Teflon buttress inhibits recanalization of uncut stapled bowel

The uncut Roux Limb operation is designed to have the benefits of a Rous li mb but still have electrical continuity from proximal to distal bowel, thus eliminating the risk of Rous stasis syndrome. The main complication has be en recanalization of the uncut staple line leading to bile reflux. This stu dy aims to employ a new technique, which will not allow recanalization of a n uncut staple line but will not interfere with normal bowel myoelectric ac tivity. Fourteen mongrel dogs, 25 to 35 kg, underwent a midline laparotomy under general anesthesia. An uncut staple line was placed 25 cm from the li gament of Treitz. In seven animals an uncut staple line alone was placed, a nd in the other seven animals the bowel was stapled between a sandwich of T eflon reinforcing strips such that the staples were held on both sides of t he bowel by the Teflon. A jejunojejunostomy was placed 6 cm proximal to the staple line. insulated bipolar electrical leads were placed around the sta ple line, After the electrical leads were monitored 2 days to 3 months post operatively for bowel myoelectric activity, the animals were killed and the operative sites inspected. No animal suffered morbidity or mortality from the procedure. All seven unreinforced staple lines recanalized and all seve n reinforced staple lines remained competent. The duodenal pacemaker potent ials were transmitted through the staple line in five animals (3 controls a nd 2 with Teflon reinforcement) within 1 week postoperatively. The uncut st aple line does nut reliably transmit the duodenal pacemaker potentials. The staple line does not recanalize when it is reinforced with a permanent mat erial, increasing che utility of the "uncut" Roux limb operation.