No abstract available.
Hemorrhoidectomy ; Hemorrhoids ; Constriction, Pathologic ; Surgical Stapling ; Pain, Postoperative

OBJECTIVETo investigate the safety and feasibility of domestically made endoscopic stapling instrument in laparoscopic assisted rectal cancer resection (Dixon).

METHODSSixty-four patients with rectal cancer were randomly divided into the research group (35 cases) to receive laparoscopic assisted rectal cancer resection using ENDO RLC general endoscopic linear cutter and single-use loading unit and circular staplers with staples (from REACH medical equipment co.LTD) and the control group (29 cases) to receive surgery with the corresponding products widely used (fom Johnson and Johnson Medical Euipment C.Ltd). The clinical data of the two groups were compared.

RESULTSSatisfactory therapeutic effects were obtained in all the cases. The two groups showed no significant differences in the operative time, intraoperative anastomosis success rate, or postoperative complications (anastomotic bleeding, leakage, or stricture) between the two groups (P>0.05), but the average cost of endoscopic stapling instrument was significantly lower in the research group (6604.31 ± 699.95 vs 7822.28 ± 576.98 RMB Yuan, P<0.05).

CONCLUSIONThe domestic endoscopic stapling instrument is safe, effective and less costly for laparoscopic assisted rectal cancer resection.

Humans ; Laparoscopy ; Postoperative Complications ; Rectal Neoplasms ; surgery ; Surgical Stapling ; instrumentation

Intracorporeal classic gastrointestinal anastomosis using circular stapler in totally laparoscopic gastrectomy (TLG) for gastric cancer requires intracorporeal anvil placement and suitable access for introduction of the circular stapler to the abdominal cavity without gas leak. The novel techniques for anvil placement have been updated, but there is no progress for proper access for circular stapler. In the study, intracorporeal circular-stapled gastrointestinal anastomosis were successfully accomplished using a novel device of sealed cap access with a central hole (WLB-60/70-60/100, Wuhan Widerep Medical Instrument Co.,Ltd, China) customized to the incision protection retractor for the simple and accessible introduction of the circular stapler and anvil under the optimal maintenance of pneumoperitoneum pressure in TLG. In these 3 cases, there was no gas leakage and the pneumoperitoneum was well maintained when performing the gastrointestinal anastomosis, and there was no transition to laparotomy or other anastomosis techniques. The result suggests that the sealed cap access could be a novel choice for introduction of the circular stapler to the abdominal cavity in order to obtain laparoscopic circular-stapled gastroin-testinal anastomosis in TLG.
Anastomosis, Surgical ; China ; Gastrectomy ; Humans ; Laparoscopy ; Stomach Neoplasms/surgery* ; Surgical Stapling

BACKGROUND: In low rectal cancer, creating a permanent stoma can be avoided by applying a low anterior resection using the double stapling technique. However, the problem of local recurrence is still a major pattern of tumor recurrence in rectal cancer. We aimed to verify the clinicopathologic variables related to exfoliation of tumor cells and searched for an efficient method to remove the tumor cells from the rectal stump during a low anterior resection. METHODS: Forty-four patients who underwent a low anterior resection using the double stapling technique were enrolled prospectively. For patient, we irrigated each rectal stump twice with 500 cc of normal saline through the anus. Two specimens from each irrigation were obtained and examined for any malignant tumor cells. Cases in which no tumor cells were found from the two specimens were defined as Group I, cases in which tumor cells were found in only the first specimen were defined as Group II, and cases in which tumor cells were found in both the first and the second specimens were defined as Group III. Clinicopathologic variables were analyzed with regard to the presence of exfoliated tumor cells in irrigated saline. RESULTS: There were sixteen (36%), fourteen (32%), and fourteen cases (32%) in Groups I, II, and III, respectively, according to the examination results. Age classification (P=0.05) and metastatic lymph nodes (P=0.013) were associated with the presence of tumor cells in irrigated saline (I vs. II, II). CONCLUSIONS: Stump irrigation during a low anterior resection using the double stapling technique is recommended as an easy and simple method to remove exfoliated tumor cells from anastomosis sites, although further study is necessary to elucidate the association between exfoliated tumor cells and local recurrence.
Anal Canal ; Classification ; Humans ; Lymph Nodes ; Prospective Studies ; Rectal Neoplasms ; Recurrence ; Surgical Stapling

Procedure for prolapse and hemorrhoids( PPH) is one of the important techniques developed for the treatment of hemorrhoids with severe degree in the last decade. Its principle is based on the "anal cushion" theory.Compared with traditional hemorrhoidectomy , PPH has advantages of shorter operation time , minor degree of postoperative pain , shorter hospital stay and quicker recovery.However, the occurrence of relapse and re-prolapse of hemorrhoids is high. Besides, the short-term efficacy of PPH for the constipation outlet obstruction caused by anterior rectocele is also favorable.
Anal Canal ; Hemorrhoids ; diagnosis ; Humans ; Operative Time ; Pain, Postoperative ; Prolapse ; Surgical Stapling

Prolapsed hemorrhoids is a common clinical disease, and severe symptoms can significantly affect work and life. The transanal stapler has the advantages of simple operation and less trauma in treating prolapsed hemorrhoids. Its clinical efficacy is closely related to the selection of indications, the standardization of surgical operations, and the prevention and treatment of complications. In current clinical practice, there is no consensus on the treatment of prolapsed hemorrhoids with transanal stapler. Hence a discussion was held by the Professional Committee of Colorectal Diseases of Chinese Society of Integrated Chinese and Western Medicine, concerning the indications, contraindications, operating specifications and perioperative management of prolapsed hemorrhoids. A consensus was consequently formed, aiming to provide a guideline for the clinical practice.
Anal Canal/surgery* ; China ; Consensus ; Hemorrhoidectomy/methods* ; Hemorrhoids/surgery* ; Humans ; Surgical Stapling/methods* ; Treatment Outcome

Sutures may cause endothelial trauma and occlusion. The vascular clip system (VCS) clip applier may minimize endothelial injury. Fourteen carotid arteries of nine adult rabbits were transected and re-anastomosed with either #7-0 polypropylene (Group I, n=8) or VCS clips (Group II, n=6). The animals were sacrificed at 1, 3, 8, 14, and 30 days postoperatively. The operation time and bleeding amount were checked for each anastomosis. Carotid angiograms, photography, H&E staining and scanning electron microscopy (SEM) were performed. Fibrin and thrombus, inflammatory cell infiltration, endothelial disruption, luminal distortion, fibrosis, and wall thickening were compared. The luminal diameter was greater in group II. There were minimal differences in thrombosis, wall thickening and fibrosis between the two groups. However, fibrin, inflammatory cell infiltration, multinucleated giant cell formation, endothelial disruption, and luminal distortion were greater in group I. On SEM, group I showed trans-mural penetration. In contrast, group II showed suture margin eversion and no transmural penetration. Stenosis was greater in group I than in group II on carotid angiogram. The operation time was shorter in group II than in group I, i.e. 5+/-1.4 min vs. 11+/-3.8 min, respectively. The current data showed similar or superior results with VCS clips in comparison to conventional suturing with polypropylene.
Angiography ; Animal ; Arteriovenous Shunt, Surgical/*instrumentation/methods ; Carotid Arteries/pathology/*surgery/ultrastructure ; Microscopy, Electron, Scanning ; Rabbits ; Surgical Stapling/*instrumentation/methods

We have invented a barrel-shape suturing-aid apparatus with a light source on one side and a trapzoid cranny for suturing on the other side. There are many advantages proved by clinical practices in applying the suturing-aid apparatus: 1. to increase the suturing speed and relieve the pains of patients; 2. to avoid the infection of HBV by blood and crossinfection; 3. to improve the illumination condition and avoid no suturing of the hurt tissue.
Delivery, Obstetric ; Equipment Design ; Female ; Humans ; Lacerations ; surgery ; Surgical Staplers ; Surgical Stapling ; instrumentation ; methods ; Vagina ; injuries ; surgery

OBJECTIVETo evaluate the feasibility of the correction idiopathic-type scoliosis by implanting the staple in growing animal models.

METHODSFourteen female goats were performed unilateral pedicle screws asymmetric tethering in left side in combination with right rib resection (age: 5 to 8 weeks, weight: 6 to 8 kg). The observing time was about 8 weeks. Goats that had been created scoliosis model successfully were classified in 2 groups randomly.

CONTROL GROUPjust removing the posterior tether, no treatment was offered. Correct group: the removing of posterior tether and the stapling of anterior spinal epiphysis were performed simultaneously. Dorsoventral and lateral plain radiographs were taken preoperatively and postoperatively. Serial X-ray postoperatively were performed every 4 weeks to measure the Cobb angle of the spine and to observe the condition of the insert. The observing time is about 8 weeks.

RESULTSRadiography showed that 12 goats had created scoliosis model successfully. CONTROL GROUP (n = 6): Series X-ray show that the change of the Cobb angle was not obviously. The initial curves after the procedures measured an average of 40.8 degrees (28 degrees-56 degrees), the average Cobb angle was 42.5 degrees (30 degrees-58 degrees) after 8 weeks, no statistics difference are found (P > 0.05). Treatment group (n = 6): no complication such as pedicel screw break, instrument loosen, dislocation, injury of blood vessel, nerve injury and organ injury of thoracic cavity etc, were found during the observing period. The initial curves after the procedures measured an average of 44.5 degrees (36 degrees-57 degrees), to some degree, the Cobb angle decreased and the average was 42.5 degrees (30 degrees-58 degrees) after 8 weeks. There are statistics difference between the initial and final curves (P < 0.05).

CONCLUSIONAs a means of mechanical modulation, stapling can be manipulate conveniently and safely, and can modulate the spinal growth of the animal model successfully, predicted that it may be a new selection for idiopathic-type scoliosis in growing children.

Animals ; Disease Models, Animal ; Female ; Follow-Up Studies ; Goats ; Internal Fixators ; Scoliosis ; surgery ; Spine ; surgery ; Surgical Stapling

OBJECTIVETo investigate the efficacy of the procedure for prolapse and hemorrhoids (PPH) combined with external hemorrhoids excision in the treatment of III or IV mixed hemorrhoids.

METHODSOne hundred and twelve patients with III or IV mixed hemorrhoids admitted for surgical treatment were randomly divided into three groups: PPH 1 group (34 cases), PPH2 group (36 cases), and Milligan-Morgan group (42 cases). PPH1 group received the standard PPH operation, PPH2 received PPH and external hemorrhoids excision, and Milligan-Morgan group received Milligan-Morgan hemorrhoidectomy. Postoperative 24 h-pain index, pain index when defecating, bleeding, anal discomfort feeling , wound edema, the ability of controlling feces, operating time, hospitalization time and charges were recorded. The change of anal dynamics was detected by anorectal manometry. All the patients were followed-up for 0.5-1 year.

RESULTSThere were no significant differences among the three groups in bleeding, anal discomfort feeling, the ability of controlling feces (P>0.05). The postoperative 24 h-pain index of PPH1 group was lower than those of the other two groups (P<0.05). PPH1 group and PPH2 group were better than Milligan-Morgan group in pain index when defecating, wound edema, operating time, and hospitalization time (P<0.05). Milligan-Morgan group was better than the other two groups in postoperative urinary retention and hospital charges (P<0.05). The change of anal duct pressure of Milligan-Morgan group was less than those of the other two groups (P<0.05). Within 0.5-1.0 year follow-up, 3 patients got thrombosed external hemorrhoid in PPH1 group, 2 patients recurred and 1 patient got thrombosed external hemorrhoid in Milligan-Morgan group, no recurred patients in PPH2 group.

CONCLUSIONPPH combined with external hemorrhoid excision is a safe and effective treatment for mixed hemorrhoids, which is suitable for mixed hemorrhoids with severe external hemorrhoids.

Adult ; Aged ; Anal Canal ; surgery ; Female ; Follow-Up Studies ; Hemorrhoids ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Prolapse ; Surgical Stapling