one fifth the strength of the stapled and one third the strength of the sutured anastomosis. There was no sign of rejection of the glue (of human origin) on histological examination. Glued and stapled anastomoses showed signs of mild inflammation, which did not reach the intensity of that around the sutured anastomoses. CONCLUSION: It is possible to make a sutureless anastomosis that does not leak with a modified stapler using fibrin glue instead of staples, but the anastomosis has considerably lower breaking strength than either stapled or sutured anastomoses.

Anastomosis, Surgical↗
PubMed2003

Multiple intravesical linear staples identified during surveillance cystoscopy after laparoscopic nephroureterectomy.

Laparoscopic nephroureterectomy has faced technical criticism secondary to the unknown effects of urine-exposed intravesical or intraureteral staples. Although not reported, staples exposed to urine theoretically create a nidus for encrustation and stone formation. We present a case of a 66-year-old man after left laparoscopic ureterectomy for ureteral malignancy. Surveillance cystoscopy at 6 months revealed a nearly complete intravesical titanium staple line without encrustation. Successful transurethral removal of all staples with standard cystoscopic graspers revealed no immediate, or delayed, sequelae.

Aged↗
PubMed2004

Circular vascular stapling in coronary surgery.

Stapling devices have been clinically applied to connect blood vessels. The early application of these staplers in cardiovascular surgery, including coronary bypass surgery, was encouraging. With further refinement of suture material, however, vascular staplers became impractical and soon fell into oblivion. With advancement in robotic surgery, these devices might become valuable tools once again. Herein early experience with vascular circular stapling devices is reviewed.

Coronary Artery Bypass↗
PubMed2002

Constrictive pericarditis caused by candida glabrata in an immunocompetent patient: case report and review of literature.

Candida pericarditis is a rare disease described mostly in patients with recent cardiothoracic surgery or debilitating chronic diseases and is generally considered to be associated with high mortality. To our knowledge, we report the first case of Candida pericarditis in a healthy host who had not undergone thoracic surgery and the first documented case and cure of pericarditis caused by C. glabrata. The most probable underlying factor in the development of this pericarditis was the abdominal surgery the patient underwent to correct a gastrogastric fistula, without an intraabdominal leak, which developed 10 y after surgical gastric stapling for weight reduction. The literature on Candida pericarditis is reviewed. If Candida pericarditis is diagnosed early and treated with a combined medical and surgical approach, the prognosis today is much more favorable than that previously reported.

Adult↗
PubMed1999

Manual compared with mechanical cervical oesophagogastric anastomosis: a randomised trial.

OBJECTIVE: To compare the short and medium term result of hand-sewn and stapled anastomoses after oesophagectomy. DESIGN: Randomised study. SETTING: Teaching hospital, Italy. SUBJECTS: 41 patients who required oesophagectomy between February 1993 and December 1996. INTERVENTIONS: Oesophagectomy and left cervical gastroplasty. MAIN OUTCOME MEASURES: Mortality and morbidity. RESULT: 21 patients were randomised to have the anastomosis hand-sewn, and 20 to have it stapled. The two groups were comparable. 3 patients died in hospital (2 in the hand-sewn and 1 in the stapled group), and the remainder were followed up a mean of 21 months (range 6-34). There was one clinical leak in the hand-sewn group compared with 3 in the stapled group, and 1 further radiological leak in the stapled group. 2 patients in the hand-sewn and 3 in the stapled group developed strictures. CONCLUSION: Though the numbers are too small to be assessed statistically, we think that these result are sufficient to persuade us that oesophagogastric anastomoses should be hand-sewn rather than stapled.

Anastomosis, Surgical↗
PubMed1988

Aids to scalp reduction surgery.

Utilizing certain surgical techniques during scalp reduction surgery will assist the surgeon in achieving a carefully planned and more efficient result. Measurement of scalp depth will assist in predicting the amount of skin to be excised. A simple method of safe identification of the periosteum is described along with the description of an elevator which assists in rapid, safe, and extensive undermining in the galeal-periosteal plane. An accessory supra-auricular scalp incision can be employed to allow for extensive scalp undermining. A transverse incision into the skin flap to be advanced, allows the surgeon to safely approximate the amount of skin to be excised. When skin closure becomes impossible due to overzealous excision of bald skin, galeotomies can provide closure. A special order suture is described which allows for easier galeal closure. Surgical skin staples are recommended to provide a faster skin closure.

Alopecia↗
PubMed2001

Delayed oesophageal perforation following endoscopic stapling of a pharyngeal pouch.

Endoscopic stapling of pharyngeal pouches is gaining popularity and is said to be a quick procedure with minimal morbidity and mortality. So far, there have been few reported cases of any severe complications following this procedure. However, complications as with other treatment modalities can occur. A case of mediastinitis due to delayed oesophageal perforation following the stapling procedure is presented.

Esophageal Perforation↗
PubMed2026

Stapled versus hand-sewn intestinal anastomosis in pediatric surgery: A systematic review and meta-analysis.

BACKGROUND: Intestinal anastomosis is a core procedure in pediatric gastrointestinal surgery, performed for conditions such as necrotizing enterocolitis, intestinal atresia, Hirschsprung's disease, and inflammatory bowel disease. Although stapled anastomosis (SA) may improve operative efficiency, its safety and effectiveness compared with hand-sewn anastomosis (HA) in children remain uncertain. This meta-analysis compared clinical outcomes of SA and HA in pediatric patients. METHODS: The study followed PRISMA guidelines and was prospectively registered in PROSPERO (CRD420251177257). A systematic search of PubMed, Dimensions, and the Cochrane Library was conducted through June 2025. Studies including children under 7 years undergoing intestinal SA or HA were eligible. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessment using ROB 2 and ROBINS-I tools. Statistical analysis was conducted using Comprehensive Meta-Analysis software (v3) with a random-effects model. RESULTS: Eleven studies involving 903 patients met inclusion criteria, including two randomized controlled trials. Of these, 333 patients underwent SA and 570 underwent HA. SA was associated with significantly shorter operative time (mean difference [MD] = -19.26 min; 95% CI: -24.24 to -14.28; p < 0.001) and earlier initiation of oral feeding (MD = -2.32 days; 95% CI: -3.78 to -0.86; p = 0.002). No significant differences were found in anastomotic leakage, stricture formation, reoperation rate, or length of hospital stay. CONCLUSIONS: Stapled anastomosis appears as safe as hand-sewn techniques in pediatric intestinal surgery while offering shorter operative duration and faster postoperative feeding recovery. Selective use of stapled techniques is supported when anatomically feasible, though further multicenter randomized trials are needed.

Humans↗
PubMed2005

Ferguson hemorrhoidectomy: long-term results and patient satisfaction after Ferguson's hemorrhoidectomy.

PURPOSE: Perioperative morbidity and long-term results after hemorrhoidectomy (Ferguson's technique) were evaluated as a basis for comparison with new methods such as stapled hemorrhoidectomy. METHODS: All records of patients who underwent conventional hemorrhoidectomy between January 1, 1993 and December 31, 1997 (five years) were retrospectively analyzed. The surgical technique was Ferguson closed hemorrhoidectomy. Long-term results were evaluated with a standardized questionnaire that was sent to all patients. RESULTS: Five-hundred-fourteen patients (195 female, 319 male) with a mean age of 52 (range, 22-96) years were evaluated. Postoperatively, seven patients had a relevant hemorrhage, and two had to undergo reoperation (reoperation rate within 30 days, 0.4 percent). In 15 cases (3 percent) patients received urinary catheters for postoperative urinary retention. Mortality was 0 percent. The questionnaire was returned by 403 patients (78.4 percent). The mean follow-up was 4.7 (range, 2.1-7.8) years. The leading symptom was relieved in 275 patients (67.4 percent), ameliorated in 111 (27.2 percent), and unchanged or worse in 22 (5.4 percent). Incontinence (soiling) was not present in 291 (71.7 percent) patients, light in 86 (21.2 percent), moderate in 25 (6.1 percent), and severe in 4 (0.98 percent). Reoperation rate for recurrent hemorrhoids was 0.8 percent. Patients evaluated the surgical result as excellent in 286 (70.5 percent) cases, good in 87 (21.4 percent), moderate in 25 (6.2 percent), and bad in 8 (1.9 percent) cases. CONCLUSION: Ferguson closed hemorrhoidectomy results in very low rates of perioperative morbidity. Long-term results demonstrate high patient satisfaction and low incontinence and reoperation rates. It could be the gold standard to which other techniques are compared.

Adult↗