Eur J Pediatr Surg 2011; 21(2): 103-105
DOI: 10.1055/s-0030-1267207
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Clip Migration in Clipped Intestinal Non-Perforating Anastomosis (CINPA)

S. Holland-Cunz1 , M. Chmelnik2 , P. Romero2 , B. Klein2 , B. Rumstadt3
  • 1University Hospital Heidelberg, Division of Pediatric Surgery, Heidelberg, Germany
  • 2University of Heidelberg, Division of Pediatric Surgery, Heidelberg, Germany
  • 3Fuerst Stirum Hospital Bruchsal, Surgery, Bruchsal, Germany
Further Information

Publication History

received June 23, 2010

accepted after revision September 05, 2010

Publication Date:
04 November 2010 (online)

Abstract

Introduction: Our studies of clipped intestinal non-perforating anastomosis (CINPA) of the small bowel in a rat model have demonstrated that all clips migrated from the outside to the inside of the small bowel during the healing process. The aim of this study was to describe how the clips migrate.

Material and Methods: In male Sprague Dawley rats small bowel anastomoses were performed with single, non-perforating metal clips. Bowel specimens were obtained from the anastomosed region for histological examination.

Results: On the day of surgery all clips were situated in the serous membrane. On the first postoperative day, an intramural migration could be observed. By days 6, 8, and 10 no clip was found in the peritoneum. All egested clips were found either in the distal lumen of the bowel or in the solid feces. H&E staining of the anastomoses studies indicated that the bowel wall everts immediately after being cut and becomes more and more inverted during the first few days after being anastomosed.

Conclusion: Our studies showed that the observed dynamic movement of the bowel wall determines the movement of clip migration from the serosal to the mucosal side of the small bowel. In pediatric surgery the observed clip migration would be an important precondition for employing clipped intestinal non-perforating anastomosis (CINPA) routinely. However, further studies are necessary before the technique can be applied in daily practice.

References

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Correspondence

Priv. Doz. Dr. Bernhard Rumstadt

Fuerst Stirum Hospital Bruchsal,

Surgery

Gutleutstrasse 1–14

76646 Bruchsal

Germany

Phone: +49/7251/708 5801

Fax: +49/7251/708 5802

Email: bernhard.rumstadt@kliniken-lk.de