Is stapling feasible for small bowel anastomosis in neonates?

Abstract

Stapling has been used as an alternative to traditional suturing in bowel and vascular anastomosis in adults. This technique has not been possible in neonates because of size limitations. This study examines the efficacy of using Auto Suture* Vascular Closure Staples (VCS* clips) for end-to-end small bowel anastomosis. In order to simulate neonates, we used rabbits that had comparably sized small bowel. All five rabbits in the study had an uneventful postoperative course. At sacrifice, which was performed three weeks after surgery to assess the anastomosis, one rabbit had an incisional hernia and another had luminal stenosis at the anastomotic site. We conclude that stapled anastomoses can be successfully performed using singly placed VCS* clips in the small bowel of rabbits, and it would thus be feasible to employ this stapling technique in neonates. Further investigation involving more subjects and including large bowel anastomosis are needed prior to clinical use in neonates.