Investigation of Tear-Out Behavior of Small Intestinal Anastomoses Introducing a New Standardization of the Measurement Procedure

Purpose: The goal of the study was to investigate the influence of independently varied parameters on the tear-out force of small intestinal anastomoses of abattoir pigs using methods which provide a high grade of standardization and reproducibility. Methods: The tear-out force of sutured small intestine tissue was recorded, while independently varying the thread type (I), the number of stitches (II), the stitch-to-stitch distance (III), and the stitch to sample-edge distance (IV). Results: The tear-out force was shown to be significantly higher when using Vicryl 3-0 in comparison to PDS II 3-0, the significance being highest for small numbers of stitches. Given a fixed number of stitches, small stitch-to-stitch (stitch-to-edge) distances <~5.0 mm yield a significantly lower tear-out force than larger stitch-to-stitch distances. Conclusion: Standardization of methods used in the investigation of anastomoses of the small intestine is desirable and shown to be possible. Significant dependence of the tear-out force on some of the investigated parameters can be observed.