A Study of Hand-Sewn Bowel Anastomosis Technique versus Stapler Assisted Bowel Anastomosis Technique In Gastro-intestinal Surgeries

Abstract

Background: Both the techniques of anastomosis (hand sewn and stapler assisted) of gastro-intestinal tract are well accepted and well established with their own advantages surgery depends on underlying disease, site of anastomosis and the caliber of bowel. The purpose of this study was to compare the outcomes of both these techniques. Methodology: A retrospective comparative study was done in 95 consecutive cases of gastro-intestinal surgeries involving resection and anastomosis of bowel between January 2017 to May 2018, among which 43 were stapler assisted anastomoses and 52 were hand sewn anastomoses. These surgeries were evaluated for operation time, post-operative anastomotic integrity, return of bowel activity, and length of hospitalization. Results: No significant variation was noted in both the suturing techniques in terms of their outcomes as post-operative anastomotic leakage, and return of bowel activity. However, operation time were significantly reduced in stapler assisted technique than hand sewn technique. Conclusion: Both suturing techniques are more or less equally effective, however, stapler assisted suturing technique significantly reduces the operative timing and less bowel handling and reduced tissue injury, easier at difficult  access sites like deep pelvis, quick to perform. Hence, the implementation of a particular suturing technique in a particular surgery remains solely the surgeons’ choice.