In vitro comparison of three suture techniques for anastomosis of the equine small intestine

Reasons for performing study: The equine small intestine can be affected by a variety of disorders that may require some form of bypass or anastomosis. Many suture patterns have been used in equine anastomoses to minimise post operative complications, which include leakage from the anastomosis site, stenosis and adhesions. Because of the critical condition of horses undergoing colic surgery, it is imperative this is performed as quickly as possible. Objectives: To evaluate, in vitro, differences in the time of execution and leakage pressure between the Lembert single layer (Lsl), Gambee and Lembert double layer suture patterns for intestinal anastomosis in the horse and correlate the time taken to complete the anastomosis and hemicircumference of the anastomotic site Methods: Small intestinal loops immersed in polyionic solution were anastomosed with one of the 3 suture patterns. The intestines were insufflated via a flexible rubber hose, connected to a pressure gauge, inserted into the lumen at one end and fixed at 25 cm fromthe anastomosis site with a locking clip and, using a tube fixed in the same manner at the other end connected to a sphygmomanometer bulb, the pressure at which leakage from the anastomosis site was revealed by the presence of bubbles. Results: The time spent in the execution of the Lembert single layer was significantly less than that for both Gambee and Lembert double layer The leakage pressure of Lembert single layer was significantly higher than that recorded for both Gambee and Lembert double layer Conclusions and potential relevance: This study shows that the continuous Lsl pattern takes less time to execute and fails at higher pressures than the Lembert double layer or Gambee patterns.