Type

Journal Article

Authors

Thomas N Walsh
Mayilone Arumugasamy
Sebastian Smolarek
Robert P Brennan
Yvonne D'Cruz
Gary A Bass
Abdelmonim E A Salih

Subjects

Medicine & Nursing

Topics
humans middle aged instrumentation stomach neoplasms surgery equipment design female stomach prospective studies esophagus gastrectomy aged 80 and over laparoscopy male aged suture techniques esophageal neoplasms anastomosis surgical

Extending the reach of stapled anastomosis with a prepared OrVil™ device in laparoscopic oesophageal and gastric cancer surgery. (2014)

Abstract The introduction of minimally invasive surgery and the use of laparoscopic techniques have significantly improved patient outcomes and have offered a new range of options for the restoration of intestinal continuity. Various reconstruction techniques have been described and various devices employed but none has been established as superior. This study evaluates our experience with, and modifications of, the orally inserted anvil (OrVil™). We conducted a prospective observational study on 72 consecutive patients who underwent OrVil™-assisted oesophago-gastric or oesophago-jejunal anastomosis between September 2010 and September 2013. We collected data including patient demographics, disease site, type of procedure, location of the anastomosis, involvement of resection margins and peri-operative complications. Seventy-two patients were included in the study. Patient ages ranged from 45 to 92 years (median ± SD = 69 ± 10 years). Total gastrectomy with Roux-en-Y anastomosis was the most-commonly performed procedure (n = 41; 57 %). R 0 resection was achieved in 67 patients (93 %). There were no Orvil™-related clinical leaks during the study period, and just two patients (2.8 %) demonstrated radiological evidence of leak, both of whom were managed conservatively. There were three in-hospital mortalities during the study period; these were unrelated to the anastomotic technique. Despite a steep learning curve, the OrVil™ device is safe and reliable. It also permits the creation of higher trans-hiatal anastomoses without resorting to thoracotomy in high-risk patients with cardia tumours. Certain shortcomings of the device, that had implications for patient safety, were identified and addressed by intra-operative modification during the study period. We commend the use of a prepared OrVil™ device, as a game changer, for upper gastrointestinal reconstruction.
Collections Ireland -> IT Blanchardstown -> PubMed

Full list of authors on original publication

Thomas N Walsh, Mayilone Arumugasamy, Sebastian Smolarek, Robert P Brennan, Yvonne D'Cruz, Gary A Bass, Abdelmonim E A Salih

Experts in our system

1
T N Walsh
IT Blanchardstown
Total Publications: 53
 
2
Sebastian Smolarek
IT Blanchardstown
Total Publications: 4
 
3
Gary A Bass
IT Blanchardstown
Total Publications: 8