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At least 415 records · Page 23Linked to original sources
PubMed2001

Extracorporal resection of the rectum in the treatment of complete rectal prolapse using a circular stapling device.

UNLABELLED: BACKGROUND AND PATIENTS: The technique of the extracorporal resection of the rectum using a circular stapler in the treatment of complete rectal prolapse is described on the basis of 31 successfully applied operations at the Surgical Unit in Düsseldorf-Gerresheim. RESULTS: The easy-to-perform operation does not require general anaesthesia, the incidence of peri-operative complications (5/31) and lethality (1/31) is acceptable and post-operative recovery is fast due to less physiologic insult as compared to transabdominal procedures. The recurrence rates (0/22) stand the comparison with transabdominal procedures. The operation can be re-performed in the case of a recurrent prolapse. CONCLUSIONS: Our good results show that the perineal rectosigmoidostomy using a circular stapler is a safe and efficient means of controlling rectal prolapse. Many advantages in comparison with transabdominal procedures make it an attractive option for many patients suffering from rectal prolapse.

Digestive System Surgical Procedures↗
PubMed2001

Stapling of an aortic arch aneurysm.

Saccular aneurysms of the aortic arch are usually managed with patch graft aortoplasty or with tube graft replacement. In either case, hypothermic circulatory arrest is necessary. The use of stapling devices has revolutionized pulmonary and gastrointestinal surgery; however, these instruments have rarely been used in aortic surgery except during thromboexclusion procedures. We present a simple and seemingly innovative stapling method that eliminates the need for circulatory arrest.

Aged↗
PubMed1996

Two techniques of laparoscopic Burch repair for stress incontinence: a prospective, randomized study.

STUDY OBJECTIVE: To determine if outpatient laparoscopic Burch procedure performed with mesh and staples is as effective as that done with the suture technique. DESIGN: Prospective, randomized study. SETTING: Community hospital. PATIENTS: Sixty-nine women with genuine stress incontinence (GSI) randomly assigned to either the suture group (group 1) or the mesh-staple group (group 2). INTERVENTIONS: Before surgery each patient had a complete history, physical and neurologic examinations, 24-hour urolog, urology questionnaire, urine culture and sensitivity, Q-Tip test, transperineal ultrasound, cough stress test, cystourethroscopy, and cystometrogram. Stress incontinence was diagnosed by positive Q-Tip, ultrasound, and cough stress tests and a negative cystometrogram for detrusor contraction. The laparoscopic Burch procedures were performed with either sutures for bladder neck elevation or with mesh and staples. Clinical and, if necessary, urodynamic studies were repeated at 6 weeks and 1 year postoperatively. MEASYRENEBTS AND MAIN RESULTS: The cure rate at 1 year was 91% in group 1 and 94% in group 2. Only objective cures by urologic testing are reported. The hypermobile urethra, as tested by transperineal ultrasound, was cured by both procedures. Of the 69 women, 68 were able to void spontaneously within 24 hours. CONCLUSIONS: Early results suggest that laparoscopic Burch colposuspension is effective in curing GSI. Both sutures and mesh with staples yield good outcomes.

Adult↗
PubMed1998

An adjustable vertical banded gastroplasty does not eliminate the risk of staple-line disruption.

BACKGROUND: The two main reasons for reoperation after vertical banded gastroplasty (VBG) in the treatment of obesity are staple-line disruption and stomal stenosis. PATIENTS: Seven morbidly obese patients of mean (+/-SEM) body mass index (BMI) 43.7 +/- 1.9 kg/m2 treated with an adjustable vertical banded gastroplasty (AVBG). RESULTS: No complications of the band system were reported. Weight-loss [BMI at 2 years follow-up 33.9 +/- 6.9 kg/m2 (n = 5)] was equivalent to that seen after VBG with a fixed band. Two of the patients developed staple-line disruption at 18 and 24 months after surgery. CONCLUSION: AVBG allows adjustment of the stoma, but staple-line disruption was common in this small series. It is possible that an excessive filling of the band in order to achieve excess weight loss results in a high pressure in the upper pouch which increases the risk of staple-line disruption.

Adult↗
PubMed1995

Anastomotic diameter of circular stapled oesophagojejunal anastomoses and its implication for weight development. A clinical and experimental study.

OBJECTIVE: To investigate the increase in diameter of the oesophagojejunal anastomosis after total gastrectomy with a circular stapler, and to assess experimentally the influence of oesophageal diameter on weight. DESIGN: Open prospective clinical and experimental studies. SETTING: University department of surgery, Sweden. SUBJECTS AND MATERIAL: 36 Consecutive patients who underwent total gastrectomy, and 13 domestic pigs. INTERVENTIONS: Clinical study: the end to side oesophagojejunal anastomoses were made with EEA staplers size 25 or 28, and the increase in diameter over a 12 month period was studied by by fibreoptic endoscopy. Experimental study: Each pig had 0.5 cm of the distal oesophagus resected; in 7 the oesophagus was anastomosed with one layer of continuous 3/0 polyglycolic acid, and in 6 an ILS21 stapler was used. Animals were weighed and killed at 4 1/2 months, and the width of the oesophagus at and below the anastomosis was measured. MAIN OUTCOME MEASURES: Clinical study: width of the oesophagus at 12 months. Experimental study: correlation between weight and oesophageal width at time of death. RESULTS: Clinical study: The median increase in size after 12 months with the size 25 cartridge was 8.45 mm (range 6.5-22), and for the size 28 cartridge 12 mm (2.3-30.2). The larger cartridge gave a significantly larger anastomosis (p = 0.007), but the comparative increases were similar. Experimental study: There was a significant correlation between increase in weight and anastomotic width in the 10 pigs that completed the study (r = 0.86, p < 0.001). CONCLUSION: A stapled oesophagojejunal anastomosis has the ability to dilate as necessary, and this ability is not prejudiced by the presence of the staples.

Adult↗
PubMed2004

[Colorectal stapled anastomosis: results after anterior resection of the rectum for cancer].

OBJECTIVE: Stapled end to end anastomosis makes the restoration of digestive continuity at the level of lower pelvis easier, but carries a certain risk. The aim of this report was to evaluate this risk in terms of immediate results and tumor recurrence after surgery for rectal cancer. PATIENTS AND METHODS: The data of 301 patients operated on following this technique between 1980 and 2000 have been reviewed in order to analyse the tumor characteristics, the operation and associated complications, the immediate postoperative complications and recurrence rate. RESULTS: Among the 301 patients (192 males and 109 females) with median age of 66 years, 19 (6.3%) received an emergency operation due to bowel obstruction. The rectal adenocarcinoma was located in the upper rectum in 132 cases (43.8%), in the middle rectum in 141 cases (46.8%) and in the lower rectum in 19 cases (9.4%). Preoperative radiotherapy was carried out in 148 cases (49%): between 1987 and 1996 with a dose of 30 Grays (Gy), later increased to 39 Gy and 45 Gy in 12 cases. From 1990, 113 patients have received adjuvant chemotherapy for stage III and IV tumors and in some position cases for stage II tumor. The excision left a safety margin under the tumor of less than 2 cm in 59 cases (19.6%), and the anastomosis was located at 5 cm or less from the anal verge in 178 cases (59%). Primary defunctioning stoma was formed in 39 cases (13%). An anastomotic defect was observed during the operation in 18 cases (6%) and 26 fistulas occured postoperatively (7.6%), significantly related to the location of the anastomosis with regard to the anal verge (P = 0.0009). The hospital mortality was 8 cases (2.6%). Cases of stenosis were uncommon : 11 cases (3.6%), significantly associated with preoperative radiotherapy (P =0.02). The local recurrence rate was 12% (37 cases) in a median time delay of 16 months, essentially related to the tumor stage (P = 0.004) and the considered period (P = 0.001). CONCLUSION: Stapled end-to-end colorectal anastomosis after excision of rectum for cancer is a reliable technique with a low rate of complication and tumor recurrence, when the surgical procedure is included in the curative therapy management of cancer.

Adenocarcinoma↗
PubMed2006

Use of nonpenetrating vascular closure staples in feline renal transplantation.

Renal transplantation is a potential treatment for irreversible renal failure in pet cats. Our aim is to reduce warm ischemic time by using nonpenetrating vascular closure staples (VCS), thereby improving graft survival. Experimental cats were divided into the VCS group (n = 4; autotransplantation) or suture group (n = 6; allotransplantation). The renal artery was anastomosed with the external iliac artery in an end-to-end fashion, and the renal vein was attached to the external iliac vein in an end-to-side fashion. Warm ischemic time as well as arterial and venous anastomotic times were measured. Cats in the suture group were administrated cyclosporine and prednisolone orally after transplantation. Ischemic and anastomotic times in the VCS group were significantly reduced compared with the suture group. Two of 6 allografts had a ureteral anastomotic stricture, and 4 allografts were rejected. Histological findings of autografts showed normal structure. In conclusion, VCS staples were useful in feline renal transplantation.

Anastomosis, Surgical↗
PubMed1997

Bladder replacement with modified Studer pouch using absorbable staples.

The use of absorbable staples may allow to reduce the operating time of orthotopic bladder replacement. We report our experience in 14 patients with a modification of the Studer technique using absorbable PolyGIA instruments. The technique has been shown to be simple and quick to perform (time for pouch creation 15-40 minutes, mean 16 minutes) with no significant intraoperative difficulties. Urodynamic data and continence are satisfactory and seem comparable to different procedures and not related to staples' use. The main question remains if the reduced operating time equalizes the high cost of staple devices.

Absorption↗
PubMed2004

Endoscopic stapling vs conventional methods of surgery for pharyngeal pouches: results, benefits and modifications.

Endoscopic stapling of pharyngeal pouches using the Endo GIA-30 stapling gun is a relatively new technique. We compared the outcome of patients who had endoscopic stapling of their pharyngeal pouch with those who had excision of the pouch along with a cricopharyngeal myotomy using conventional methods. A total of 19 patients were included in the study, 9 in the conventional technique group and 10 in the endoscopic stapling group. Data was collected by reviewing patient records and a postal questionnaire. Median stay in hospital for the conventional technique group was 10 days while in comparison the average stay in hospital for the endoscopic stapling group was 3.9 days. The median fasting time for the conventional technique group was 6 days while all patients in the endoscopic stapling group commenced oral feeding on day one post surgery. The postal questionnaire showed that endoscopic stapling was associated with a high patient satisfaction rate. We conclude that endoscopic stapling of pharyngeal pouches has similar results to the conventional open technique, but is less invasive and associated with a shorter stay in hospital. We also discuss a technical modification employed in the stapling of small pouches with thick anterior walls.

Adult↗
PubMedDate not supplied

A randomized comparison of the early outcome of stapled and unstapled techniques of laparoscopic total extraperitoneal inguinal hernia repair.

OBJECTIVE: The need for stapling is a relative drawback of laparoscopic hernia repairs because it adds to the complications and costs. The safety of unstapled repairs as a viable alternative lacks validation, due to the dearth of analogous comparative trials. METHODS: Patients were randomized to undergo either stapled or unstapled total extraperitoneal hernia repairs. The groups were matched for age and the type of hernia repaired. Pain scores, intraoperative complications, postoperative complications, postoperative recovery, and long-term outcomes (ie, groin pain, paraesthesias, testicular atrophy, and recurrence) were studied. RESULTS: The incidence of complications, pain scores, pain trends, hospital stay, return to activity, and long-term outcomes were comparable. No recurrence has been noted at a median follow-up of 23 months in 63 hernias repaired in 49 patients. CONCLUSION: Unstapled laparoscopic hernia repair scores are equivalent to their stapled counterparts with respect to recurrence and complications.

Adult↗