In vitro evaluation of a closed-bowel technique for one-layer hand-sewn inverting end-to-end jejunojejunosotomy in the horse

Objective - To report a technique for closed-bowel 1-layer inverting end-to-end jejunojejunal anastomosis in horses. Study Design - Experimental study. Sample Population - Fresh cadaveric jejunal segments from 12 horses. Methods- For each bowel segment a 1-layer closed and a 2-layer inverting end-to-end jejunojejunosotomy was created. Anastomosis construction time and anastomotic bursting pressure were measured and compared. Results - Closed-bowel anastomosis was significantly faster to create than a 2-layer technique. Luminal narrowing (< 30%) was similar with both techniques and comparable with other inverting techniques. Bursting pressure was significantly higher for the 2-layer technique, although all anastomoses resisted pressures higher than those reported for other jejunojejunal anastomosis techniques. Conclusions - A 1-layer hand-sewn, closed, inverting jejunojejunosotomy using a modified Doyen clamp was easy and faster to perform, and resulted in functional characteristics similar to, a 2-layer hand-sewn inverting technique. Clinical Relevance - A closed, 1-layer inverting technique could be considered for equine jejunal anastomosis but requires in vivo evaluation before recommendation for clinical use. (c) Copyright 2006 by The American College of Veterinary Surgeons.