Miller et al: Performance time and leak pressure of hand-sewn and skin staple intestinal anastomoses and enterotomies in cadaveric cats
Veterinary Surgery 4, 2024

🔍 Key Findings

  • Skin staple anastomosis (SSA) had comparable leak pressures to hand-sewn anastomosis (HSA) but required half the time to complete.
  • Skin staple enterotomy (SSE) had significantly lower leak pressures than hand-sewn enterotomy (HSE) and failed in 12/20 constructs during pressure testing.
  • HSE constructs took 8× longer to complete than SSE, but had much higher intraluminal pressure tolerance.
  • All SSE constructs leaked from the center, with 35% leaking immediately and 60% showing catastrophic failure.
  • SSA leakage occurred at the center in 40% of constructs, likely due to a learning curve in early samples.
  • All constructs had higher pressures than normal physiologic intestinal pressure (4.0 mmHg ±2.0), except some SSEs with immediate leaks.
  • Authors recommend SSA as a viable alternative with appropriate training but do not recommend SSE using the tested technique in live cats.
  • Staple size and placement technique are key factors; smaller or more precisely placed staples may reduce leak risk.

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How critical is this paper for crushing the Boards?

🚨 Must-know. I’d bet on seeing this.

📚 Useful background, not must-know.

💤 Skip it. Doubt it’ll ever show up.

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