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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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← Articles

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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Multiple Choice Questions on this study

In Miller 2024 et al., on staple vs. hand-sewn feline GI techniques, how did HSE compare to SSE in terms of construct completion time and leak resistance?

A. HSE was faster and more secure
B. HSE was slower but more secure
C. HSE was slower and less secure
D. SSE was more secure and faster
E. No significant difference

Answer: HSE was slower but more secure

Explanation: HSE took 8x longer than SSE but had much higher leak pressure tolerance.
In Miller 2024 et al., on staple vs. hand-sewn feline GI techniques, what was the most common location of leakage for skin staple enterotomy (SSE)?

A. Suture bite hole
B. Clamp site
C. Staple bite hole
D. Center of closure
E. Mesenteric border

Answer: Center of closure

Explanation: All SSE constructs leaked from the center of closure, with immediate leakage in 35%.
In Miller 2024 et al., on staple vs. hand-sewn feline GI techniques, what did the authors conclude about skin staple enterotomy (SSE) for use in live cats?

A. Promising with larger staples
B. Suitable with wider spacing
C. Acceptable for all cases
D. Not recommended
E. Equivalent to hand-sewn

Answer: Not recommended

Explanation: Authors do not recommend SSE due to low leak pressure and high failure rates.
In Miller 2024 et al., on staple vs. hand-sewn feline GI techniques, which enterotomy method showed significantly lower intraluminal pressure resistance?

A. Hand-sewn enterotomy (HSE)
B. Skin staple enterotomy (SSE)
C. Hand-sewn anastomosis (HSA)
D. Skin staple anastomosis (SSA)
E. Linear stapled enterotomy

Answer: Skin staple enterotomy (SSE)

Explanation: SSE had significantly lower leak pressures and failed in 12/20 constructs, making it less secure.
In Miller 2024 et al., on staple vs. hand-sewn feline GI techniques, which construct had equivalent leak pressure to hand-sewn anastomosis but with significantly reduced completion time?

A. Skin staple enterotomy (SSE)
B. Hand-sewn enterotomy (HSE)
C. Hand-sewn anastomosis (HSA)
D. Skin staple anastomosis (SSA)
E. Control (no incision)

Answer: Skin staple anastomosis (SSA)

Explanation: SSA had similar leak resistance to HSA but took ~50% less time to complete.

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