A Potential Technique Error in Stapled Side-to-Side Anastomosis of the Small Intestine of the Horse

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Abstract
Anastomotic leakage was noted to occur at the junction of the staple lines used to create the stoma during small intestine side-to-side anastomosis. The anastomosis was performed in a clinical equine patient by joining the lateral surfaces of the intestinal segments using a gastrointestinal anastomosis stapling instrument (GIA). The cause of this problem was investigated by performing six anastomoses in the jejunum of a single anesthetized adult horse using the GIA; three anastomoses were created by joining the antimesenteric edges of the bowel segments and three anastomoses were created by joining the lateral surfaces of the bowel segments. Bowel segments were then dissected to examine the stoma and the integrity of the staple lines. No defects were detected in anastomoses performed by joining the antimesenteric edges. Anastomoses performed by joining the lateral surfaces all had a defect at the junction of the double rows of staples used to create the stoma. Such defects would have allowed leakage of fluid and/or ingesta at the anastomotic site.

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