Modification of the cutting thread technique for intestinal anastomoses using diathermy.

The author has modified a surgical technique, which was originally developed at the turn of the century, for the aseptic establishment of an intestinal anastomosis. The principle of this technique, known as the "cutting thread" principle, was that a loop of thread was introduced into the lumen of each of two approximated loops of intestine. After suturing the two loops of intestine together around the intraluminal parts of the thread, the latter was used as a "wire-saw" to create a stoma between the two intestinal loops. The author modified the method in such a way that the cutting could be performed with diathermy, thus avoiding the risk of uncontrollable traumatization which was inherent in the original technique. The author also used "steering" sutures which encircled the diathermy wire, preventing the wire from running "off the line". The cutting thread of the original method was replaced by a silver-plated copper wire, insulated with teflon except for a few mm in the middle and a few cm at each end. The stoma was cut with diathermy, using the uninsulated middle of the wire as an electrode. After testing in experimental animals, this technique appears to be of value in certain clinical operations, e.g. implantation of the small intestine into the caecum or colon following an ileal respective caecal resection in the horse.